During the development of the toothpaste dispenser programme, Dentaid became aware that the current ISO standard prohibited the use of containers over a certain size for packaging fluoride toothpaste. This regulation had been inserted during a revision of ISO standards many years ago as a safety measure against potential fluoride poisoning from ingestion. However, subsequent science had proven that the limit on the maximum concentration of fluoride in toothpaste was sufficient to protect the public from fluoride poisoning as a result of ingestion. In essence, vomiting occurs before fluoride toxicity reaches a dangerous level. Unfortunately, as no-one had conceived a toothpaste dispenser or similar receptacle, this anomaly remained part of the ISO standard, rendering the toothpaste dispenser and other similar initiatives to not comply with ISO standards thus potentially prohibiting its use by organisations who tie themselves to ISO standards. Dentaid therefore lobbied the FDI World Dental Federation, the CTPA (Cosmetics Toiletry and Perfumery Association - who represent major toothpaste manufacturers) and others, to support Dentaid’s proposal to the ISO committee reviewing the standard to make an exemption for such receptacles in community based programmes. This exemption was accepted by the Committee reviewing the ISO Standards during their September, 2006 meeting in Shenzuan, China and while there are several committee stages still to go, probably taking another 1 –2 years, this change to the ISO standard is an important step in the development and delivery of fluoride tooth brushing programmes in schools and other community environments in middle and low income countries.