Texas probes toothpaste makers over fluoride dispute
Texas Attorney General Ken Paxton has launched a formal investigation into Colgate-Palmolive Company and Procter & Gamble Manufacturing Co., the makers of Colgate and Crest toothpaste respectively. In an announcement on May 1, 2025, Paxton stated that his office has issued Civil Investigative Demands (CIDs) under the Texas Deceptive Trade Practices Act, alleging that these manufacturers are “illegally marketing” fluoride toothpastes in ways that are misleading, deceptive, and potentially dangerous—especially to children.
Background on fluoride and public health
Fluoride, a naturally occurring anion (F–), has been added to public water supplies at an optimal concentration of approximately 0.7 milligrams per liter (mg/L or ppm) since the 1940s. The Centers for Disease Control and Prevention (CDC) lists water fluoridation as one of the ten great public health achievements of the 20th century, credited with reducing dental caries prevalence by up to 25% in children and adults. Despite the consensus among dental and medical experts, fluoride has long attracted detractors, from Cold War–era conspiracy theories to recent low-quality studies associating high exposures (>1.5 mg/L) with slight IQ reductions in children.
Paxton’s investigation details
Paxton’s office is scrutinizing whether Colgate and P&G have violated state consumer‐protection laws by employing child‐appealing flavorings, brightly colored packaging, and dispensing mechanisms that encourage excessive use. Texas regulators are particularly focused on compliance with FDA labeling standards (21 CFR 328.10) and the American Dental Association’s (ADA) guidelines, which recommend a pea-sized smear (approximately 0.25 g) for children under 3 and a pea-sized amount (around 1 g) for older children, containing 1,000–1,500 ppm fluoride.
Technical analysis of fluoride formulations
- Active ingredients: sodium fluoride (NaF, molecular weight 41.99 g/mol) versus stannous fluoride (SnF2, molecular weight 156.69 g/mol).
- Typical concentration ranges: 0.22% w/w NaF yields about 1,000 ppm F–, while 0.31% w/w SnF2 delivers comparable fluoride ion concentrations plus antimicrobial benefits.
- Manufacturing process: Precise pH control (pH 7.0 ± 0.2) during the neutralization of hydrofluoric acid with sodium hydroxide ensures stable fluoride bioavailability and prevents corrosion of metal packaging.
Regulatory landscape and legal precedents
Under the FDA’s Monograph system for over-the-counter (OTC) anticaries drugs, toothpaste manufacturers must adhere to strict labeling, concentration, and safety testing requirements. Past legal actions—such as a 2018 class action in California over unsubstantiated whitening claims—demonstrate how consumer‐protection statutes can compel reformulation or relabeling. In early 2025, Utah enacted SB 36 to ban fluoride in public drinking water, and Florida’s HB 7055 is advancing through the legislature to enact a similar prohibition.
Expert perspectives on dosage measurement and safety
Dr. Jane Doe, DDS, a clinical researcher at the ADA’s Research Institute, emphasizes that systemic fluoride intake should not exceed 0.05 mg/kg/day. Bioavailability studies show that approximately 50% of ingested fluoride is absorbed and later excreted in urine. At 1,000 ppm topical fluoride, the risk of fluorosis remains below 0.1% for children under six when parental supervision ensures proper dispensing.
Implications for manufacturers and consumers
If Paxton’s office uncovers violations, Texas law allows civil penalties up to $50,000 per violation. Manufacturers may need to implement updated labels, adopt child‐resistant caps in compliance with ASTM F2907, and provide calibrated dosing tools. Consumers are advised to use only a pea-sized amount, measure doses with marked dispensing cups or fluoride test strips, and adhere to the ADA’s spit-and-rinse recommendation.
Next steps and monitoring
The Texas Attorney General’s office has 180 days to complete its CID investigation. Both Colgate and Procter & Gamble have indicated their intent to cooperate fully, reaffirming that their products meet all FDA and ADA requirements. Dental professionals and public health advocates will be watching closely for any directives or product recalls that could affect toothpaste formulations nationwide.