For more than 60 years, fluoride has been added to Healdsburg’s water to fight tooth decay.

But that could end if opponents of fluoridated drinking water convince a majority of voters to stop the practice.

Activists recently filed a notice of intent to begin circulating petitions to put the issue on the ballot.

Healdsburg is the only city in Sonoma County to add the chemical compound to its water. But the Sonoma County Water Agency is studying whether to fluoridate its water, which gets delivered to Santa Rosa, Petaluma, Rohnert Park, Cotati, Windsor, Sonoma, Valley of the Moon and Marin County.

“I am trying to stop the Sonoma County Board of Supervisors (who oversee the Water Agency) to help them not vote for fluoridation,” said Dawna Gallagher Stroeh, who also is spearheading the attempt to end the practice in Healdsburg.

She maintains that the fluoride in water is unsafe and doesn’t work.

“Teeth in Healdsburg are no better that teeth in Sonoma County,” said Gallagher Stroeh, a former Rohnert Park City Council member.

Healdsburg Mayor Jim Wood, a dentist, disagrees.

“I do believe water fluoridation is a time-proven, research-proven way to reduce cavities in children — no question,” he said. “I believe it’s effective and very safe.”

It was 1952 when Healdsburg voters approved the fluoridation of the town’s water, a practice that gained momentum across the country after World War II and has now grown to include water systems serving more than 200 million people.

Gallagher Stroeh said a couple of generations of Healdsburg residents have had no say in the matter and it should be presented to voters again.

She said her “team” should have no problem collecting enough signatures to place it on the ballot, which requires 10 percent of the nearly 6,000 registered voters, according to the city clerk.

One of the proponents of the ballot measure is Healdsburg resident Barbara Wentzel.

She was unaware that Healdsburg adds fluoride to the water when she moved there three years ago. She worries about how it affects the health of her two-year-old grandson who stays with her.

Wentzel, an organic grapegrower, looked into getting a filter to remove the fluoride in her household water, but discovered it would cost $3,500. “I thought the best thing for me to do now is join forces to put it on the ballot, so people can be aware and make the choice,” Wentzel said.

The third supporter of the ballot initiative to stop adding fluoride to the drinking supply is Sebastopol dentist Michael Lipelt, who did not immediately return a call Friday.

But advocates for fluoridation say established science supports the practice.

“I hope the citizens realize the public health benefits of this and leave it in the water,” said Wood, the mayor.

Councilman Tom Chambers said he would be surprised if voters overturn fluoridation, which has “no deleterious effect as far as I’m concerned.”

“There are a lot bigger priorities out there,” he said.

Panels of experts from health and scientific fields have provided strong evidence over the years that water fluoridation is safe and effective, according to the federal Centers for Disease Control and Prevention.

The practice is backed by the U.S Surgeon General, World Health Organization, National Cancer Institute, and American Dental Association, which called water fluoridation “the single most effective public health measure to prevent dental decay.”

But skeptics point to studies in other countries that report virtually identical levels of decay among children raised on fluoridated and non-fluoridated water. They cite a 2006 National Research Council report that found fluoride can cause harm to teeth, bones, brains and endocrine systems.

At levels eight times greater than recommended, they say, ingesting fluoride can lead to mottled teeth and brittle bones, and more potential incidence of hip fractures among older people. Because it’s added to toothpaste, soft drinks and other consumables, critics argue that getting too much fluoride is a risk for communities that fluoridate their water.

In essence they say it is a form of mass medication.

But defenders of fluoridation in drinking water say studies have shown it reduces the decay rate by 25 percent, according to Santa Rosa dentist Anthony Fernandez, a member of the Redwood Empire Dental Association who has been a vocal proponent.

“It’s a real no-brainer in the scientific community. For people opposing it, it’s a more philosophical or political point of view,” he said.

He said that adding fluoride to water is like putting Vitamin D in milk to prevent rickets, adding iodine in salt to prevent goiter, or putting folic acid in bread to fight neural tube defects, all accepted practices.

The opposition, he said, may be well intentioned and health conscious, but “they are not able to discern the difference between junk science and real science — peer-reviewed, credible sources, and groups with a website with a political agenda.”

Fernandez said the average person would need to drink 600 to 1,200 gallons at a time to get a lethal dose of fluoridated water, but you can only drink eight-to-10 gallons of water before suffering from brain edema.

“The water will kill you before the fluoride kills you,” he said.

County health officials have advocated water fluoridation as a way to combat a tooth decay epidemic.

Both the Cotati and the Sebastopol city councils have opposed fluoridation of the county’s drinking water even though Sebastopol has its own water supply that would not be directly affected by the county water agency proposal.

But Sebastopol officials have raised concerns about fluoride leaching into the waterways and its effect on wildlife in the Laguna de Santa Rosa.

The county project to fluoridate water has an estimated cost of $8.5 million, with an annual upkeep of nearly $1 million, according to estimates released a year ago.

The much smaller Healdsburg system, which also provides water to adjacent Fitch Mountain, spends an “insignificant” amount of money for fluoridation — $40,000 annually — according to Ryan Kirchner, the city’s operations and utilities superintendent.

“Fluoride is pretty cheap,” he said.

In 2013, Healdsburg treated 711 million gallons of water, so the cost to fluoridate is estimated at less than six cents per 1,000 gallons, he said.

He said the city doses the water at .08 parts per million of fluoride, or less, and carefully monitors it to ensure it falls within state department of Public Health guidelines.

He acknowledged that anything in high doses, including fluoride, can be hazardous.

“Our role as operators of the water and wastewater systems is protecting the public health and the environment,” Kirchner said. “We take it pretty seriously.”