It once got a Spokane dentist called a murderous crook and threatened with a "belly full of lead."
For almost 50 years, the idea of fluoridating area drinking water has been about as popular as a pulled tooth. Voters have twice rejected attempts to fluoridate Spokane's water.
Fluoridation forces have been fairly silent for the last 13 years. But the executive board for the Spokane Regional Health District last fall asked the district to research fluoridation.
"This is one of those things periodically we need to review, see what the literature shows and see what the community thinks," said board member Phyllis Holmes, a Spokane City Council member. "We may decide there's an issue here. We may find out there's not."
Today, the board's 11 members will listen to a fluoridation presentation by the district's oral health coordinator, and receive informational packets that outline fluoridation's effects.
There's no proposal and no resolution being considered. But it opens the door to more talk of fluoridating the area's water.
Unless a health threat was declared, the health district couldn't force fluoride down the community's throat.
But the board could adopt an advisory resolution asking communities to consider fluoridation. That's what happened with smoking signs in restaurants, which both the City Council and county commissioners approved.
Hundreds of studies over the past 50 years show that fluoridation prevents tooth decay. Fluoridation supposedly costs 54 cents per year per person - substantially less over a lifetime than the cost of even one filling, advocates say.
Opponents claim that putting fluoride into drinking water poisons the water supply. They have their own studies that link fluoride to bone cancer, infertility and hip fractures.
Since fluoride tablets mottled her daughter's teeth in the 1960s, Betty Fowler has been suspicious of fluoride, the 13th-most abundant element found in nature.
In 1988, the Spokane resident formed the Safe Water Coalition of Washington State. The organization has about 700 supporters, said Fowler, the Eastern Washington representative.
She worries about fluoride's effects not on people's teeth, but their bodies.
"It only benefits industries turning people into industrial waste dumps," Fowler said. "It does not stop tooth decay. We have to stop it."
The issue has been controversial in Spokane ever since Grand Rapids, Mich., decided to fluoridate its water in 1945. Dentists first pushed the issue with the Spokane City Council in 1951, and continually championed the movement for years.
In response, fluoridation foes formed groups and circulated petitions. One fringe member sent a threatening letter to a dentist in 1960 that said: "You will be the first to suffer in a serious way if you succeed in adding such poisons to our water."
Spokane voters narrowly approved fluoridation in 1968 in an advisory vote to the City Council. After a challenge, the voters went to the polls again, this time rejecting fluoridation.
They rejected it again in 1984, after the City Council approved fluoridation, and opponents petitioned to let voters decide.
"To tell you the truth, it was a whole different ballgame at that time, as far as awareness," said Michele Vanderlinde, the district's oral health coordinator who will speak to the health board today.
Spokane is one of the largest cities in the nation without a fluoridated water system.
About 145 million people nationwide, or 62 percent of the U.S. population, drink fluoridated water. That's 45 of the country's largest 50 cities, according to a 1995 survey by the Centers for Disease Control and Prevention.
The U.S. Public Health Service's Healthy People 2000 initiative says 75 percent of the population should be served by fluoridated water systems by the end of the decade. Washington state aims to have 55 percent of its residents on fluoridated water systems.
More and more communities are turning to fluoridation. The Bremerton, Wash., City Council voted to add fluoride to city water last month.
Two years ago, California lawmakers voted that all communities with at least 25,000 residents should add fluoride. San Antonio, Texas, the largest city nationwide that doesn't have fluoridated water, is considering the switch.
In this region, Sandpoint, Cheney, Pullman and Fairchild Air Force Base have fluoridated water systems.
Several members of the health board said they were waiting to hear the district's report before making any decision on fluoridation. County Commissioner Kate McCaslin said she was nervous about putting fluoride in the water.
But Phil Harris, also a county commissioner and health board member, said he drank fluoridated water off and on for 20 years when he served in the Air Force.
"Maybe I'm crazy and I don't know it," Harris said. "But I don't know of anything wrong with fluoridation."
