Recently, my daughter lost her very first baby tooth. It happened one afternoon while eating lunch; her loose tooth just popped right out of her mouth and into her bowl of ramen noodles. After I fished out the tooth with my fingers and wiped away her tears, my sweet little daughter looked up at me with her new toothless grin and exclaimed: “This means the Tooth Fairy is coming tonight! I’m gonna be rich!” Well, maybe not exactly rich. I’m still in grad school, so despite the fact that inflation has driven up the price of a tooth to nearly four dollars, in my house the Tooth Fairy only pays a measly buck.
It’s a well-documented fact that historians have a tendency to over-analyze life events when normal people just enjoy them (Don’t ever go see a historical movie with one of us, as we will ruin the fun). So naturally, my daughter’s first brush with the Tooth Fairy got me thinking about the history of this dental-obsessed pixie. Where did the modern concept of the Tooth Fairy come from? How has the tooth fairy been depicted in American culture over time? Has the Tooth Fairy been co-opted and commercialized to the extent that Santa Claus and the Easter Bunny have? Over the course of a few days, I conducted a quick Google search and also perused a few academic databases to see if I could get some answers. What I found was an eclectic, odd, and somewhat sparse accounting of Tooth Fairy history.
The Tooth Fairy in American Print Culture
Most sources date the modern Tooth Fairy to the dawn of the twentieth century, but how and why she emerged at this time is not exactly clear.  Her popularity, nonetheless, grew over the next few decades and according to the website, The Straight Dope, she may have first appeared in print in a 1927 children’s play by Esther Watkins Arnold called, appropriately enough, The Tooth Fairy. Although Google Books has an entry for the play, my go-to academic database, Worldcat, does not. Worldcat does, however, have several listings for plays written by Arnold during this period, and so it is possible that the play exists. In any event, I did find a brief reference to the Tooth Fairy that actually predates Arnold’s play in a 1925 edition of Cosmopolitan.
It turns out that the Tooth Fairy, when compared to other mythical childhood figures like the Easter Bunny or Santa Claus, made few appearances in American newspapers and magazines during the first half of the twentieth century. I found a handful of references in magazines like Collier’s Weekly , Ladies’ Home Journal, and LIFE , but she did not become a ubiquitous cultural presence until the 1950s. Folklorist Tad Tuleja has suggested that in the postwar years, child-centered family culture as well as increased attention to dental hygiene may have helped foster the late-twentieth century explosion of children’s books, cartoons, and other materials focusing on the Tooth Fairy.
Cold War Tooth Fairy?
Perhaps the strangest but coolest tooth fairy-related history item I stumbled across was the “St. Louis Baby Tooth Survey.” From 1959-1970, physician Louise Reiss, with the help of the Washington Dental School and St. Louis University, collected and tested over 300,000 donated baby teeth from St. Louis area children. Reiss believed that communities near nuclear weapons testing sites were being exposed to harmful levels of radiation. To test this hypothesis, Reiss and her team analyzed the donated teeth for heightened levels of strontium-90. Instead of placing their teeth under their pillow at night, local children were encouraged to donate their teeth to science.  According to the Washington University School of Dental Medicine’s online exhibit:
“The Greater St. Louis Citizen’s Committee for Nuclear Information (CNI) initiated and conducted the collection of teeth in the St. Louis area, assisted by area dentists who collected and submitted teeth. A large and active group of CNI volunteers coordinated the distribution of tooth collection forms to all St. Louis City and County schools, private and parochial schools, libraries and even drugstores throughout the area. Assistance came from church and social organizations and Boy Scout, Girl Scout, YMCA and YWCA groups.”
The results of the St. Louis Baby Tooth Survey were quite startling. The first study issued in 1961 reported that strontium-90 levels in children’s teeth were steadily increasing over time. A second study released a few years later revealed that children born after 1963 had “fifty times more strontium-90 than those born before nuclear testing began”. The early findings of the survey helped convince President Kennedy to sign the Partial Nuclear Test Ban Treaty with the United Kingdom and Soviet Union, which ended above-ground testing of nuclear weapons.
With results like this, I am sure the Tooth Fairy didn’t mind missing out on a few hundred thousand teeth.
Tooth Fairy Smithsonian Project
So far, we have explored a brief history of the Tooth Fairy and how she contributed to ending the Cold War, but a lingering question remains: Where does the Tooth Fairy store all of those teeth anyway?
Well, the folks over at the Smithsonian have a sneaking suspicion that their venerable museum has become a storage site for, not only the Tooth Fairy, but also Rantoncito Pérez (the Spanish and Hispanic version of the Tooth Fairy). A few years ago, the Smithsonian curator in the Division of Medicine and Science, Katherine Ott, discovered an unmarked box containing several thousand teeth in a museum storage area. Now, although they turned out to be artificial porcelain teeth, Ott decided that it would be fun (and educational) to create a “Tooth Fairy File,” a video for children that explores the possibility that the Tooth Fairy and her associates use the Smithsonian to store their toothy treasures. According to Ott, the video introduces children to the material culture of the past:
“We used real objects and accurate, technical vocabulary: an early 19th century tooth key used for pulling teeth, a puppet from the early 1930’s made by Works Progress Administration artist Donald Cordry, sheet music from the DeVincent collection, a drawer of coins, shells, and other substances used as money, and cartes-de-viste and tintypes of children from the late 1800s.”
Ott hopes that the video (which you can watch here) will encourage children to come visit the Smithsonian and explore the museum’s vast collection of dental history materials. If you can’t make it to D.C., the museum also maintains a Flickr site with several photos of their collection, including those nifty nineteenth-century teeth keys, used for pulling teeth.
So, my quick Google search turned up some fascinating Tooth Fairy history, but I am still a bit puzzled as to why I was unable to find any vintage tooth fairy imagery. Is it because she’s not as commercialized as Santa or the Easter Bunny? Maybe it is because Christmas and Easter are annual holidays that center on, for better or worse, commercialized gift giving, whereas losing a tooth is an individual event that is usually celebrated with coins and dollars. I also wonder if the lack of a commercialized Tooth Fairy is the reason why we don’t have a singular vision of what she looks like? Most people agree that the tooth fairy is female (except here and here), but beyond that, her appearance varies considerably.
In the end, maybe it’s a good thing that the Tooth Fairy remains an enigmatic figure that has largely resisted cooptation and standardization by American corporations. After all, there is something kind of depressing about the fact that we often associate Santa with Coca-Cola and the Easter Bunny with Cadbury or Reese’s. Maybe the Tooth Fairy’s lack of corporate sponsorship is something worth preserving. 
Well, what do you think, Nursing Clio readers? I know we have a very intelligent and diverse readership out there, so help me fill in the blanks. Are there vintage advertisements that feature our elusive fairy? What about postcards, films, or newspapers? The modern concept of the Tooth Fairy has been with us for well over one hundred years, so it’s hard to believe that there is not a toothy treasure trove out there somewhere.
 The Tooth Fairy is, of course, a modern iteration of several different folk traditions that extend far back in time and place. Rosemary Wells examines the various “rites of passage” associated with childhood tooth loss in “The Making of an Icon: The Tooth Fairy in North American Folklore and Popular Culture,” in Peter Narváez, The Good People: New Fairylore Essays (New York: Garland Pub, 1991).
 Tad Tuleja, “The Tooth Fairy: Perspectives on Money and Magic,” in Peter Narváez, The Good People: New Fairylore Essays (New York: Garland Pub, 1991).
 Interesting point of fact: When I submitted this post to our editing team, fellow Nursing Clio blogger and chief copy editor, Dr. Elizabeth Reis mentioned that she was one of those children who donated her tooth to science. She even got the pin! In the blog post for Biopolitical Times, Dr. Reis briefly discusses her childhood experience in a broader context of what it means to be a medical donor.
 Interestingly, Tad Tuleja suggests that the Tooth Fairy is perhaps a mythical figure born of a modern capitalist ideology. While Santa Claus offers gifts in exchange for kindness and good behavior, the Tooth Fairy’s ultimate lesson is that anything, even baby teeth, can become a product of the free market. Tuleja, “The Tooth Fairy: Perspectives on Money and Magic,” in Narváez, Peter. The Good People: New Fairylore Essays, 419.