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For the fourth time, Portland has defeated an attempt to add fluoride to the water supply, making the city the largest in the United States that has avoided fluoridation efforts.

Portland has had fluoride wars for over half a century. In 1956, as cities all over the country were adding the chemical to their drinking water, Portland voters rejected a proposal to add fluoride to theirs. A similar proposal was struck down in 1962. It seemed that the tide had changed in 1978, when it was approved but, two years later, a court struck down the law before fluoride could be added to the water.

This time, according to Oregon Live, it seemed like it was in the bag. Five Portland city commissioners had voted to put fluoride in the water supply. Even after a petition garnered 20,000 signatures, leading to a referendum on the matter, supporters of the measure outraised opponents by 3 to 1. It was not enough though. Fluoride again failed to pass into law, with 60 percent of voters deciding against it.

Supporters are disappointed. They say that adding water will be a safe, affordable and non-invasive way to improve the dental health of children from low-income backgrounds. The Los Angeles Times reports that Oregon, which has a low rate of water fluoridation, has one of the worst track records for children's dental health; 35 percent of children from the state suffered from untreated tooth decay in 2007, compared to the neighboring state of Washington, which reports half that number.

Meanwhile, fluoride opponents have come a long way since the beginnings of the fluoride wars in the 1950s, according to the Associated Press. At that time, opponents of fluoride suggested that it was a Communist plot. Now, opponents say that it would pollute the city's drinking supply, adding traces of arsenic and other chemicals to the city's neighboring rivers.

Opponents also say that it violates the people's right to consent to medication, and say that some research suggests that high amounts of fluoride are linked to health problems, like kidney issues. Because fluoride exposure would be linked to the amount of water that people drink, there would be no way to track how much fluoride a person ingests.

Today, 66 percent of Americans around the country have fluoride in their water supply.

Portland approved a second initiative to renew a program called the Children's Levy, which provides money to support things like after-school programs and foster care.