Charlie Graff wants Bozeman to stop putting fluoride in its drinking water.

“No one really knows for sure if it’s safe or not,” he told Bozeman City Commissioners earlier this month. “There are some of us out here who are really concerned.”

Graff, a sophomore at Montana State University, won’t drink or bathe in unfiltered city tap water. He drinks bottled water and showers beneath a special filter that neutralizes fluoride.

Despite widespread scientific support for the cavity fighter, the decades-old debate about whether fluoride is safe has bubbled up again.

“On the typical year, I’m going to estimate I get about four comments from people who are opposed to it and about four inquiries from people who want to make sure their water is fluoridated,” said Rick Moroney, superintendent of Bozeman’s water treatment facilities.

“It’s the only process that we do to the water that’s not required by state or federal regulations,” he said. “There’s a wealth of information from people supporting it and also much information from people who are opposed.”

The issue of fluoridation made national headlines last year when the Pinellas County Commission in Florida voted to stop putting fluoride in its public water supply. The county ended the practice citing cost savings and skepticism about the benefits.

Many other towns have done the same, even though federal government and federal health officials maintain their full support for water fluoridation, which they say reduces tooth decay by 25 percent.

Bozeman has been adding fluoride to its water since 1953.

In Montana, at least six other cities add fluoride to their water, including Chester, Colstrip, Hardin, Laurel, Miles City and Scobey, Moroney said.

Montana is one of the least fluoridated states, ranking 46th in the nation, according to the Centers for Disease Control and Prevention. About 30 percent of Montanans have fluoridated water.

Maryland is the most fluoridated, with nearly every resident on a fluoridated water system. Hawaii is the least, with only 11 percent having fluoridated water.

Opposition to fluoridation has existed since the process began in the 1940s, and the issue has frequently been the subject of conspiracy theories.

Opponents of fluoride, such as the Fluoride Action Network, claim fluoride is a toxic substance that should not be administered by the government. Anti-fluoride activists claim fluoride lowers children’s IQs, causes kidney disease and weakens bones.

Recent debate has been sparked in part by government officials cautioning people about excessive fluoride.

The National Academies’ National Research Council found in 2006 that children may develop dental fluorosis — stains or pits on their teeth — if the fluoride in their water exceeds the maximum level set by the U.S. Environmental Protection Agency.

The report also found that people who drink water fluoridated at the maximum level – 4 parts fluoride per million parts water – over a lifetime are at an increased risk for bone fractures.

Bozeman puts 1 part per million in its tap water, Moroney said.

The city uses a powder, sodium silicofluoride, and a liquid, hydrofluorosilicic acid, to adjust fluoride levels in the water, he said. Some fluoride, generally less than 0.5 part per million, is in the water naturally.

Last year, the EPA said it would review its maximum levels for fluoride, which are 0.7 to 1.2 parts per million.

“The EPA indicated that they were going to recommend that we lower it to 0.7 parts per million, and they indicated that the formal recommendation was going to come out last spring,” Moroney said.

But that recommendation hasn’t come out yet, he said.

Moroney notified Bozeman City Commissioners last year that the city might reduce fluoride levels based on the EPA’s recommendation. Commissioners directed him to continue adding fluoride at the recommended amount.

Bozeman spends about $35,000 a year on fluoridation, Moroney said.

In Europe, fluoride is rarely added to water supplies. In England, about 10 percent of the population has fluoridated water.

In the U.S., the Centers for Disease Control and Prevention and the American Dental Association continue to recommend water fluoridation, saying it’s especially important for low-income communities where people can’t afford dental care. The dental association recommends fluoride pills for children living in non-fluoridated areas.

Graff said he went fluoride-free a couple years ago. If he does drink city water accidentally, he said he sometimes gets a stomachache. In addition, he said he has white spots on his teeth that he believes is dental fluorosis and is the result of drinking fluoridated water as a kid.

“When I found out we were getting more than water, it concerned me,” he said. “I don’t know what to think about it.”

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