Finding an unexpected, hard bump in your mouth can be alarming, often leading people to search for terms like “bone spurs.” While the term “bone spur” is typically used to describe growths that form near joints, similar hard, bony protrusions do occur inside the mouth. These oral growths are usually benign and represent a common variation of anatomy, not a disease process.
Understanding the Difference Between Bone Spurs and Oral Bony Growths
A true bone spur, clinically known as an osteophyte, is an outgrowth of bone that forms primarily at the margins of joints, such as the spine or knee, and is frequently associated with degenerative conditions like osteoarthritis. These osteophytes develop as the body attempts to stabilize a damaged joint. Oral bony growths, by contrast, are not signs of joint degeneration but are classified as exostoses—benign overgrowths of bone tissue projecting from the surface of a bone. The most common types are named “tori.” These growths are considered developmental or reactive, consisting of dense, compact bone that is generally slow-growing and often appears in late adolescence or early adulthood.
Types and Locations of Benign Oral Growths
The location of the bony growth determines its specific name, with three main types frequently encountered in the oral cavity.
Torus Palatinus
This is a bony protrusion found on the midline of the hard palate, or the roof of the mouth. This type is often a singular mass and is more common in females than males, with a prevalence ranging from 20 to 35% in the U.S. population.
Mandibular Tori
These are located on the tongue-side surface of the lower jaw, typically near the premolar teeth. These growths are commonly bilateral, meaning they occur on both sides of the jaw, and are usually painless, with a prevalence of about 7 to 10%.
Buccal Exostoses
These are bony protrusions found on the cheek-side of the upper or lower jawbone. They tend to be multiple, smooth, and broad-based masses, often located in the premolar and molar regions.
All three types are covered by a thin layer of gum tissue, which can sometimes appear paler than the surrounding mucosa. Histologically, all oral exostoses show a composition of dense cortical bone.
Factors Contributing to the Development of Oral Bony Growths
The formation of oral bony growths is considered multifactorial, arising from a combination of genetic and environmental influences. A strong genetic predisposition is a major factor, as these growths often run in families and may suggest an autosomal dominant pattern of inheritance. Environmental factors primarily involve functional stress and excessive chewing forces placed on the jawbones. Habits such as bruxism (chronic grinding or clenching of teeth) can stimulate bone growth in areas of mechanical tension.
These growths are considered a form of bony buttressing, where the bone reinforces itself in response to local stress from chewing or clenching. They typically begin to develop in the late teens and may increase in size slowly over time, often stabilizing later in life. Other contributing factors can include localized trauma or continued jawbone growth throughout adulthood.
When Treatment and Removal are Required
Oral tori and exostoses are typically asymptomatic and require no treatment other than routine monitoring during dental checkups. Since they are benign and pose no malignant potential, the standard approach is observation. Surgical removal is only recommended when the growths begin to interfere with oral function or health.
One of the most common reasons for removal is interference with prosthetic dentistry, such as preventing the proper seating or stability of full or partial dentures. Removal may also be necessary if the thin overlying mucosa is subjected to chronic trauma, leading to frequent and painful ulcerations. Large mandibular tori can occasionally interfere with speech or swallowing, which would also necessitate bone reduction surgery.
The surgical procedure involves exposing the bone, carefully trimming the excess bony mass, and smoothing the surface before suturing the gum tissue back into place. This is a routine oral surgery procedure, typically performed under local anesthesia, and provides a positive long-term prognosis.