Monstro's Tooth is an unlockable activated item.
- A friendly Monstro jumps on a random enemy, dealing 120 damage while destroying nearby obstacles like rocks.
- This item will target Isaac if it is used in a room without monsters and will cause damage.
- Monstro will target shopkeepers.
- Like Mom and Satan's stomp attacks, this attack is treated as an explosion, so Pyromaniac and Host Hat will be activated if Monstro falls on Isaac.
- This item does not affect Monstro.
- Book of Virtues: Spawns wisps in the middle ring, looking like teeth. These wisps shoot 50% slower than the average wisp, but deal 12 damage per shot.
- The tooth can be seen missing in Monstro's/Monstro II's mouth.
- This item is similar to II - The High Priestess, but deals less damage.
- Judging by the sprites of Monstro/Monstro II, it can be assumed that the missing tooth is an incisor tooth or canine tooth. The item physically resembles a molar tooth however.
PC A2FG 42AR (Treasure Room adjacent to spawn)
PC 3ZB7 V6MT (Treasure Room adjacent to spawn)
Vita ZX3S DMQ8 (First floor Treasure Room)
3DS QQD4 7QLK (Treasure Room adjacent to spawn)
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