Comedian George Carlin once joked that everybody complains about their local tap water, and nobody brags about it. Not so in Portland. “Portlanders pride themselves on having some of the best drinking water in the world,” said Kim Kaminski, executive director of Oregonians for Safe Drinking Water, a Portland-based nonprofit that opposes adding fluoride to municipal water supplies throughout the state.

Now Portland’s City Council is about to vote on the issue, and three of five city commissioners have stated publicly that they intend to support adding fluoride to the water supply on September 12 after hearing public comment September 6.

For now, it looks like a lock, but anti-fluoride activists have already started circulating petitions – the online petition site actually has several petitions asking Portland’s City Council not to add fluoride to drinking water – and intend to create a ballot referendum if the council takes such action. Thus far, the largest petition has gained more than 2,500 signatures.

Fluoride has long been a contentious issue in Oregon, which has some of the highest rates of dental decay in the nation, particularly among school-age children. In 2005 and 2007, legislators defeated bills that would have mandated adding fluoride to water supplies in all cities with populations of more than 10,000.

Now the fluoride fight is happening at the municipal level. Earlier this year, the citizens of Philomath voted to add fluoride back to their drinking water after the city council voted had it removed last year. Last summer, Portland City Commissioner and Water Bureau director Randy Leonard – asked why Portland has not fluoridated its water historically and whether he would consider an initiative – told The Lund Report he favored fluoridation.

“Coincidentally, I’ve been looking into the issue and am weighing whether or not to bring a proposal forward for city council consideration that would allow us to fluoridate our water,” he said in an e-mailed statement to The Lund Report. “It seems unfair to me that our poorest communities in Portland that cannot afford regular dental care has children that suffer from increased cavities due to the lack of fluoridation in our drinking water.”

The recent push to fluoridate is the result of campaigning by a coalition of healthcare and community groups called Everyone Deserves Healthy Teeth. A list of partners and funders can be found here.

“All of the funders are members of the coalitions on that list. We’re solely funded by community foundations and health organizations,” said coalition spokesperson Kylie Menagh-Johnson. She declined to share specifics about how the coalition campaign is funded, but confirmed she’s a paid contractor with Upstream Public Health, which received a $50,000 grant from the Oregon Community Foundation to campaign for children’s dental health.

“Upstream Public Health as well as every paid coalition member has paid staff doing this as part of their job,” Menagh-Johnson said.

“I want to underscore that this has been a behind the scenes, hush-hush campaign to put toxic wastes into our drinking water,” Kaminski said. Her group, and others petitioning against the use of fluoride in drinking water, said if communities are really concerned about poor children’s dental health, there are ways to improve it without fluoridating drinking water.

Oregon Community Foundation Communications Director Joan Vallejo said the foundation has supported children’s dental health for several years. In 2011 it gave grants to Friends of Creston Children’s Dental Clinic (for general operational support), the Dental Foundation of Oregon (for the Tooth Taxi oral health program) and Umpqua Community Health Center (for a school-based children’s health program).

In 2010, Northwest Health Foundation made a $35,000 grant to Upstream Public Health to advocate for community water fluoridation, and has also made grants to clinics to provide dental sealants and dental care for low-income children and families. (The foundation also provides grant funding to The Lund Report, but neither dictates coverage nor reviews stories for publication.)

School children in Multnomah County receive fluoride rinses and tablets through a school-based dental health program – but still experience twice the amount of dental decay as children in Washington.

Dental pain is also a major cause of emergency room referrals. According to Jim Newman, associate director for media relations at Oregon Health & Science University, its emergency room saw 678 patients last year who came to the hospital with dental pain or dental health issues. Eleven people were admitted to the hospital, and the majority were either uninsured or on the Oregon Health Plan.

If anti-fluoridation activists – some of whom say the drug isn’t safe or even effective taken systemically – are skeptical that fluoridation will improve children’s oral health, they’re also concerned about the environmental effects.

Most major environmental groups, including the Sierra Club, Willamette Riverkeeper and Columbia Riverkeeper, oppose public water fluoridation, partly because community water supplies are usually supplemented with fluorosilic acid, a byproduct of fertilizer manufacture, instead of sodium fluoride, which is typically used in pharmaceutical fluoride and is more expensive.

According to Menagh-Johnson, the Environmental Protection Agency’s standards for evaluating fluoride additives are actually more stringent than pharmaceutical standards.

The Environmental Working Group, which advocates for reduced amounts of fluoride in public drinking water and for more research on its possible carcinogenic effects, has ranked Portland’s tap water 59th in a survey of 100 major cities in terms of the quality of its tap water, because of the concentration of halacetic acids (chemicals used to disinfect water) in the city’s water.

Both sides maintain that fluoridation is a social justice issue, and critical to public health. Whether or not voters decide to support fluoridation, Kaminski believes they should be the ones making the call.

“If you are putting a product into our drinking water for the purpose of medication, people deserve the right of informed consent,” she said.