Freaked out by the chart about lead in toothpaste? Thinking you should stick to a fluoride-free toothpaste in the no-lead-detected section?
In evaluating the chart, we need to ask:
How much lead will your child be consuming if you use a grain of rice sized amount of toothpaste to brush their teeth, assuming they swallow it all?
Let’s look at the 100 ppb section (Rubin 2025), which is where the toothpastes that my kids typically use are found.
100 parts per billion tells us the concentration of the lead, but we need to convert it to a measure like micrograms per gram to know how much is in the toothpaste, and we need to know how much toothpaste the child is consuming.
How much toothpaste is it?
Fluoride Use in Caries Prevention in the Primary Care Setting describes a 1-inch strip of toothpaste as 1 gram, a pea-sized amount as ¼ of an inch, and a grain of rice as half the size of a pea (Clark et al. 2014). A grain of rice is thus 0.125 grams.
100 ppb of lead is 0.1 μg/g, so for the amount of toothpaste they’d be consuming, that would be 0.0125 μg lead in 0.125 grams toothpaste.
How much is too much?
No lead is good lead, but lead is everywhere in the earth’s crust, so it’s inevitable that we’re exposed to some lead.
An article about Afghan refugee children resettled in Washington State explored the relationship between their elevated blood lead levels and the aluminum cookpots they brought with them (Fellows et al. 2022). The authors of this study cite FDA’s interim reference levels (IRLs) for lead, which are the maximum daily dietary intakes of lead from food. The FDA derived an IRL of 3 µg/day for children and 12.5 µg/day for people capable of pregnancy in order to maintain BLLs below CDC’s previous BLRV of 5 µg/dL. The CDC has since decreased its blood lead reference value (BLRV) to 3.5 µg/dL. “Assuming a linear relationship between daily lead dose and associated BLL, the childhood IRL should be lowered to 2.1 µg/day.”
It would take 168 daily doses of toothpaste to reach this amount.
Conclusion: keep using fluoride toothpaste
Children are doubtlessly exposed to other sources of lead, so this toothpaste won’t be their only contribution to this max, but these findings should not push you to abandon fluoride toothpaste, which is the most effective way to prevent dental cavities.
I would certainly avoid the toothpastes at the end of the list though, with 3000+ ppb lead!
Clark, Melinda B., Rebecca L. Slayton, SECTION ON ORAL HEALTH, Adriana Segura, Suzanne Boulter, Melinda B. Clark, Rani Gereige, et al. 2014. “Fluoride Use in Caries Prevention in the Primary Care Setting.” Pediatrics 134 (3): 626–33. https://doi.org/10.1542/peds.2014-1699.
Fellows, Katie M., Shar Samy, Yoni Rodriguez, and Stephen G. Whittaker. 2022. “Investigating Aluminum Cookpots as a Source of Lead Exposure in Afghan Refugee Children Resettled in the United States.” Journal of Exposure Science & Environmental Epidemiology 32 (3): 451–60. https://doi.org/10.1038/s41370-022-00431-y.
Rubin, Tamara. 2025. “Chart Comparing the Toxicant Profiles of Popular Toothpaste and Tooth Powder Products Tested by an Independent, Third-Party Lab in 2025.” Lead Safe Mama. January 31, 2025. https://tamararubin.com/2025/01/toothpaste-chart/.
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