You can find Shiny Tooth in random places in The Blood of Dawnwalker, but you'll start getting more of them once you complete the Pearly and Precious quest with the Sanzhani in The Blood of Dawnwalker. That's because the Sanzhani you meet on that quest is the one who would buy the Shiny Tooth from you.
Although you will notice a higher drop rate for the Shiny Tooth after completing the Pearly and Precious quest, you can actually get one even before you do it. For example, the pig pen by Andrei's hideout, which you can find during The Heart Wants What It Wants quest, hides a Shiny Tooth inside its hay.
Other than that, Shiny Tooth is mostly a random drop from defeating enemies like humans or undead.
You first discover the Sanzhani in the Good Home quest in The Blood of Dawnwalker. Then, you can trigger Pearly and Precious by going to the Small Bridge Shrine in the Briar Sloughs region. Head south, inspect the camp, and follow the footsteps to find the Sanzhana. It will refuse to talk to you unless you give her a Shiny Tooth, which you can get from defeating Bandit Camp southwest of its location.
There's also a route in the Good Home quest that requires you to give the Tsarina three Shiny Tooth before you can complete the mission.
After giving the Sanzhana the Shiny Tooth, you'll unlock the Sanzhana Merchant in The Blood of Dawnwalker. Despite saying that gold doesn't matter to them, you can purchase items in the shop for Denarii. Note that the Sanzhana location will change after completing the Pearly and Precious quest. To sell more Shiny Tooth after completing the quest, you must head back to the Sanzhana lair in Yawning Burrow, in Svartrau Outskirts.
The Sanzhana Shop will have various valuables to purchase, mostly rings and amulets. The shop inventory may refresh occasionally; I've even seen a legendary amulet in her inventory, so it's worth checking back often after selling the Sanzhana Merchant your stash of Shiny Tooth.
The Sanzhana merchant is one of the two ways to get a Bundle Of Silk Threads for the A Bulwark Against Darkness quest in The Blood of Dawnwalker.
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