Graham Joyce's coming-of-age tale of three friends growing up in a small town in England during the 1960s is a rich and rugged dark fantasy. Like his other novels, The Tooth Fairy has psychological underpinnings, calling into question the definition of reality.

Sam, Clive and Terry are best friends, and the novel episodically recounts their various adventures, starting with the pike that bites off two of Terry's toes when he is only 5. Although that's quite unusual, their lives are relatively normal until Sam loses his first tooth and puts it under his pillow. He wakes up to see a strange creature in his room -- the Tooth Fairy. This is no gossamer creature of sparkles and light -- this Tooth Fairy wears mustard- and green-striped leggings and thick muddy boots, and its own teeth are sharply pointed. It smells of damp earth and wild growing things, and it is not at all pleased that Sam has seen it.

Thus begins a childhood and adolescence haunted and tormented by the genderless Tooth Fairy, which appears to Sam as a male at first, then a female as he begins to mature. Sometimes a nightmare, sometimes an ally, many of the Tooth Fairy's appearances are linked with serious events in Sam's life, some catastrophic, some inconvenient, and some that are just plain silly. While it seems as if the Tooth Fairy is the catalyst for these events, they all could have happened independently; the reader is never entirely sure whether the Tooth Fairy really did something or whether it was coincidence or circumstance. The ambiguity adds dimension to the book.

Terry's older cousin Linda inspires Sam's first glimmerings of adolescent lust, and eventually, a schoolmate named Alice joins the group, inspiring the trio of boys to compete for her attention as they grow older -- neither of which goes over well with the now-female Tooth Fairy, who adds seduction to her interactions with Sam. Life seems to continue around them, oblivious to any inner turmoil, including guilt about having committed a terrible crime. The memory haunts all four until it is finally resolved -- but I'm not going to give that away.

Joyce writes with an engaging style and a solid memory of what it was like to be a child; Sam and his friends are convincing well-rounded characters. The plot is tightly written, drawing the reader along no matter what, and at times the narrative verges onto horror. There are passages of shimmering beauty and passages of sheer brutality, but every word is necessary to the tale.