When Bill Stowe took over as CEO of the Des Moines Water Works a year ago, some of the first calls he got were about fluoride.

Dentists, scientists and public health officials credit the addition of fluoride to public water supplies, a practice that began in the early 1950s, with dramatically reducing tooth decay nationwide.

But a vocal group opposes fluoridation on a variety of claims, including the belief that the government is forcefully medicating its population and that fluoride itself is a poison with a host of negative health consequences.

Stowe has opened up the issue for public comment through Saturday. More than 270 comments have already been logged. They run 3-to-1 in opposition to continued fluoridation, making the topic easily some of the hottest waters Des Moines Water Works officials wade through. The water works is the largest water utility in Iowa and serves a half-million people in metro Des Moines.

“You sometimes see opposition to rate increases, but you don’t get this kind of heat and fire,” Stowe said. “It’s an issue that some people feel very passionately about.”

Des Moines began fluoridation in 1959

Dentists and scientists identified the link between fluoride in water and improved dental health in the early 20th century. The practice of adding small amounts of fluoride to water supplies began in the late 1940s and was officially endorsed by the U.S. Public Health Service in 1951. Des Moines began fluoridation of its water in 1959.

The Centers for Disease Control and Prevention named water fluoridation as one of the 10 great public health achievements of the 20th century, in such company as advances in workplace safety, motor vehicle safety, prenatal care and immunizations.

In the early 1960s, about a fifth of all Americans had lost all their permanent teeth by the time they reached their mid-50s. Today, the figure is less than one in 10.

“Among the most striking results of fluoridation is the change in public attitudes and expectations regarding dental health,” a 1999 CDC report said. “Tooth loss is no longer considered inevitable, and increasingly adults in the United States are retaining most of their teeth for a lifetime.”

Fluoridation is endorsed by the American Dental Association, Centers for Disease Control and Prevention, American Medical Association and the World Health Organization.

Nationally, nearly 70 percent of Americans live on public water systems that provide fluoridated water, according to the U.S. Department of Health and Human Services.

Almost 42 percent of Iowa’s nearly 1,200 community water systems add fluoride to the water supply at a rate of 0.7 parts per million or greater, according to the Iowa Department of Health.

Another 13 percent have naturally occurring fluoride levels sufficient to improve oral health.

Practice has long stirred controversy

To some degree, fluoridation has always been controversial. In the 1950s, adding fluoride to the water was linked to a communist mind-control plot.

Today’s fluoridation doubters come mainly from two groups: those who seek to limit government’s role in their lives, and those who believe food and water should be as natural and pure as possible, devoid of nearly all chemical interference.

“It’s debatable how much fluoridation improves dental health,” said Bill Hamilton, 37, a Des Moines artist and filmmaker who opposes fluoridation. “Everything I research shows that fluoride is toxic and shouldn’t be something forced upon us.”

Most who submitted comments on fluoridation to the Des Moines Water Works echoed Hamilton’s sentiments.

“Get it out of our water!!” wrote Brandon Brown. “So many people are against this. There is a lot of evidence that it’s bad for us.”

“I am against fluoride in drinking water,” wrote Greg Hefner. “I’m no scientist, but just reading the directions on a toothpaste container says it all. Contact your poison control center if ingested. Why would we want a chemical that could make us ill in drinking water?”

Aaron Lea accused Des Moines Water Works board members of “practicing medicine without a license.”

“Doctors cannot prescribe medicine without a license,” he wrote. “Pharmacists cannot distribute drugs without a license. The board of Des Moines Water Works is both prescribing and dispensing this drug without a license, and each member should (and will) be held legally liable if this practice continues.”

Professor: It’s safe, averts tooth decay

However, voices raised in favor of fluoridation often belong to the medical and scientific community.

“The daily exposure to low levels of fluoride benefits all of us,” said Steven Levy of the University of Iowa College of Dentistry.

“It’s the most efficient and cost-effective way to prevent dental caries. It benefits people of all ages, and it is safe.”

The Des Moines Water Works spends about $125,000 per year to fluoridate water. The fluoridation rate is 0.7 parts per million.

Water works officials lowered the fluoridation levels from 1 part per million to 0.7 parts per million in 2011. The 0.7 parts per million factor is the minimum recommended standard by the U.S. Department of Health.

Officials dropped the amount because of the proliferation of fluoride-enhanced toothpastes, mouth rinses and other over-the-counter products.

Fluoridation helps reach the segments of the population that cannot afford toothpaste or other health products, Levy said.

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