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Procter & Gamble has started sending updated Crest children’s toothpaste packaging to stores under an agreement with Texas Attorney General Ken Paxton following concerns that the previous boxes encouraged excessive fluoride use.
Paxton in 2025 began investigating Procter & Gamble and Colgate-Palmolive Company, which manufactures Colgate toothpaste, because officials said that they were advertising toothpaste containing fluoride to children in ways that were “misleading, deceptive, and dangerous.”
“When parents are teaching their kids the basic habit of brushing their teeth, they shouldn’t have to worry about deceptive marketing endangering their children,” Paxton said in a Jan. 8 statement. “Misleading images that show excessive amounts of fluoride toothpaste put children’s health and brain development at risk. This settlement is an important step in ensuring that large corporations ... no longer engage in these deceptive practices.”
Procter & Gamble, based in Cincinnati, said it was “fully committed to delivering safe, reliable products that benefit the oral health outcomes of our consumers,” and “voluntarily agreeing to ensure that our artwork reflects recommended dosing levels for children.”
Procter & Gamble began rolling out the updated packaging on Jan. 1.
Colgate-Palmolive reached an agreement with Paxton in 2025 to show a pea-sized amount of toothpaste in images of toothpaste on a toothbrush on packaging or in marketing.
The Centers for Disease Control and Prevention says parents should put an amount of toothpaste equivalent to the size of a grain of rice on the toothbrushes of children under the age of 3, and toothpaste equivalent to the size of a pea on toothbrushes for kids aged 3 to 6.
Fluoride is a natural mineral. It is included in many brands of toothpaste to strengthen tooth enamel, which results in better resistance to tooth decay, according to the American Dental Association.
Excessive fluoride ingestion during childhood can result in fluorosis, or the hardening of dental tissues, according to the National Academies.
Texas Attorney General Ken Paxton speaks at a news conference in Dallas on June 22, 2017. Tony Gutierrez/AP Photo
Paxton has aligned himself with the Make America Healthy Again movement associated with U.S. Health and Human Services Secretary Robert F. Kennedy Jr, who opposes adding fluoride to public water systems. Paxton is running for the U.S. Senate.
The agreement between Paxton and Procter & Gamble comes after a federal judge in Chicago rejected Procter & Gamble’s bid to dismiss a private lawsuit, saying it violated state consumer protection laws by depicting a full strip of toothpaste atop a toothbrush, with a seal of approval from the American Dental Association, on Kid’s Crest labels.
