Some public health advocates are saying, “Don’t drink the water” — if it’s supplemented with fluoride.

Once viewed as a Communist conspiracy to brainwash America, fluoridated water has become a hot-button issue again. Anti-fluoridation Internet sites are flooding the Web and voters in some parts of the country have even rejected legislation introducing water fluoridation.

But fluoridated water these days is as common as caffeine in coffee.

Federal health officials believe any arguments against the use of fluoride are exaggerated and no evidence exists against its use.

In West Virginia, 92 percent of the population served by a public water system receives fluoride in its water. That accounts for 1.27 million people.

Some health advocates, including registered nurse Terri Swearingen, believe the presence of fluoride in any drinking water is too much.

“It’s unnecessary,” said Swearingen, of Chester. “Why do we need it in our water? That’s the bottom line.”

Fluoride, which has been routinely added to much of the country’s water systems since 1945, is believed to fight cavities and tooth decay. Municipal systems have added fluoride, mostly in the form of hydrofluorosilicic acid, to water serving 170 million Americans.

No one really disputes the fact that fluoride protects tooth enamel. But opponents say too much fluoride, a natural element found in rocks and groundwater, can cause harm.

They argue that toothpaste contains enough fluoride for a person. Some studies have also concluded that fluoride ingested in high doses can be toxic.

“To me, the fluoride issue is one of basic common sense,” Swearingen said. “First of all, the Centers for Disease Control and everyone knows that any beneficial effect from fluoride is topical, and not systemic.”

The amount of fluoride in the Elk River regional system, which services Kanawha, Putnam and Boone counties, is about 1 part per million, according to a report from West Virginia American Water Co.

That amount is smack in the center of what the CDC considers the optimal level, between 0.7 and 1.2 parts per million. The World Health Organization has a fluoride-safety standard of 1.5 parts per million.

“We do it for dental care purposes and health benefits for our customers,” said Todd Beane, spokesman for West Virginia American Water.

The water company serves 165,000 customers in 17 counties across the state and adds fluoride to all of its systems.

West Virginia American Water started adding fluoride in the early 1950s as a result of state regulations.

According to state health officials, “community water fluoridation is the single most effective and efficient means of preventing dental cavities.” The CDC calls water fluoridation “one of the 10 great public-health achievements of the 20th century.”

Beane said he’s aware that the issue remains controversial in some segments of society.

“The issue has been around since the early 50s,” Beane said. “People are still expressing their opinions, but they don’t realize the facts. It doesn’t really cause health concerns or else the regulations wouldn’t be in effect.”

But Swearingen believes mandatory water fluoridation also impedes on an individual’s right to choose if they want it or not.

“It’s like saying, ‘We’re going to mass medicate the entire population,” she said. “Since 1999, over 70 U.S. communities have rejected water fluoridation. When given the chance to vote, they vote against it.”

In the past three years, legislation encouraging fluoridation has been defeated or tabled in Arkansas, Nebraska, Oregon and Hawaii.

More recent, controversial contentions from opponents link fluoridation with bone cancer and thyroid disease. Federal health officials disagree.

However, the CDC has said that 32 percent of American children now have some form of dental fluorosis, a white or brown mottling of the teeth. Health officials blame it on swallowing of toothpaste while fluoride critics believe fluoridated water is a contributing factor.

“I have no hidden agenda,” said Swearingen, who earned a Goldman Prize, awarded to grassroots environmentalists worldwide, in 1997 for exposing the dangers and illegal practices of a toxic waste incinerator in East Liverpool, Ohio.

Her husband is a dentist and her daughter is a dental student at West Virginia University. Swearingen said both agree with her stance on the issue.

“What do I have to gain by opposing water fluoridation but to protect human health? That’s my area of interest.”