Oral tori are common, benign bony growths discovered during routine dental examinations. While most tori do not require intervention, surgical removal is an option for individuals experiencing specific functional or prosthetic difficulties. This procedure addresses growths that interfere with daily life or necessary dental treatments and offers a predictable recovery process.
What Are Oral Tori?
Oral tori are slow-growing, non-cancerous overgrowths of bone tissue inside the mouth. The term tori is the plural of torus, referring to a bump of excess bone covered by normal gum tissue. These growths vary in size and shape.
Tori are classified into two main types by location: Torus Palatinus and Torus Mandibularis. Torus Palatinus is located along the midline of the hard palate (roof of the mouth) and is found in about 20% of the population. Torus Mandibularis appears on the tongue-side of the lower jaw, often near the premolars, and occurs in about 6% of the population, frequently on both sides.
The exact cause is unknown, but development is influenced by genetics and local stressors. Genetic predisposition is often suggested as a primary cause. Other contributing factors include teeth grinding or clenching (bruxism), which puts pressure on the jawbone. Dietary factors, such as a diet high in polyunsaturated fats and Vitamin D, have also been theorized to play a role.
Indications for Surgical Removal
Tori alone do not usually require surgical treatment since they are harmless and asymptomatic. Removal is recommended when the growths interfere with necessary dental procedures or compromise comfort and function.
The most frequent justification for surgery is the need to fit a removable dental prosthetic, such as a full or partial denture. Tori located in denture-bearing areas prevent a proper fit, leading to instability and gum irritation.
Chronic irritation or ulceration of the overlying gum tissue is another indication. The mucosa covering the bony growth is often thin and easily traumatized by hard foods or chewing. This repeated trauma results in painful sores that heal slowly, necessitating removal.
Large tori can also interfere with normal oral functions, affecting speech or obstructing the tongue’s movement, impacting swallowing and chewing. Additionally, large or rough tori can accumulate food particles and plaque, making proper oral hygiene difficult and increasing the risk of periodontal disease.
Surgical removal is also necessary as a preparatory step for complex dental treatments, such as placing dental implants or certain orthodontic procedures, where the growth might obstruct the planned site.
The Removal Procedure and Recovery
The surgical removal of oral tori, known as a tori reduction, is a relatively straightforward outpatient procedure often performed by an oral surgeon. The process typically begins with the administration of local anesthesia to numb the surgical area, though some patients may opt for sedation depending on the size of the growths and their comfort level. The entire procedure generally takes between 30 to 60 minutes, with the duration depending on the size and location of the tori.
Once the area is numb, the surgeon makes an incision in the overlying gum tissue to expose the excess bone. The gum tissue is carefully lifted away, and specialized dental instruments are used to excise and reduce the bony mass. The surgeon may use a high-speed surgical burr, a drill, or sometimes a chisel and mallet to carefully shave away or smooth down the excess bone until the area is contoured properly.
After the bone is reshaped, the area is thoroughly cleaned with a saline solution to disinfect the site. The gum tissue is then repositioned over the reduced bone and secured with sutures, which are often dissolvable. The sutures promote healing and help ensure the new contour of the bone is maintained.
Post-operative care is crucial for a smooth recovery, which typically involves managing mild swelling and discomfort. Patients are generally advised to use ice packs on the face to control swelling and to take prescribed or over-the-counter pain medication as directed. A soft food diet is required for the initial recovery period to prevent trauma to the surgical site and to allow the gums to heal.
Minor bleeding is normal for up to 48 hours following the procedure, and keeping the head elevated can help minimize this. Patients are instructed to follow specific oral hygiene guidance, such as gentle rinsing with salt water, and to avoid strenuous activity for a few days. A full recovery from the procedure usually takes about a month, though the surgical site will heal over the course of approximately eight weeks. Regrowth of the tori after removal is very rare, though it can occur in individuals with a strong genetic predisposition or continued bruxism.