In New Jersey, a Battle Over a Fluoridation Bill, and the Facts (Published 2012)

“We think the cost benefit is not there,” said Karen Alexander, the president of the association.

Many opponents say their information has come online, from national groups like the Fluoride Action Network and Citizens for Safe Drinking Water, which argue that fluoridation would cost $5 billion statewide. On their Web sites, the groups argue that fluoridation would lead to fluorosis, a rare staining of the teeth. They say fluoride has many adverse health effects, including bone cancer, and no proven benefit.

But public health officials say that the National Academy of Sciences examined the studies linking fluoride to lowered I.Q. and could not substantiate them. Similarly, two large and recent studies, one from Harvard and the National Cancer Institute, the other in California, found no link between fluoride and bone cancer. Fluorosis in the United States, they say, tends to be barely visible.

“The opposition can point to one or two studies that say this or that,” said Dr. Bailey, of the C.D.C. “We look at the overall weight of the evidence and what expert panels have said.”

There are several ways to fluoridate water, depending on the water system, said Kip Duchon, the national fluoride engineer for the C.D.C. But they are not cost-prohibitive, and most are simple, he said.

Jared Martin, 27, who started a No Fluoride New Jersey page on Facebook after reading about the bill and fluoride online, acknowledged that there was evidence to support fluoridation.

“That’s the thing,” he said. “When you’re searching the Internet, it depends where you’re looking.” But he was made suspicious, as were many opponents, when the federal Department of Health and Human Services revised the recommended level of fluoride in water to avoid the possibility that children would receive too much. The recommended level had been 0.7 to 1.2 milligrams per liter; the department last year advised that it not exceed the lower end of that range.

In the last four years, about 200 municipalities nationwide have stopped fluoridating the water. Antifluoride groups cite this as evidence that more people are acknowledging the dangers.

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