Texas Attorney General Ken Paxton’s agreement with Procter & Gamble regarding imagery of fluoride on children’s toothpaste has sparked both praise and criticism, renewing the debate on consumer protection amidst rising concerns about fluoride exposure.
Paxton announced on January 8 that his office had reached an agreement with Procter & Gamble Manufacturing Company, the maker of Crest toothpaste, requiring the company to update the marketing and packaging of its children’s products to depict the recommended amounts of fluoride toothpaste accurately.
Paxton’s announcement noted misleading images showing large dollops of toothpaste could encourage overuse and pose health risks to children.
Under the agreement, Procter & Gamble will ensure that Crest children’s toothpaste packaging depicts appropriate amounts of toothpaste, with updated packaging rolling out on January 1, 2026.
The company is required to maintain compliance for five years.
The agreement follows a similar settlement Paxton’s office reached with Colgate in 2025, which his release described as the first of its kind.
Paxton said in a statement that parents should not have to worry about “deceptive marketing endangering their children,” adding that excessive fluoride exposure can put children’s health and brain development at risk. His press release framed the agreement as part of a broader effort to align toothpaste manufacturers with federal health guidance.
BREAKING: I secured a major agreement with the Crest toothpaste manufacturer to protect children from excessive fluoride exposure. pic.twitter.com/3kVX3DxzWU
— Attorney General Ken Paxton (@KenPaxtonTX) January 8, 2026
The settlement comes as litigation over fluoride marketing and exposure continues nationwide.
In January 2025, a class action lawsuit was filed in federal court in Illinois alleging that Procter & Gamble deceptively marketed children’s Crest toothpaste by depicting excessive amounts of fluoride, omitting age restrictions, and using flavors that encourage ingestion. That case was brought by attorney Michael Connett of Siri & Glimstad LLP and remains pending.
Connett said the Texas agreement represents progress but leaves key issues unresolved.
“I do think it’s worth noting that the agreement does not require P&G to comply with the current requirement that kids under 3 use no more than a RICE GRAIN (aka smear),” Connett told The Dallas Express via text.
“While it’s good to see some forward progress, it is not good enough for P&G to be allowed to continue telling parents that 2-year-old children can use a pea-sized amount. That is NOT the current guideline from health authorities, including pro-fluoride dental organizations like the ADA.”
The American Dental Association website states, “The ADA recognizes the use of fluoride and community water fluoridation as safe and effective in preventing tooth decay for both children and adults.”
Some dental professionals welcomed the agreement while criticizing the process that led to it.
Dr Griffin Cole, DDS, NMD, a biologic dentist who grew up in San Antonio and now practices in Colorado, said the settlement addresses a long-standing concern.
“Attorney General Paxton’s agreement with Procter & Gamble is a step in the right direction for the health of Texas’s children and one that is long overdue,” Cole told The Dallas Express. “It shouldn’t have required a lawsuit to bring this to fruition, but this is a win for all of us concerned about fluoride toxicity.”
Anti-fluoride activists in Texas also reacted to the announcement by drawing a distinction between toothpaste and fluoridated drinking water, which remains common across the state.
Regina Imburgia, a Dallas-based activist who has repeatedly urged local officials to end water fluoridation, said the agreement does little to address what she sees as a larger problem.
“My first thought is: ‘Great’ when any movement is made to reduce fluoride exposure, but buying toothpaste is an elective situation,” Imburgia told The Dallas Express via text.
“Community water fluoridation uses our tax dollars to raise the fluoride level in our tap water. Surely, Paxton could add some weight to this issue.”
Imburgia said policymakers should emphasize the difference between topical, pharmaceutical-grade sodium fluoride used intentionally on teeth and fluoride compounds added to municipal water supplies.
Procter & Gamble, for its part, said the agreement does not reflect any admission of wrongdoing.
In a statement emailed to The Dallas Express, a company spokesman said, “P&G and the Crest brand are fully committed to delivering safe, reliable products that benefit the oral health outcomes of our consumers. The quality and safety of our products is our top priority.”
The spokesman added that the company was “pleased that the Texas Attorney General acknowledged in the settlement that our products comply with all laws and regulations regarding directions for use,” and said Procter & Gamble is “voluntarily agreeing to ensure that our artwork reflects recommended dosing levels for children.”
The agreement comes amid heightened scrutiny of fluoride exposure more broadly, including recent federal court rulings and ongoing appeals over community water fluoridation, according to prior reporting by The Dallas Express and advocacy groups tracking the issue.
For now, Paxton’s office has characterized the Crest agreement as a consumer protection measure focused narrowly on marketing practices, even as critics on both sides say it may fuel a wider debate over fluoride policy in Texas and beyond.