How the 'The Tooth Fairy' has become big business

Issue 9

“What is the going rate for the Tooth Fairy these days?”

“What is the going rate for the Tooth Fairy these days?”

It’s an interesting question. Historically, the Tooth Fairy exchange rate has kept up with the Consumer Price Index (CPI), from all the way back to the early 1900s. According to the Tooth Fairy Poll®, the rate of gift-giving for lost deciduous teeth has tracked along with the S&P 500 since 2007.

Yes, things got a little tight around then (as we all may attest to with our practice revenues taking a decline), but the Tooth Fairy has exceeded expectations in the giving trend, and the amounts have escalated since 2007.

Yes, Tooth Fairy inflation is on the rise.

As we all know, it is customary to give a something when the child loses a tooth. There were myths and folk tales about disposal of deciduous teeth as well as fairies, but The Tooth Fairy did not “appear” until the early 1900s.

Legend has it that money or a token (in some cases fairy glitter dust) is left in place of the lost primary tooth in this rite of passage towards a permanent dentition. The United States is not alone in our acceptance of the Tooth Fairy folklore. It is worldwide tradition with a variety of means of celebration.

As recent as 1965, the rate was a dime. It escalated to $2 in the mid 1990s. It seemed so easy when you only gave a quarter, or even a dollar. There were no expectations of anything more until the price wars started.

Lately, the Tooth Fairy appears to be big business. Visa now has a downloadable Tooth Fairy calculator app to determine the appropriate amount per parental age group, education level, and income bracket!

It isn’t just in real estate where it’s all about location, location, location either. Where you live also determines what the Tooth Fairy is doling out. The range now seems to be $3.30 in the Midwest to $4.10 in the Northeast.

The national average is $3.70, which is up 23% from last year and 42% in two years. Two percent of parents are giving $50 per tooth and I understand there are other parents who are topping the $100 mark. Parents use the monetary reward as a jumping off point for saving college funds or merely an incentive to proper oral care for the sparkling new tooth. Regardless, primary teeth are big business.

I have also heard of families that give gifts in lieu of cash. Though this is less than 2% of all Tooth Fairy visits, there are a wide variety of other gifts that are given. Candy, cookies, and gum are left (though, as a dentist, I would never suggest that to patients).

One clever family started a snow globe collection. I have also heard of families creating an “add a pearl” necklace for little girls. Books, graphic novels, a cool new toothbrush, gift certificates for frozen yogurt, foreign coins, or small notes are also alternatives. Some families have a rule of three: three coins or bills, with one to spend, one to save, and one to donate. This does instill a lifelong lesson in giving back, which I believe is a great idea.

What happened to the days of giving a quarter or some small change? Parents do not want to be “outdone” by their neighbors or their children’s friend’s parents. There are also some thoughts that, due to the stress of the working parent and the lack of time they are spending with their children, the gift-giving gets a little higher. But at what point is this truly overindulgence? That is only for the parents, their bank, and their conscience to determine.

Regardless, it does seem like money is the “tooth fairy standard.” How much? That is truly a parent’s choice. Do you want to be competitive with your child’s friends or create your own standard of comfort? That is the $1 million question! Personally, I would like to see the tradition trend to giving a new toothbrush, but I don’t know how far that will go with my grandchildren.

We all know that, for the great majority of our patients, they will lose 20 primary teeth. How those little pieces of enamel and dentin are monetized is a question for the ages.

Dr. Sheri B. Doniger is a leading dental clinician, author, educator, and consultant who practices dentistry in Lincolnwood, Ill. She can be reached by email at

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