What's Missing Here?

I took the picture below just a few weeks ago in preparation for the picture that follows.

Yep. The first tooth has fallen out. Actually, rather than gently "falling" out, it was yanked out by a tube of toothpaste. Here is my lovely daughter demonstrating how the tooth got yanked out.
She tells us that because she could not open the toothpaste with her fingers, she tried to open it with her teeth.

In the end, she never did get her toothpaste tube opened by herself.