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It’s been called one of the ten greatest public health achievements of the 20th century; adding cavity-fighting fluoride to the drinking water. But some people in Portland are fighting tooth and nail to keep fluoride out.

Portland is one of the largest cities in the U.S. without fluoride added to the water supply.

“And, because of that, their decay rates are not as low as they should be,” said Moffett Burgess, dental director at Seattle-King County Public Health. A TV ad running in Portland features a young mother who declares that because fluoride is not added to the water in Portland, “we have 40 percent more untreated tooth decay than Seattle.”

King County voted for fluoridation in 1968. Burgesss said almost three-quarters of American cities add fluoride to the drinking water. “And that’s been going on for about 60 years.”

On the other side of the debate in Portland is actor Ed Begley, who reminded viewers in an ad that he played a doctor on TV. “You don’t need to be a doctor, however, to know that adding fluoridation chemicals to our water is a 1940’s idea that doesn’t make sense today.”

Begley argued that fluoride has little benefit in drinking water because it works topically, not by swallowing it.

Burgess, at the health department, says it’s true that fluoride works topically. But Burgess insists fluoride in the water is an effective, inexpensive benefit, particularly for the poor.

“They may or may not have a standard routine for brushing their teeth with fluoride toothpaste so that’s one of the groups that benefits the most from fluoride in the water,” said Burgess.

The Rose City fluoride critics, known as ‘Clean Water Portland,’ characterize fluoride as a contaminant, a chemical or at the very least an additive. But Burgess says it’s naturally occurring in some water supplies.

Ballots are due Tuesday in Portland and a recent TV news poll shows the anti-fluoride forces leading by nine points.