After a five-hour meeting Tuesday, the Sonoma County Board of Supervisors approved a $103,000 study to analyze the feasibility of fluoridating the county's water supply. The decision drew concern from some Petaluma residents leery of the costs and health effects, and support from local health officials.

The additional analysis comes after a year-long study authorized by the Board of Supervisors last year concluded that while fluoridation could be accomplished, it would cost approximately $8.5 million up-front in capital improvements to the county's central water system, plus an additional $973,000 per year to keep the program going.

Fluoride was originally introduced to the U.S. water supply in the 1970s. Today, about three quarters of the nation's public water systems are fluoridated, reaching approximately 196 million people nationally.

The new study authorized Tuesday is meant to help explain how the project costs would be funded and if they could be passed on to ratepayers. David Rabbitt, Petaluma's representative on the Board of Supervisors, has long supported the fluoridation of county water, but admitted that the costs were significant.

"The costs and logistics are still unclear to me," he said. "It's also unclear whether anyone out there is willing to pay for this through rates, or if we'd need to find grants or some other funding mechanism. So this new study will explain how we could roll fluoridation out, and make sure that people are really behind this."

Rabbitt's hesitation over public support stems from dozens of emails he said he has recently received on the subject of fluoridating the county water supply and the many critics who showed up at Tuesday's meeting. The subject has been a hot-button issue locally for many years. While those in the medical community support it, some members of the public do not, citing safety and health concerns.

Dissenters often point out that most children do not drink tap water anymore and as a result, may not even be exposed to the fluoride intended to help them. They add that the costs of fluoridating the water supply far outweigh any potential benefits.

One particular source of opposition has been the local chapter of the Weston A. Price Foundation — a nonprofit focused on nutrition. Local resident and Sonoma County Price foundation member Jaana Nieuwboer said that she is concerned that public health officials are universally "medicating" a population. "Any supplements or additives to our drinking water should only serve to provide cleaner, safer, drinking water," she said. "(They should not) serve as an attempt to administer medication."

She and others argue that health problems, such as fluorosis — a staining of the teeth resulting from overexposure to fluoride; lowered IQ; and other harmful side effects can stem from added fluoride.

Health care officials throughout the world support water fluoridation, including the Centers for Disease Control and Prevention, the surgeon general, the World Health Organization and the American Dental Association. Ramona Faith, CEO of the Petaluma Health Care District, said that the district supports fluoridating the county's water supply. "Fluoride is needed for good oral health and we need to make sure it's available to everyone, including those without access to oral healthcare," said Faith.

Rabbitt added that the science behind the benefits of fluoride is strong. "You can argue about (how much fluoride is healthy), which is what naysayers will do, but the amount added to water has been proven safe and beneficial," he said.

But even if the study finds a funding mechanism for the program, fluoridation still has to be approved unanimously by all eight of the county's water retailers. Rabbitt said the last time a multi-agency agreement was undertaken in the county, it took more than eight years to finalize.

The Board of Supervisor's final decision on fluoridation is not expected until March of 2014.

(Contact Janelle Wetzstein at janelle.wetzstein@arguscourier.com.)