The Toothpaste Fairy drops by Sesame Street in Episode 2980 upon hearing that someone lost a tooth. At first, Big Bird mistakes her for the expected Tooth Fairy, to which she openly wonders why everyone who sees her thinks that. Unlike the money-distributing Tooth Fairy, the Toothpaste Fairy instead distributes toothpaste to children who lose their baby teeth, keeping a tube in a pouch.
She holds Alexia, who lost the tooth, to a promise to take care of her teeth, then announces she has a present for everyone else. Big Bird assumes everyone else is getting a tube of toothpaste, but she disproves him once more by granting toothbrushes "and a squeeze" of toothpaste to everyone else present. Big Bird is initially sullen, as he doesn't have teeth, but the Toothpaste Fairy lightens him up by suggesting he brush his beak.