My father used to say, “Be true to your teeth or they’ll be false to you.” Good advice, which I have always tried to follow. When I tell my dentist I floss, I am being truthful. But sixteen years ago, I noticed that two of my upper molars were as wiggly as a six-year-old’s front teeth. I had to slide my teeth together gently to be able to chew on that side. What gives, I asked my dentist. He didn’t know. Neither did the periodontist or the next two dentists I went to see. I finally found someone who figured it out: I had a benign tumor, called ameloblastoma, which had probably been there all my life, gradually ballooning outward and nibbling away at the roots of the precious molars I had been loyal to all those years. I felt betrayed by my own body, knowing that a destructive thingy the size of a ping pong ball had taken up residency inside my face. It didn’t show from the outside, nor could I feel the stealthy, cheeky enemy growing within.
Oddly enough, I had always had strange dreams about a huge wad of gum that I tried and tried to pull out of my mouth, without success; like the scarves up a magician’s sleeve, the gum kept stretching out the more I pulled. I had these dreams right up until I had the surgery to remove the tumor. The coincidence hit me one morning in the shower after I’d read an article about “prodromal dreams,” those dreams in which our bodies tell us things that we aren’t consciously aware of. My dreams were always about something I was desperate to remove. I just didn’t know there really was something like that.
But my dream alert system failed this time. After almost twenty years, the damn thing is back. I felt a sort of achiness in my upper jaw about two months ago. I knew it didn’t have anything to do with my actual teeth, because the missing molars have been replaced by a bridge with no nerve endings. Fearing the worst, I went to see my dentist (a new one, since I’d lost faith in the other one), and as he poked around, he confirmed that there was “something.” The x-ray showed a growth in the same spot as before.
As of now, the tumor is about the size of those little red balls we used to play jacks with as kids. Again, no sign of it from the outside. Now I can feel it a little bit, if I massage the area with my fingertips. And this time the surgery will be more drastic and invasive. I’ve consulted with an ear, nose and throat doctor, and a maxillofacial surgeon. They both agree on what the treatment will be: not only will they remove the tumor, but they have to take “margins,” which will mean removing part of my palate and maybe some bone and perhaps another tooth or two. The hole will be permanent, meaning I’ll get fitted with something called an obturator: a combination retainer and denture. Not an accessory I will be able to show off to anyone who is the tiniest bit squeamish. Not that I would ever want to show it off. I’ve seen pictures online. The very idea is kind of gross, if you think about it, which I have been quite a bit lately.
I didn’t have to look too hard to find a Facebook group for people who have ameloblastoma. Some folks have the tumors on the lower jaw, which seems like a much more complicated situation involving bone and skin grafts and titanium and many, many surgeries to restore bone and teeth and other parts of the infrastructure of their faces. I’ve wished good luck and a speedy recovery to several people about to undergo their operations— in Italy, New Zealand, the Philippines, Indonesia, across the country, and close to home here on the west coast.
At this point, I don’t know when my surgery will take place. I’ll find out soon enough. It may happen this summer or perhaps in the late fall, depending on the rate of growth since the last scan. I’m already waking up in the middle of the night worrying about it. I don’t exactly know what’s coming next or how to prepare: liquids only for possibly a month, some effect on my speech as I get used to having a foreign object stuck to the roof of my mouth. Facial structure changes are possible too. . .and as the song goes, I’ve grown accustomed to my face.
Today, I am full of questions about the past and the future; could I have known sooner something was wrong? I do know now that these tumors are almost guaranteed to recur the way mine did. Even so, I can’t escape the feeling that my subconscious let me down— I never dreamed this would happen again.
The original article is reproduced below.
The dreams were almost always the same: my teeth were loose or falling out, or I had a huge wad of chewing gum in my mouth that I was unable to remove. The gum dreams were more stressful: I would be in a "gum-inappropriate environment" and the endless struggle to remove it was fruitless and embarrassing. Loose tooth dreams just mean you are getting old. Everyone knows that. But I had always had these dreams, for as long as I could remember, actually—and the ones about the impossible-to-remove, taffy-like gum debacle occurred more and more frequently.
Eventually, when I was in my late 40s, my right upper molars really did become loose, and I began trying to figure out why. I went to see my dentist, who advised me to see a gum doctor. This seemed almost funny, in light of the dream imagery I struggled with for so many years. Nothing seemed to be amiss, and I was advised to "watch it" and see if anything changed. The teeth stayed loose, nothing changed, the dreams continued. My back molars no longer met the way they should and there was noticeable shifting and wiggling when I tried to chew on that side.
Finally, I went to see another dentist who wiggled my teeth, then stepped back and cupped his chin with his hand. "Hmm," he said. "I have been wiggling teeth for many, many years and I have never seen this before. I wiggle one, and they both move. Something is going on here, and I think I know what it is." It turns out he was right; something was going on and had been for most of my life.
An aggressive cyst was growing inside my maxillary cavity. It was a benign sort of thing in that it wasn't malignant, but it was by no means harmless. It had slowly been gnawing away at the roots of two molars, growing undetected for all of my life. It was called an ameloblastoma, and would have to come out before it did more damage.
Prior to surgery, I had to bid farewell to those molars. By the time they were pulled, they resembled the nubbins of baby teeth children tuck under their pillows for the tooth fairy. I could have used the tooth fairy for support then, but at 48, I was far beyond her demographic. While they were pulling things anyway, the oral surgeon tried to grab a piece of the thing—painfully and unsuccessfully. It was so attached to me, that the mere pulling created a huge bruise in the shape of South America on my face, with Tierra del Fuego at my chin.
Before I went into surgery, the doctor expressed some concern about how invasive the cyst might be. What if other bones had been worn thin or weakened by the existence of this thing that seemed to have taken up long-term residence in my cheek? When they took it out, would my face collapse like an underdone soufflé? Then what?
In the parlance everyone uses to describe these things, it was either the size of an apricot or a ping-pong ball. How can you have something that size growing inside your cheek? I still can't get over that. Once I knew it was there, I could feel it with my fingertips when I washed my face every day, but how big could it have grown before it showed? Blessed with Slavic bone structure, could I have stuck it out to peach-sized? Or whiffle-ball? Fortunately, I never had to find out.
The cyst was removed after a considerable amount of cutting and tugging, or so I heard. I understand the pathologist got very excited while writing his report. I never saw what they removed, and from the description of it, I’m just as glad. Maybe I’ll look it up one day.
While sipping my morning coffee about a year after my surgery, I read an interview with an author named Marc Ian Barasch. He'd had reoccurring dreams in which necks "were a puzzling leitmotif." These alarming dreams were full of vivid, painful details, always focused on his neck. Ultimately, after insisting that his doctor do some tests, he discovered that he had thyroid cancer. He wrote a book based on his experience, and his further research into such "prodromal" dreams—dreams that Barasch subsequently described as those "which anticipate a medical problem not yet clinically detected"—entitled Healing Dreams.
In his interview, Barasch stated that, like Freud, “he believes that the unconscious often picks up on the body's signals before the conscious mind does, communicating its findings through dreams." How interesting, I thought, to have those dreams and realize that they were trying to tell you something about your body that you could not have possibly known. I was still thinking about this in the shower, when it dawned on me that my loose tooth and gum catastrophe dreams had stopped. They stopped after I had the thing in my cheek removed. My dreams had been telegraphing the news for as long as I could remember—but I didn’t understand the message.
I guess some dreams are really a wake-up call. Mine were. Ever since the whole picture fell into place for me, I pay attention to the symbols in my dreams and check the metaphors for deeper meaning. I'm still puzzling over diamonds in the hem of my dress and broccoli in my dessert, but thankfully the tooth dreams have left me.