Mandibular tori are common, non-cancerous bony growths that appear on the inner surface of the lower jaw. These firm, painless lumps are frequently discovered incidentally during routine dental examinations. Although benign and posing no threat to health, their presence often raises questions about whether they can diminish or disappear naturally over time. This article explores what causes these oral structures to form and addresses the common query about their potential for natural resolution.
What Mandibular Tori Are and Why They Form
Mandibular tori are localized overgrowths of dense, compact bone located on the lingual side of the lower jaw, nearest the tongue. They typically appear bilaterally (on both the left and right sides) and are most often found near the premolar teeth. The tori are composed of cortical bone, similar to the hard outer layer of other bones, covered by a thin layer of gum tissue.
The development of these bony structures is multifactorial, resulting from an interplay between genetic and environmental influences. A strong genetic predisposition is suggested, as they often run in families. Environmental factors, such as chronic bruxism (teeth grinding and clenching), play a substantial role. This persistent mechanical stress stimulates bone cells to deposit extra bone tissue in response to high local forces on the jaw.
Addressing the Question of Resolution
Mandibular tori do not go away or shrink on their own. Because these growths are composed of mature, dense bone tissue, the body lacks a natural mechanism to reabsorb them like it might with inflamed soft tissue.
The growths are typically slow-growing, often beginning to form in early adulthood (between the ages of 20 and 30). Their growth rate usually stabilizes by the time a person reaches their 40s. While the size may fluctuate slightly in response to changes in mechanical stress, the tori will not vanish without intervention.
For the majority of people, these structures remain small and asymptomatic, requiring no treatment. Management is generally a “watch and wait” strategy, where the dentist monitors the tori during regular check-ups. Unless the tori begin to interfere with daily life or dental work, they are best left undisturbed.
Indications for Surgical Intervention
While most tori are left alone, an oral surgeon may recommend removal (a procedure known as a toriectomy) under specific circumstances. The most common reason is interference with the placement or proper fit of a removable dental prosthetic, such as a complete or partial denture. The bony bulk prevents the appliance from seating correctly, leading to instability or chronic irritation.
Another indication for removal is chronic trauma to the overlying gum tissue. Because the gum tissue covering the tori is thin, it is easily injured by hard foods or sharp edges, which can lead to painful, recurring ulcers. If the tori become extremely large, they may also interfere with normal tongue movement, potentially affecting speech or swallowing.
The surgical procedure involves making an incision over the growth, carefully shaving the excess bone, and then suturing the tissue closed. Full healing typically takes about six to eight weeks.