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The Portland City Council voted 5-0 during a raucous public meeting Wednesday morning to add fluoride to Portland’s drinking water, ending the city’s status as the only major U.S. city that hasn’t approved fluoridation.

But opponents immediately vowed to try to thwart the effort by gathering enough signatures in 30 days to block the plan and force a public vote.

The unanimous decision — affecting about 900,000 residents in Portland, Gresham, Tigard and Tualatin — followed a nearly seven-hour hearing Sept. 6 in which people on both sides of the issue traded statistics and made impassioned pleas. Some argued that fluoride effectively fights tooth decay, for example, while others characterized fluoridation as forced medication.

Wednesday, the typically placid council chamber occasionally erupted in disorder. Mayor Sam Adams ejected several audience members and repeatedly reminded others to remain quiet. Some held anti-fluoride signs, booed and gave the elected officials a thumbs down. One protester unfurled a white sheet from a balcony. “Public water deserves a public vote,” the homemade banner read.

Council members were undeterred. “This is the right thing to do, and I’m pleased to vote aye,” said Commissioner Dan Saltzman, drawing jeers from the crowd.