Torus palatinus (TP) is a common, non-pathological finding characterized by a bony growth on the roof of the mouth. This growth is generally considered harmless and is often discovered incidentally during a routine dental examination. When a lump is found in the mouth, it can understandably cause concern and prompt questions about potential health risks. This article clarifies the nature of TP and addresses the specific circumstances where this benign growth might cause functional problems or necessitate medical attention.
What Exactly is Torus Palatinus?
Torus palatinus is defined as a benign exostosis, a localized overgrowth of bone tissue. This bony protrusion is typically located along the midline suture of the hard palate, the anatomical division between the two palatal shelves. While the size can vary greatly, most palatal tori are less than two centimeters in diameter, though they may gradually increase in size throughout early adulthood and life.
The torus is composed of dense cortical bone with only a minimal amount of internal cancellous bone or marrow. This dense structure gives the growth its hard, unyielding texture when palpated. Prevalence varies widely, ranging from 9% to 60% across populations, and it tends to be more common in females. The development of TP is considered multifactorial, involving genetic predisposition and local factors like masticatory stress or teeth grinding.
Primary Health Concerns and Functional Impact
The primary concerns related to torus palatinus arise from its size and location interfering with normal oral function, not from the growth itself. The most common issue occurs when the bony mass complicates the use of dental prosthetics, particularly full upper dentures. A large torus can prevent the necessary suction seal required for a stable denture, leading to poor fit, discomfort, and instability.
The thin layer of mucosa covering the torus is susceptible to trauma and ulceration, especially when chewing hard foods. If the torus is lobular or nodular, the irregular surface can create undercuts that trap food debris, leading to hygiene issues and chronic inflammation. In rare cases, a very large growth can interfere with tongue movement, potentially causing minor speech impediments or difficulty with swallowing. The presence of a noticeable lump can also cause psychological distress, leading patients to seek consultation and removal after proper diagnosis.
When Surgical Removal Becomes Necessary
Surgical removal, known as torectomy or torus excision, is reserved for cases where the torus palatinus actively causes functional problems that cannot be managed otherwise. The decision to pursue surgery is guided by functional needs, not merely by the presence of the growth.
Indications for surgical intervention include:
- Obstruction to prosthodontic rehabilitation, making it impossible to fit a necessary denture or retainer.
- Recurrent mucosal ulceration due to chronic trauma during chewing or speaking.
- Severe food trapping leading to persistent hygiene problems.
- Growth large enough to impair speech or swallowing.
The procedure is generally straightforward, often performed under local anesthesia, involving the careful removal of excess bone. The prognosis following surgical removal is excellent, and recurrence is rare.