America is a fluoride nation. Beginning in 1945, when Grand Rapids, Mich., became the first city in the world to add the stuff to its water supply, the practice has spread across the United States. In most areas it is simply understood that ingesting minuscule levels of fluoride is good for dental health. As of 2010, almost three-quarters of Americans drink fluoridated water from community water systems, and the nation’s 30 most populous cities consume it.
With one weird exception: Portland, Ore., whose water system, sourced from the Bull Run River, serves 900,000 people.
A fluoridation proposal was put up for a popular vote in 1956, when many major metropolitan areas were adopting the practice, but it failed by a sizeable margin: 105,191 to 75,354. A similar attempt in 1962 failed, too. The late 1970s saw a flurry of activity, long after the issue had faded from the national political discourse. Oregon voters killed a statewide ballot initiative that would have banned fluoride (1976); Portlanders voted to add fluoride to the water (1978); and then they reversed course and voted to keep it out of the water supply (1980).
The fluoridation debate remained dormant until last summer, when someone leaked to the Oregonian that a coalition was quietly pushing the City Council to simply approve fluoridation without relying on a ballot measure. Less than a month later, the council unanimously did just that by enacting Ordinance 185612, which required the Water Bureau to add fluoride at 0.7 parts per million beginning in March, 2014. Atlantic Cities’ Nate Berg wrote approvingly at the time, “resistance from one of the country's biggest cities may be coming to an end.”
Resistance was just beginning. The banners of dissent were quickly raised. A public hearing on the ordinance lasted for almost seven hours, and almost all of the speaking time was taken by people against fluoridation. When the council voted the motion through, protesters booed loudly, vowing to bring the matter before the public. (Several of the more boisterous activists were expelled from the chamber.) Within a month more than 43,000 signatures were collected, more than twice the number needed to bring the issue to a popular vote.
“The fact that we collected so many signatures shows the citizens of Portland were really upset that they were going to fluoridate without a public vote,” says Kellie Barnes, spokeswoman for Clean Water Portland. “We are entirely grassroots. The executive staff are all volunteers, none of us are paid. … I’m a physical therapist and a mother who cares about not adding contaminants to our water.”
On paper, the fight over fluoridating Portland’s water supply looks absurdly uneven. The pro-fluoridation group Healthy Kids, Healthy Portland, as of May 13, had received $689,376 in cash and $65,093.64 in the form of donated supplies and labor. The anti-fluoridation Clean Water Portland received $194,333 and $59,137. Healthy Kids enjoys the backing of a diverse coalition that ranges from major health care and dental providers, such as Kaiser Permanente and the Oregon Dental Association (both have donated tens of thousands of dollars), to organized labor and almost all of the region’s major groups representing and organizing with people of color and low-income communities. Oregon’s Wild West campaign spending laws (they basically don’t have any) allow huge contributions: The Northwest Health Foundation alone has donated well over $200,000. The Urban League is the premiere advocacy group for Portland’s African-American community and it has an organizer devoted full-time to the cause.
Arguably most importantly, Healthy Kids and fluoridation have the endorsement of the massed forces of rationality and medical authority. Almost every credible national, state, and local health and science organization—private and public—gives its blessing to optimal levels of water fluoridation: The American Medical Association, the American Dental Association, the Environmental Protection Agency, the World Health Organization, American Academy of Family Physicians, and the Center for Disease Control and Prevention, which named the measure one of the 10 greatest public health achievements of the 20th century. They all agree that fluoridated water is perfectly safe and extremely effective at preventing tooth decay.
Clean Water Portland’s anti-fluoridation supporters include the Pacific Green Party, Nutritional Therapy Association, Organic Consumers Association, Oregon Association of Acupuncture and Oriental Medicine, and the Cascade Club, a local libertarian think tank. The Portland chapter of the NAACP is the only local organization representing people of color that has come out against fluoride, but according to most political observers it is tiny and has very little influence. (United Latin American Citizens is also listed as a supporter because their national organization has opposed the policy generally, but according to Barnes their Portland chapter has not officially endorsed CWP.) Out-of-state supporters include the Fluoride Action Group and Kansas Taxpayers Network, which is a far-right group that recently merged with Americans for Prosperity. Anti-fluoride funding also comes from a variety of groups bearing the name of Joseph Mercola, a doctor the FDA censured multiple times for making untrue health claims. His website includes articles opposing fluoridation, vaccinations, and mammograms. Mercola.com also features an extensive interview with a man who denies that HIV causes AIDS.