Texas Attorney General to investigate fluoride in toothpaste, citing HHS report as cause
AUSTIN (KXAN) — Texas Attorney General Ken Paxton announced in a Thursday press release that he has a new investigative target: Toothpaste.
Specifically, he said his office sent civil investigative demands to toothpaste manufacturers Colgate-Palmolive Company and Proctor & Gamble Manufacturing, over their use of “misleading, deceptive, and dangerous” marketing of children’s fluoride toothpaste.
“I will use every tool available to protect our kids from dangerous levels of fluoride exposure and deceptive advertising,” Paxton said. “Toothpaste manufacturers must follow state law to ensure that they aren’t putting Texas families in peril through their false, misleading, and deceptive marketing … As this investigation continues, I will take aggressive action against any corporation that puts our children’s health at risk.”
KXAN reached out to those companies and the Texas Dental Association for comment. Neither company is headquartered in Texas.
Colgate sent KXAN a response that noted the “American Dental Association and other oral health professional organizations in the US continue to strongly endorse the use of fluoride in oral care products, including children’s toothpaste.”
“Tooth decay is the most common chronic disease of childhood in the United States, and poor oral health can have a negative effect on children’s quality of life, performance at school, and success later in life. Our children’s toothpastes that contain fluoride provide important oral health benefits, are safe to use as directed, and provide directions for proper use consistent with US Food and Drug Administration requirements, including appropriate age restrictions and directions regarding the amount of toothpaste children should use,” it said.
What does the research say?
In his release, Paxton accused the companies of “encourag[ing] kids to ingest fluoride toothpaste and mislead their parents to use far more than the safe and recommended amount of fluoride toothpaste.”
A 2018 meta-analysis found that flavoring agents “did not increase ingestion of toothpaste by children.”
In his release, Paxton cited an August 2024 meta-analysis by the US Health and Human Services’ National Toxicology Program, which found that excessive fluoride exposure has a negative impact on children’s IQ.
However, it also rated 52 of the 74 studies that it reviewed as “low quality” with a “high risk of bias.”
“The determination about lower IQs in children was based primarily on epidemiology studies in non-U.S. countries such as Canada, China, India, Iran, Pakistan, and Mexico where some pregnant women, infants, and children received total fluoride exposure amounts higher than 1.5 mg fluoride [per liter] of drinking water,” the report’s authors wrote. “The U.S. Public Health Service currently recommends 0.7 mg/L, and the [WHO] has set a safe limit for fluoride in drinking water of 1.5 mg/L.”
The report’s authors also noted that more research is necessary to know how, or if, fluoride exposure at the recommended level affects child development.
What does the ADA recommend?
The American Dental Association, the world’s oldest and largest dental organization, acknowledged in 2014 that there are dental risks from overuse of fluoride and recommended caregivers talk with a dentist before using a fluoride toothpaste.
“All children should undergo a caries risk assessment before their dentists make recommendations associated with preventing or controlling dental caries … It also is critical that the dentist assess a child’s total fluoride exposure from all sources when developing a preventive treatment plan that is directed at optimizing caries control and safety,” the ADA wrote.
According to the ADA’s website, it only puts its “seal of acceptance” on toothpaste with fluoride and without flavoring agents that cause tooth decay.
Regardless of age, ingesting large amounts of toothpaste isn’t safe.
Where does state law stand?
Texas law allows for the addition of fluoride to public drinking water, and allows schools to run “fluoride mouth rinse programs.” The state’s health code requires public water utilities to notify customers if it intended to cancel fluoridation of drinking water.
In February, Texas Agriculture Commissioner Sid Miller asked Gov. Greg Abbott to ban fluoridation, as previously reported by Nexstar.
Lawmakers introduced SB 2653 and HB 3429 this session to ban fluoride in public water; however, both are still pending in committees.
