Utah seems on the verge of another controversy over fluoridation of public drinking water - a practice that would either add dangerous chemicals to water or improve the dental health of children, depending on your outlook.

Thursday, the Salt Lake City-County Board of Health voted to ask the County Commission to place an initiative about fluoridation on the November ballot. The voice vote was without dissent.Commissioners are generally disposed to let residents vote on the matter.

Commissioner Mary Callaghan, who also sits on the Board of Health, generally supports putting citizen initiatives on the ballot. She said, "In my raw straw poll, I see it split about 50-50, which is all the more reason to put it to a vote."

A group of interested residents, primarily dentists and other health professionals, approached both the County Commission and Board of Health last summer with the fluoridation idea. The commission could have put the matter on the ballot without the board's recommendation, though the recommendation gives it added impetus to do so.

Commission Chairman Brent Overson said he would probably support a vote if city officials can give some input beforehand. Commissioner Randy Horiuchi supports fluoridation. (His wife is a professor of dental hygiene at Weber State University.)

The action, the first in decades, was made possible by the 1998 Legislature passing HB405, an act allowing citizens to vote on whether fluoride should be added to public water supplies. The measure replaced a 1976 law that made it difficult for the issue to reach the ballot.

"A very small percentage of Utah water systems are fluoridated," said Lewis Garrett, director of family health services for the City-County Health Department. "In the nation, a majority of water systems are fluoridated."

The reason stems from scare tactics of fluoridation opponents, he believes.

Decades ago, some opponents made ridiculous claims against fluoridation, he said. One argument: Fluoridation was intended to make the population somnolent so evil bureaucrats could take over. Others were "this is a communist plot, that it numbs the mind, lowers the IQ," Garrett said.

Today, he believes, "most people are pretty rational about fluoride, and most people, I think, support it."

"I tell people that before it was a communist plot, but today there are no more communists, so . . . ," Horiuchi joked.

Claims of adverse health effects are simply unfounded, Garrett said. "Fluoride has been used in the United States for more than 50 years and has an exceptional track record for safety and effectiveness."

If a small amount is added to drinking water, "we could expect a 40 to 50 percent reduction in dental decay. That has been the experience over and over and over, all over the country, when they do this."

The biggest benefit is for children whose teeth are forming, but older people can be helped, too, he said. "As gum lines recede, the exposed roots of the teeth are bathed with fluoridated water," protecting them.

But Utahns still haven't embraced fluoridation.

"We're the worst," Garrett said. Counting 51 entities - every state plus Washington, D.C. - "we rank 50th. . . . We tie with Nevada" in terms of fewest residents getting artificial fluoride in the drinking water.

He hastened to add that fluoride is natural to nearly all water sources. Salt Lake County water has fluoride in it already, "but just not enough to do the job."

Gene W. Miller, a Providence, Cache County, man who is a retired biology professor from Utah State University, is opposed to fluoridating public water systems. He has researched the effect of fluoride on organisms and is the secretary of the International Society for Fluoride Research, a professional organization.

The society coordinates research by physicians, biologists, dentists, animal physiologists and plant physiologists, he said. It does not campaign about fluoride but studies it.

In higher concentrations, fluoride can cause physical problems in animals, he said. "Not too many years ago, we had problems with fluoride pollution in Utah County and also southern Salt Lake County," with the pollution blamed on a now-closed steel mill.

Coal that the mill burned contained fluoride, which billowed from the mill's smokestacks. "The fluoride then accumulated in plants, and the forage crops were eaten by cows, other animals," he said.

The danger is that fluoride in high concentrations can cause bone abnormalities. "The bones may become two to three times larger than normal and very brittle," he said. While some problems may have been reported in livestock, humans had no difficulties.

Drinking water would be treated with fluoride only to the extent of one part per million, not enough to cause that kind of trouble. Miller said the levels would be monitored so that one PPM wasn't exceeded.

A concentration of one PPM is not likely to cause complications, he said - except for certain people with medical conditions.

Patients who must have dialysis because of kidney failure may find that fluoridated drinking water causes "a real problem for them," Miller said. "And there are individuals who have allergies where the fluoride may initiate problems."

Miller is against fluoridating water because people "may themselves purchase fluoride pills that would assist the formation of teeth and help individuals when these teeth are erupting."

Fluoride pills that would help children are available over the counter in drugstores, he noted.

The main value of fluoridation is to protect children's teeth from decay. "There's not scientific evidence to any extent that it's helpful after that time," Miller said.

Fluoridation battles have a long history in the Beehive State.

In 1961, Salt Lake City voters rejected fluoridation by a 3-to-1 margin. The 1969 Legislature opposed mandatory statewide fluoridation. Three years later, Salt Lake County rejected fluoridation by 123,000 to 85,000.

But in 1976, the Utah Board of Health proposed ordering the fluoridation of Utah's public water supplies, resulting in a loud outcry. Opponents organized an initiative petition against the measure.

A grass-roots group called People of Utah Recalling Enforced Fluoridation gathered tens of thousands of petition signatures to put the matter on the ballot. Late in the year, both sides fought the issue in highly publicized hearings.

In the November 1976 election, the petition passed. Fluoride was out, 267,104 votes to 249,501.

After that reaction, fluoride went onto the political back burner - until now.

Deseret News staff writer Alan Edwards contributed to this story.