Some Tennesseans are rethinking whether it’s such a good idea to add fluoride to public drinking water supplies, questioning whether the additive is as dangerous as it is helpful.

City officials in Franklin are reconsidering their city’s long-standing practice of putting fluoride in the drinking water to help prevent tooth decay. Last year, a utility in East Tennessee stopped adding it after most of its 30,000 customers said they didn’t want it. And a state lawmaker is holding public meetings in Nashville on whether it’s a good idea.

Critics say that fluoride’s effects never have been adequately studied and that the practice of adding it to public water supplies is linked to bone cancer and other ailments.

“I’m not trying to make everyone scared,” said state Rep. Gary Odom, who held a meeting on water fluoridation in June at the Capitol and plans more. “It just, to me, makes sense that you review public policies periodically, and you look and see whether this should be reconsidered or whether more information needs to be given to local governments that are having to decide on this.”

Some 5.4 million Tennesseans are served by public and community water systems that add fluoride, acording to the state Department of Environment and Conservation.

About 90,000 people in Middle Tennessee are getting unfluoridated water from two dozen systems, according to information from TDEC.

Angie Mullins is one of those people. She thought her drinking water had fluoride in it. A dental hygienist, she even told her patients it did.

So when she learned she was wrong ˜ that her Lincoln County water isn’t fluoridated ˜ she was shocked.

Concerned for her four young children’s teeth, she’s been pushing leaders of this rural county on the outskirts of Huntsville, Ala., for the past five years to fluoridate the water.

“Most everyone, when you talk to them, they assume their water is fluoridated,” said Mullins, 34. “So when they find out, they’re pretty much upset about it.”

The Lincoln County public utilities system hasn’t fluoridated its water for about a decade, though county seat Fayetteville does. Lincoln County is the largest water system in Middle Tennessee that does not add fluoride to its water, with 16,643 customers, according to an analysis of data from TDEC.

It never was an issue until Mullins spoke out at a board meeting last spring, said Billy Joe Wiley, superintendent of the county public utilities board.

After news stories on the meeting appeared in the local paper, the board got calls from residents both approving of and protesting the county’s policy on water fluoridation. Residents at board meetings were equally divided.

Now the board feels stymied, Wiley said. He can’t predict how the issue ultimately will be resolved.

“The board doesn’t know which way to go. Those who are for it feel very strongly for it and can give a whole host of reasons for it, and those against it seem to feel equally as strong against it and they can supposedly produce volumes of reasons why you should be against it,” he said.

“What worries me, I don’t understand, if it needs to be in the water, why does the state of Tennessee not require us to put it in the water?”

While Lincoln County is debating whether to put it back in, Franklin city officials are thinking of whether to take it out.

A local researcher from Brentwood raised the issue at a recent Board of Mayor and Aldermen meeting, said Jay Johnson, the city’s administrator. The city’s Public Enterprise Advisory Committee voted unanimously in July to have city staffers research the issue, finding out which other cities don’t fluoridate their water and also to find evidence supporting fluoridation.

The largest unfluoridated water system in the state, according to TDEC data, is the South Blount County Utility District, which serves about 30,000 customers on the cusp of the Smoky Mountains.

It opted against fluoride last year after a new water plant began operating and residents in a survey rejected the additive 2-to-1, said Isom Lail, the utility’s director. County seat Maryville and the city of Alcoa each fluoridate their water.

Water fluoridation became a standard way to help prevent tooth decay after Grand Rapids, Mich., became the first community to do it in 1945. Now about 170 million Americans live in communities where the water is fluoridated, according to the Chicago-based American Dental Association, the nation’s largest professional dental organization.

The federal Centers for Disease Control and Prevention in Atlanta hails water fluoridation as one of the 10 greatest public health achievements of the 20th century. Proponents credit it as a cost-effective way to help prevent tooth decay for almost everyone, regardless of income, race or ethnicity.

For most communities every dollar spent on water fluoridation saves $38 on dental care, according to the ADA.

“In Tennessee we’ve had fluoridation, I think, 45 years-plus, and the results in terms of the amount of dental caries that school-age children and younger that has been reported has just dropped like a rock since the implementation of fluoridation,” said David Horvat, executive director of the Tennessee Dental Association.

Though many people think of it as fluoride, the additive is really one of a family of compounds called fluorides. They all contain the element fluorine. Fluorides are well known for their ability to strengthen teeth against decay, and many toothpastes contain them.

Advocates say fluoride is safe at such low levels, appears naturally in underground water supplies in many parts of the U.S., and is cheap to add to public water supplies.

But critics question the ethics of mixing medicine with something so fundamental as drinking water. They argue many people aren’t aware their water is fluoridated and never consented to it.

They also charge that the hazards of water fluoridation eventually will be proven to be so far-reaching, they eventually could rival those of tobacco and result in similar litigation.

The man who piqued Franklin officials’ interest was Dan Stockin, a researcher with a background in hazardous materials at The Lillie Center Inc., a Brentwood firm that offers environmental and public health training. He considers fluoride, when ingested, to be nothing short of a toxic.

He began researching water fluoridation a year ago for his boss, who wondered whether it was to blame for a skin irritation. He never discovered the cause of the skin irritation, but what he learned about water fluoridation prompted him to lobby municipal and state leaders against it.

Like many critics, Stockin blames fluoride for thyroid problems and says its deposits in bones and joints are to blame for pain often mistaken as arthritis.

He also points to an unpublished study, in the news this summer, by a doctoral student at the Harvard School of Dental Medicine. The 2001 study reportedly suggests a link between fluoridated water and a rare bone cancer in boys. Critics say it’s the latest study showing such a link.

Odom, his interest sparked by Stockin, held a meeting in June on water fluoridation with up to 70 representatives from the state Department of Health, U.S. Sen. Lamar Alexander’s office, U.S. Rep. Marsha Blackburn’s office, the dentistry industry, water utility districts and local health departments.

The aim was to educate, Odom said. Many municipal leaders are unaware there is no state law requiring them to fluoridate their water, he said. He plans to continue the conversation next month in meetings of the state House Conservation and Environment Committee, of which he is the chairman.

Meanwhile, Mullins buys her children fluoride supplements and calls county leaders. She has attended public meetings since the spring to lobby for the fluoride cause.

She complains that when Lincoln County quit fluoridating its water, no one was informed. She sees an effect on the teeth of young children growing up without it.

“It’s very detrimental to the health of people, mainly children because children are the ones who get the most benefit from the fluoride,” she said. “It affects your teeth for the rest of your life.”