Fluoridation is said to produce stronger teeth, but Monday night’s packed-house hearing before Skagit County commissioners showed it also produces strong feelings — pro and con.

“This is pretty weird,” said Cheryl Harrison, a speaker who opposes fluoridation.

“My dentist is here, my son’s oral surgeon is here, and they’re all wearing ‘yes’ buttons,” said Harrison, who was among several to speak against the proposal.

Harrison said she doesn’t usually like taking a side against other people in her community, but she felt she had to this time.

The commissioners, sitting as the County Board of Health, took comments for almost two hours.

Despite the passions on both sides of the fluoride issue, it appeared unlikely that the board would act soon.

Don Munks, the health board and commission chairman this year, told the crowd the board’s consideration of the proposal would be “a long process.”

“We’re not ready to render a decision and are not going to render a decision tonight or in the near future,” he said.

A group called “Citizens for a Healthy Skagit” wants the commissioners to use their health board authority to order the Skagit Public Utility District to add fluoride to water distributed through its main system. The system provides water to about 50,000 customers in Burlington, Mount Vernon, Sedro-Woolley and surrounding areas.

Fluoride helps prevent cavities by increasing the tooth’s resistance to acid and reducing acid production by bacteria living in the mouth.

Advocates Monday said adding fluoride to the water supply would help prevent tooth decay and costly emergency room visits by patients without access to regular dental care.

Proponents say the health risks associated with fluoride are negligible at the 1 part per million (ppm) concentration normally utilized in water supplies. The federal limit for fluoride exposure is 5 ppm.

But fluoride opponents, organized as “Skagit Clean Water,” said the health risks of adding fluoride to the drinking water outweigh the rewards. They said a good diet and oral hygiene are the key to healthy teeth, not adding fluoride to the water.

In her comments to the board, Harrison said adding fluoride to the water would take away individuals’ right to chose whether or not to take it.

“Why not spend money on providing topical fluoride treatments to this county’s children and elderly unable to afford treatment themselves?” she said. “There is no reason to force people against their will to drink fluoride in their water supply.” Opponents also disputed how much fluoridated water would benefit dental health. Dorris Deamud of Mount Vernon said teaching children good diet and hygiene is more important.

“Fluoridation is not a panacea for no cavities,” she said.

Many local dentists spoke in favor of fluoridation at Monday’s meeting, saying it is a safe and effective way to help prevent tooth decay. Pediatric dentist Norm Bunch said he routinely sees toddlers with swollen faces from abscessed cavities in his Mount Vernon practice.

Dentist Sarah Hill, who provides dental care in hospitals and clinics, spoke emotionally about her young patients. Hill said she would always counsel patients on good diet and hygiene, but fluoride is a safe and effective part of fighting decay.

“Fluoride is not a panacea,” she said. “It’s not a perfect thing… This is the safest way to give them a boost in the right direction.”

The county is still a long way from a final decision, with unresolved financial and legal questions to address.

The PUD has questioned whether the board can legally order it to add fluoride to the water. Don Anderson, a civil lawyer for the county, told the board Monday that no past cases provide a precedent to determine whether it has that authority.

“There’s no strong direction one way or the other at this point,” Anderson said.

The PUD has hired a consultant to figure out how much equipment and maintenance for the system would cost. District 3 PUD Commissioner James Cook said an estimate would be available in mid-October.

“If you guys want to tell us to do this, please send a check,” Cook said.

Tracy Garland of the Washington Dental Service Foundation said the foundation would cover the cost of installing the equipment. The foundation has taken the lead in the fluoridation campaign. It is the public service arm of the Washington Dental Service.

Munks said the board would hold more public meetings on the subject, culminating in a formal public hearing.