In the latest turn of events proving that packaging copywriters and pediatric dentists do not always share the same moral universe, a federal judge has allowed a lawsuit to proceed questioning whether Crest’s box art encourages kids to slather on more toothpaste than is safe.
Yes, the cartoon that looks suspiciously like a full-length toothpaste strip on a toothbrush might now be the subject of serious courtroom scrutiny — and a parade of very worried parents.
U.S. District Judge Jorge Alonso green-lit the parents’ motion, noting that the picture on Procter & Gamble’s boxes — showing an entire ribbon of toothpaste atop a child’s toothbrush — could indeed violate state consumer protection laws if it leads children to ingest unsafe amounts of fluoride.
“The fact that swallowing fluoride poses health risks to children is an essential element of the story plaintiffs are telling; it is the reason for the recommendation that they use only a smear or dab,” Judge Alonso said.
In plain English: if your packaging looks like cake frosting for a toddler’s brush, you might be on the hook when someone actually eats the frosting.
Why the fuss?
Fluoride is a tooth-defender — the World Health Organization pegs the safe fluoride concentration in toothpaste at about 1,000 to 1,500 parts per million.
But ingesting too much fluoride can cause dental fluorosis, a cosmetic discoloration that the Cleveland Clinic notes isn’t painful but is certainly not on anyone’s birthday wish list.
For that reason, pediatric guidance is clear: for young children, use only a smear or a pea-sized dab and encourage vigorous spitting (and maybe a therapist for packaging-induced disappointment).
Procter & Gamble tried to shut the case down, arguing that federal law preempts the claim and that its instructions are clear.
The judge wasn’t ready to back-flip on dismissing the suit entirely.
The decision leaves room for parents to probe whether the smiling tube on the box is more advertising flourish than public-health safe practice.
Meanwhile, Colgate — perhaps reading the toothpaste-splattered writing on the bathroom wall — quietly agreed to change its packaging after Texas Attorney General Ken Paxton negotiated a settlement.
Colgate and Tom’s of Maine replaced their full-strip imagery with the now-fashionable “pea-sized” amount, rolling out new packaging on November 1, 2025.
Enter the billboard of modern life: if your brand sells an item that can be harmful when consumed in excess, your pictures had better toe the line between aspirational and actionable.
Otherwise, a parent will spot it, and a lawyer will smell opportunity.
The case comes at an awkward time for fluoride politics in general.
U.S. Health Secretary Robert F. Kennedy Jr.’s moves on policy this year — including plans to have the CDC step back from recommending fluoridation — have amplified the debate.
Kennedy praised Utah Governor Spencer Cox for banning fluoride in drinking water, saying, “I’m very, very proud of this state for being the first state to ban it, and I hope many more will,” a line that delighted anti-fluoride activists and terrified dental hygienists everywhere.
But public-health groups caution against jumping to alarm.
The American Cancer Society says most studies “have not found a strong link” between cancer and water fluoride levels, and federal public-health bodies long defended fluoridation as a major factor in reducing tooth decay, especially in under-resourced communities.
The toothpaste lawsuit, then, is not really about whether fluoride helps teeth — it’s about whether packaging can reasonably be read as an instruction manual to overuse it.
Whatever the outcome, expect shelf art to get a makeover.
Brands that once treated box imagery like a tiny billboard for optimism may need to hire pediatric toxicologists as consultants.
Maybe future toothpaste boxes will look less like a dessert menu and more like a stern parent: “One pea. Spit. Repeat.”
Until then, parents might want to keep the toothpaste cap on (literally) and teach kids that not everything pretty-looking is edible — especially if it fights cavities.
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