Anti-fluoridation activist Betty Fowler hasn’t missed a Spokane Regional Board of Health meeting in seven years.

Each month, she sits in the audience and waits for the end of the meeting when she speaks briefly against adding fluoride to public water systems.

Next Thursday, her pet issue will be on the official agenda.

Fluoridation is back. The health board will hear a report on the topic because local advocates are bringing it to Spokane city voters in November. The advocates, a group called Fluoridation Works, thinks the city of Spokane should catch up with one of the greatest public health achievements of the last century.

Nearly two-thirds of Americans drink fluoridated water. The U.S. Centers for Disease Control and Prevention says fluoridation prevents tooth decay in children. A federal recommendation announced Friday urges doctors to prescribe fluoride supplements to preschoolers in areas where water supplies lack sufficient fluoride.

The chairman of Fluoridation Works is optimistic, even though Spokane voters rejected fluoridation in 1969 and 1984.

“I think we have a more enthusiastic group,”said John Robideaux, the local marketing businessman who chairs the coalition. And there are new truths about fluoridation. Fluoride can be good for the heart and prevent osteoporosis.

“It’s still fluoridation. It’s still the same Spokane. It’s still the same wells. But the evidence has increased in our favor.”

Fowler heard the news of the coalition’s plans Friday.

“How can they dare ask people to vote for fluoridation?” she asked. “It’s the biggest con job that’s ever been put over on the American public.”

She said compounds used to fluoridate water are made from waste products from the phosphate fertilizer industry and contain lead, arsenic and mercury.

Fowler, who founded the Safe Water Coalition of Washington State, has no beef with doctors and parents using fluoride supplements, as long as they watch for tooth staining called fluorosis.

“The main thing is to keep fluoride out of the drinking water,” Fowler said. “That negates freedom of choice.”

In the region, Cheney, Fairchild Air Force Base, Pullman and Sandpoint have fluoridated water.

On Thursday, the health board will hear about a local study that shows children in Cheney, with fluoridated water, had lower rates of rampant tooth decay — that is, decay in seven or more teeth — than children living in six other ZIP codes in Spokane.

But children in a seventh ZIP code studied, 99223 in southeast Spokane, had even lower rates. And the study size was small: 344 children.

Small studies are usually not considered strong evidence, but the results align with other national studies showing fluoridation reduces risk of tooth decay in children and decreases the difference in risk between poor and affluent children.

Spokane’s water comes from the Spokane-Rathdrum Prairie Aquifer, pumped from underground at seven well stations. At each well, the city adds chlorine, at 0.2 parts per million, as a precaution against germs.

Fluoride is a naturally occurring substance. Spokane’s water contains a background level of fluoride at 0.2 parts per million.

The recommended level for cavity prevention in children is 0.7 to 1.2 parts per million, said Dr. Kim Thorburn, chief of the regional health district.

“It really is time for Spokane to evaluate this again,” Thorburn said.

Spokane County Commissioner and Board of Health member John Roskelley asked for the report to the board.

“I thought we should be knowledgeable about fluoride, those jurisdictions that use it and the science behind it,” Roskelley said Friday. “I feel strongly that the Board of Health needs to take a stance on public health issues. To do that, we need to be better educated.”

On Friday, the U.S. Preventive Services Task Force urged doctors in areas where the water supply is deficient in fluoride to prescribe oral fluoride supplements to preschool children over the age of 6 months.

The recommendations state that doctors should know the fluoride levels in patients’ water supply before deciding on the fluoride dosage. Too much fluoride can result in discolored teeth.

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