Notification of public votes on whether a community’s fluoridation of water should cease would be mandated under legislation in the Missouri General Assembly.

The measure, filed by House Rep. Donna Lichtenegger, R-Jackson, would require a public water system to notify two state agencies and its customers at least three months before a local governmental body vote seeking to permanently end fluoridation. The state’s natural resources and health departments would be notified in such cases. The notice would come from the media or by mail.

The ongoing debate on the health merits or risks of fluoride in local water supplies recently resurfaced in St. Joseph. Fluoride opponents met to express their concerns about the chemical compound’s presence in the city’s drinking water.

Fluoride has been a part of St. Joseph’s water since 1989. An election held in 1988 approved adding 1 part per million of fluoride into the water.

Christie Barnhart, a spokeswoman for Missouri American Water, said the utility’s position on fluoridation anywhere in the state is clear.

“If there is not a city ordinance, we don’t fluoridate,” she said.

Ms. Barnhart said Missouri American reduced the release of fluoride into St. Joseph’s water to .6 parts per million in 2012.

“The recommendation came from the CDC (Centers for Disease Control and Prevention),” she added.

Only one recent civic case of fluoride elimination has occurred in Northwest Missouri. Last year, the city of Smithville, Mo., decided it would no longer add fluoride. The choice centered on economics, according to City Administrator Steve Garrett. But he said it also meant removing one additional process that had been used to treat Smithville’s water.

Residents have grown accustomed to the switch ever since, Mr. Garrett said, “other than a local dentist that was not pleased with the call.”

Rep. Dr. Jim Neely, R-Cameron, was unable to vote on Mrs. Lichtenegger’s bill due to a family commitment. He is a physician.

“I’m all for it,” he said. “I’d be foolish not to support a bill like that. The idea is great.”

Among fluoride’s most vocal detractors in St. Joseph is Larry Flinchpaugh, who criticized the legislation as making it more difficult for a community to remove fluoride — which he labels as a form of “forced medication.”

“It looks like there are those in Jeff City that want to make it more difficult for us to get fluoride removed from our water supply,” he told the News-Press. “There are powerful forces against us, even though the trend worldwide has been to end artificial water fluoridation. This should not be a political issue. It is a health issue … Those wanting to maintain the artificial fluoridation experiment are simply referring to outdated material.”

Mrs. Lichtenegger, who represents a House district in Southeast Missouri, is a registered dental hygienist. She said ensuring that residents are aware of potential fluoride changes in their water supply is her premise.

“My bill is not a mandate,” she said. “The cities have to be held accountable. In some cases around the state, there’s too much fluoride in the water … Fluoride is naturally in the water.”

The Fluoride Action Network, an international coalition to end water fluoridation, does not list any water system in Northwest Missouri as having high fluoride levels. The group said research has shown that fluoride is toxic and has health consequences ranging from cancer and cardiovascular diseases to male infertility and thyroid issues.

The bill has passed the House and faces a Missouri Senate hearing on Tuesday. It carries an emergency clause, meaning it would take effect immediately if passed by both chambers and signed into law by Gov. Jay Nixon.

The Missouri Department of Health & Senior Services said it endorses community water fluoridation as a preventive to tooth decay.