Tough Love is a passive item.
- Adds a chance to shoot a tooth instead of a tear, which deals x3.2 Isaac's damage.
- The chance for this to occur increases with Luck. The activation rate is equal to 1/(10 - Luck). At base Luck (0), the chance is 10%, maxing out at 100% at 9 Luck.
- Apple!: With 14 Luck, overrides Tough Love. With 13 Luck, Apple and Tough Love each have about an equal chance to trigger.
- Brimstone: Overridden by Brimstone.
- Occasionally fires Brimstone beam with damage multiplier of Tough Love.
- Cricket's Body / Compound Fracture: Teeth will split into smaller teeth.
- Dr. Fetus: Bombs explode with the increased blast damage and radius of Mr. Mega.
- Adds a chance for the bombs to deal increased damage. See the page for the specific damage formula.
- Fire Mind: Adds a flaming effect to the teeth, but without the chance of exploding.
- Ipecac: Teeth explode with the increased blast damage of Mr. Mega.
- Mom's Knife: Overridden by Mom's Knife.
- : Both damage multipliers apply, combined damage multiplier is x6.4.
- Haemolacria: Tears will not appear as teeth but may still gain the damage multiplier.
- Jawbreaker: Activation rates are individually applied to each tear, effectively allowing for higher amounts of teeth. At 9 Luck, the trinket is no longer needed, as Tough Love will already guarantee that every shot is a tooth.
- The Parasite: Split tears will not turn into teeth.
- Spirit Sword: Both the sword and projectiles can deal increased damage.
PC Z0ZB KE22 (First floor Treasure Room)
PC BJG8 KDT0 ( Treasure Room adjacent to spawn)
PS4 WQVF HG7V (First floor Treasure Room)
Vita ZNHL AJ8K (First floor Treasure Room)
3DS SGKP 3D9S ( Treasure Room adjacent to spawn)
Switch WCL4 V8YG (First Golden Treasure Room)
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