Buccal exostosis refers to a benign, slow-growing bony growth that develops on the outer surface of the jawbone, specifically on the cheek side of the upper or lower jaw. These growths are considered a common anatomical variation rather than a disease. They are generally harmless and often go unnoticed.
Understanding Buccal Exostosis
Buccal exostosis presents as a hard, painless lump on the jawbone, commonly found in the premolar and molar regions of either the upper (maxilla) or lower (mandible) jaw. While these growths can appear on both sides of the mouth, they may also be unilateral, affecting only one side. They are non-cancerous and consist of mature cortical and trabecular bone with a smooth outer surface.
Buccal exostoses typically become noticeable in adulthood, though they can begin developing in early adolescence and slowly increase in size over time.
Why Buccal Exostosis Develops
The precise reason why buccal exostoses form is not completely understood. However, researchers suggest a combination of factors may contribute to their development. Genetic predisposition is believed to play a role, indicating that some individuals may be more likely to develop these growths due to inherited traits.
Long-term irritation from chewing forces is another proposed contributing factor. This includes habits like teeth clenching or grinding (bruxism). Local trauma or injuries to the oral cavity have also been suggested as potential triggers for their formation.
Recognizing Symptoms and When to Act
Most individuals with buccal exostosis experience no symptoms, and the growths are often discovered during a routine dental examination. However, symptoms can arise if the growth reaches a significant size or location.
Potential issues include difficulty maintaining proper oral hygiene, leading to food trapping and compromised gum health. Large exostoses can also interfere with the placement of dentures or other dental prostheses. In some cases, they may cause speech difficulties, discomfort when eating, or aesthetic concerns. Rapid growth, pain, or functional problems are reasons to consult a dentist or oral surgeon.
Diagnosis and Management Options
Diagnosis of buccal exostosis usually involves a clinical examination where a dental professional can feel the hard, bony mass. Radiographic imaging, such as X-rays or cone beam tomography, can confirm the diagnosis by showing well-defined, round, or oval calcified structures superimposed over tooth roots. A biopsy is generally not recommended unless there is a need to rule out more serious conditions like early osteosarcomas or chondrosarcomas.
In most instances, buccal exostoses do not require active treatment and are simply monitored during regular dental check-ups. Patients are often advised on good oral hygiene practices to keep the area clean and prevent food debris accumulation. Surgical removal is considered when the growth causes functional impairment, such as difficulty eating or speaking, interferes with denture fitting, leads to chronic irritation or ulceration of the overlying tissue, or presents significant aesthetic concerns.
The surgical procedure is a minor oral surgery performed under local anesthesia. The surgeon makes an incision to expose the bony overgrowth, which is then trimmed and smoothed using dental instruments. The soft tissue is then repositioned and sutured. Recovery time is minimal, and recurrence after surgical removal is uncommon.