Although the Centers for Disease Control and Prevention point to strong scientific evidence of fluoride’s ability to protect the teeth of people of all ages from cavities, Livingston says he’s not comfortable adding it in, and notes that no law requires water systems do so. Oxford’s own system stopped between 10 and 11 years ago; after Hurricane Katrina, fluoride “quadrupled” in price, Livingston said. News accounts from mid-2006 show the nation’s top producer of the substance decreased production at the same time that other water systems began stockpiling fluoride, making it harder to get.

Calls for comment on the topic this week to dentists practicing in the city went unanswered, but for one: Dr. Patrick Ballard wishes the substance — formed when minerals bond with the naturally occurring element fluorine — was back in.

“We kind of complained about it a couple years ago,” said Ballard, who practices from an office facing Alabama 21 in Oxford. “We’d like to see it back … Fluoride in water has been proven to help with the development of healthy teeth.”

The American Dental Association, a professional organization for dentists, takes the same stance, according to association spokesman and University of California, Los Angeles School of Dentistry professor Ed Hewlett.

Both Ballard and Hewlett said that while teeth are developing, the enamel from which they’re made — a mineral called hydroxyapatite — once exposed to fluoride becomes fluorapatite, a harder, more decay-resistant mineral.

“It’s the single most effective public health measure for preventing tooth decay that we know of,” Hewlett said by phone, reducing cavities by between 20 and 40 percent.

Hewlett also noted that the addition of small amounts of fluoride to drinking water has been practiced in the United States for 70 years, and that water systems adding the chemical serve 72 percent of the country’s population.

Anniston Water Works and Sewer Board adds the U.S. Public Health Service recommended level of the compound — 0.7 milligrams per liter of water, or, put another way, less than one ion of fluoride for every million water molecules — according to general manager Ed Turner. Turner says the water and sewer board has done so for 50 years, and will continue to do so at the recommendation of public health agencies.

Alabama’s top doctor for oral health, too, supports fluoridation of community water sources.

“Any dentist,” said Dr. Robert Meador Jr., State Dental Director of the Family Health Services Bureau’s Oral Health Program in the Department of Public Health, “who has patients coming from areas with fluoridated water and non-fluoridated water — you can tell the difference in the number of cavities.”

Meador, who practiced dentistry 20 years and taught another eight at the University of Alabama’s School of Dentistry, says he and others in the profession advocate for fluoridation because they “want what’s best for children and adults.”

Meador also noted that the practice is endorsed by “more than 100 national and international health organizations.

“There is no evidence from any reputable research organization that states there is anything wrong with adding fluoride to our public water systems,” he said.

Still there are some who don’t agree with fluoride’s inclusion in drinking water. That resistance has existed almost from the widespread start of the practice. Today, critics equate the chemical’s addition to mass prescription of a drug without the public’s consent.

Voters in Portland, Ore., in 2013 for a fourth time refused fluoridation of that city’s water, swayed by unscientific and fear-based arguments that fluoride itself is toxic. Critics using that argument failed to mention that at the right amount, every other chemical encountered on a daily basis can be deadly, noted a story in Scientific American the day after the vote. Even too much water, fluoridated or not, can kill.

Livingston, for his part, says that if fluoridation was required by law, he would comply. Fluoride won’t make its way back into Oxford’s water otherwise.

“I’m not a pharmacist,” Livingston said. “Who am I to say you need this?”