CLEARWATER — Pinellas County commissioners voted 4-3 Tuesday to end the seven-year practice of putting fluoride into drinking water, a public health effort that riled conservative activists and skeptics.

More than a dozen dentists and pediatricians told commissioners that adding fluoride improve’s people’s dental health and lowers costs to the county for dental care for the needy. But critics seized on recent concerns about too much fluoride having side effects on young children and fears of government medicating the public. Some critics compared it to Soviet and Nazi practices.

Numerous federal agencies and medical groups say the practice is acceptable with the right dosage. First introduced decades ago, fluoridation has been hailed as one of the great public health advances of the 20th century.

After more than three hours of debate, the board voted to stop the practice, which costs $200,000 a year. Commissioner John Morroni, who supported the practice when it started in 2004, joined Norm Roche, Neil Brickfield and Nancy Bostock in the majority. Roche had spearheaded the effort to end the practice.

Morroni compared it to the disputed federal health care reform law mandating that individuals buy health insurance.

“I don’t think the county government should be telling people they have to have fluoride in the water,” Morroni said.

The county provides water to about 700,000 customers in the county, and Commissioner Ken Welch warned the move will leave Pinellas ranking the lowest of Florida’s largest counties on population with fluoridated water. It will not affect St. Petersburg, which handles its own water and uses fluoride.

“I do think this is a public health issue,” Welch said, noting, “We’re getting away from the facts of the matter.”

In January, the U.S. Department of Health and Human Services proposed reducing the recommended fluoride level to 0.7 milligrams per liter of water. And the Environmental Protection Agency is reviewing whether the maximum cutoff of 4 milligrams per liter is too high. Those moves came after a reported increase in spots on children’s teeth, attributed to too much fluoride.

The standard since 1962 has been a range of 0.7 to 1.2 milligrams per liter.

Pinellas County government was a latecomer to the widespread and decades old practice of water fluoridation, which helps prevent tooth decay. Commissioners voted in August 2003 to add the chemical to the water starting in summer 2004. The vote arose passions on both side, and ended Pinellas’ status as the largest water supplier in the eastern U.S. that did not fluoridate its water supply.

On Tuesday, as commissioners were voting, the county’s own website touted the benefits of water fluoridation. “Health experts endorse water fluoridation as the single most effective public health measure to improve oral health,” the website states, noting that it can reduce tooth decay, strengthen enamel and is a cost-effective way to improve community dental health.

The city of Dunedin last month debated whether to stop fluoridating its water supply, more as an economic than health issue.

After a contentious debate, city commissioners decided to schedule another public hearing at which they would consider putting the question on a referendum next year.