Buccal exostosis is a common, non-cancerous bony growth found within the mouth. These growths often prompt concern when they are first discovered, leading many people to wonder if they represent a temporary issue that will resolve on its own. This article clarifies what buccal exostoses are, why they form, and the circumstances under which professional dental attention may be necessary.
Defining the Bony Growth
Buccal exostosis is a benign, broad-based bony prominence developing on the outer surface of the jaw bone, facing the cheek (“buccal” area). These hard nodules are typically found along the gum line in the premolar and molar regions of the upper jaw, but they can occur on the lower jaw as well. Histologically, they consist of dense, mature cortical bone, appearing as well-defined, calcified masses on dental X-rays.
The exact cause for this bony overgrowth remains unclear, but chronic local stress and hyperfunction are suggested to play a significant role. This stress may include excessive chewing or teeth grinding (bruxism), which places continuous strain on the jawbone. Genetic factors are also suspected, as the growths often appear bilaterally. They generally begin to appear in late adolescence or early adulthood and enlarge slowly over time.
Why Exostosis Does Not Regress
Buccal exostosis does not go away or shrink naturally because it is composed of mature, dense bone tissue. Unlike inflammatory lesions, the exostosis is a permanent, calcified structure that the body cannot reabsorb. The dense cortical bone is highly stable and inactive, meaning the body’s natural remodeling processes are not triggered to dismantle it. Consequently, there is no biological mechanism for spontaneous regression once the prominence is established. The growth may continue to enlarge slowly throughout a person’s life, especially if underlying causative factors like continuous occlusal stress persist.
When Professional Intervention is Needed
Since the growth is permanent, treatment is elective and focuses on managing symptoms or functional interference. Intervention is necessary when the exostosis causes chronic irritation or ulceration of the overlying gum tissue, often due to trauma from chewing sharp foods. The thin mucosal tissue covering the hard bone is vulnerable to injury.
The most common indication for removal is interference with the fitting of dental prosthetics, such as dentures or partial bridges. A large exostosis can prevent a prosthetic device from achieving a stable, comfortable fit. Growths that become excessively large can also complicate routine oral hygiene, potentially contributing to periodontal disease.
Surgical Removal (Osteotomy)
Surgical removal, or osteotomy, is the treatment for symptomatic exostoses, performed by an oral surgeon. The procedure involves lifting the gum tissue to expose the underlying bone, which is then carefully reduced and smoothed. Following the procedure, the gum tissue is sutured back into place, and recovery typically involves localized swelling and discomfort.