Oral tori are common, benign bony growths that can develop in the mouth. While often harmless and unnoticed, their surgical removal, known as tori removal, becomes necessary in specific circumstances. This procedure addresses functional issues or improves oral health. Removal depends on the tori’s size, location, and impact on daily life.
Understanding Oral Tori
Oral tori are non-cancerous bony protrusions that form in the oral cavity. The most common types include torus palatinus, found on the roof of the mouth (hard palate), and torus mandibularis, located on the inner side of the lower jaw, often near the premolars. These growths are excess bone covered by normal gum tissue. While their exact cause is not fully understood, genetic predisposition, local stress on teeth, and teeth grinding (bruxism) are believed to contribute to their development. Tori are common, but usually do not require intervention unless they cause problems.
Reasons for Removal
Despite their benign nature, oral tori sometimes grow to a size or in a location that necessitates their removal. A primary reason for tori removal is interference with dental prostheses, such as dentures. Large tori can prevent dentures from seating properly, leading to instability, discomfort, and gum irritation. Tori can also pose challenges for orthodontic treatment or dental implant placement, requiring removal for a stable foundation.
Chronic irritation or ulceration of the gum tissue is another common indication for surgery. This can occur from repeated trauma during eating or accidental injury by utensils, leading to persistent sores and discomfort. Significantly sized tori can interfere with speech, swallowing, or chewing. In some cases, tori create deep undercuts where food particles become trapped, making oral hygiene challenging and increasing the risk of bacterial accumulation. Rarely, rapid growth or diagnostic uncertainty may also prompt removal.
The Surgical Procedure
Tori removal is typically an outpatient procedure performed under local anesthesia, though sedation may be an option for patient comfort. The surgical area is numbed to ensure no pain during the operation. Once numb, the surgeon makes an incision in the gum tissue directly over the bony growth to expose the underlying tori.
After the gum tissue is carefully lifted, the excess bone is removed. This is achieved using various dental instruments, depending on the size and shape of the tori. For broad-based tori, the surgeon may cut grooves to divide the growth into smaller segments for easier removal. The remaining bone surface is then smoothed and contoured. The surgical site is rinsed, and the gum tissue flap is repositioned and closed with sutures, which are often dissolvable.
Post-Operative Care and Considerations
Following tori removal, proper post-operative care is important for a smooth recovery and to minimize potential complications. Patients can expect some swelling and mild discomfort, which typically subsides within a few days to a week. Pain medication, such as over-the-counter options, can manage soreness, and cold packs applied to the outside of the face can help reduce swelling. Keeping the head elevated for 24-48 hours after surgery is also recommended.
Dietary modifications are necessary during the initial healing period. Patients should adhere to a soft food diet for several days, avoiding hard, sticky, crunchy, or highly acidic foods that could irritate the surgical site or dislodge blood clots. Good hydration is encouraged, but using straws should be avoided as the suction can disrupt the healing process. Oral hygiene requires gentle care; do not rinse or spit vigorously for the first 24 hours. After this period, gentle rinsing with lukewarm saltwater or a prescribed mouth rinse can help keep the area clean.
Strenuous physical activity should be avoided for a few days to prevent bleeding. While complications are rare, they can include infection, excessive bleeding, or nerve damage. Patients should contact their dentist if they experience excessive pain, persistent bleeding, or signs of infection. Full recovery can take two weeks to a month or more, depending on the individual and the extent of the surgery.