Mandibular tori are common, benign bony growths that can appear in the mouth. While often harmless, they can sometimes present challenges. Understanding their nature, causes, and when intervention might be required can help individuals navigate this oral condition.
What are Mandibular Tori?
Mandibular tori, also known as torus mandibularis, are bony growths located on the inner surface of the lower jaw, near the tongue. These growths typically present as hard, smooth lumps, varying in size from small, barely noticeable bumps to larger protrusions that can sometimes meet in the midline of the mouth. They are considered benign.
These bony outgrowths are most commonly found near the premolars and above the mylohyoid muscle attachment on the mandible. While they can occur on one side, they are bilateral in approximately 90% of cases, though they may differ in size between the left and right sides. Mandibular tori are relatively common, affecting about 7-10% of the adult population in the United States.
Causes of Mandibular Tori
The development of mandibular tori is believed to result from a combination of genetic and environmental factors. Genetic predisposition plays a role, with studies suggesting that approximately 30% of their formation can be attributed to inherited traits. Identical twins, for instance, are more likely to both exhibit tori, indicating a genetic link.
Environmental influences are also significant, accounting for an estimated 70% of the causes. Chronic teeth grinding (bruxism) and teeth clenching are considered major contributing factors due to the local stress they place on individual teeth and the jawbone. This mechanical stress is thought to stimulate bone growth in the affected areas. Mandibular tori tend to grow slowly over time and may become more noticeable in early adulthood, potentially fluctuating in size throughout an individual’s life.
Symptoms and Concerns
For many individuals, mandibular tori are asymptomatic and are often discovered incidentally during routine dental examinations. However, depending on their size and location, they can lead to various concerns. Large tori may interfere with the fabrication or proper fit of dental prosthetics, such as dentures. The thin gum tissue covering the tori can be susceptible to trauma from hard foods or injury, potentially leading to ulceration and discomfort.
Maintaining proper oral hygiene can become challenging around large tori, as food particles may get trapped, increasing the risk of plaque accumulation and gum issues. Very large growths can affect tongue movement, potentially leading to difficulties with speech or chewing. While not painful, significant growth can cause discomfort or a feeling of pressure.
When Treatment is Considered
Surgical removal of mandibular tori is not necessary unless they cause specific problems or interfere with oral function. Dentists usually recommend a conservative “wait-and-see” approach for small, asymptomatic tori. Intervention is considered when the growths impede the successful placement or fit of prosthetic appliances like dentures or orthodontic devices.
Removal may also be recommended if the tori experience chronic trauma, leading to frequent ulceration, pain, or infection. Significant interference with speech, difficulty with chewing, or an inability to maintain adequate oral hygiene due to the tori are additional reasons for considering surgical intervention. Patient preference can also play a role, especially if the tori cause persistent discomfort or anxiety.
Surgical Removal and Recovery
When removal is indicated, the procedure for mandibular tori is performed by an oral surgeon. It usually involves local anesthesia to numb the area, ensuring comfort during the process. The surgeon makes a small incision in the gum tissue over the tori, carefully removes the excess bone using specialized dental instruments, and then sutures the incision closed.
Recovery from mandibular tori removal involves some swelling and mild discomfort for a few days, which can be managed with over-the-counter pain medication. Patients are usually advised to consume a soft diet for a period to avoid irritating the surgical site. Proper oral hygiene, including gentle rinsing, is important during the healing process, which takes several weeks for complete recovery. Complications are rare, and the procedure is considered safe.