A tori removal is a surgical procedure that eliminates bony growths, called tori, from the roof of the mouth or the inner surface of the lower jaw. These growths are benign and surprisingly common, but when they interfere with dentures, cause recurrent sores, or make eating difficult, an oral surgeon or periodontist can shave or chisel them down to restore a smooth oral surface. The procedure is straightforward in most cases, performed under local anesthesia, though the specifics of the surgery and recovery depend on the size and location of the growths.
What Oral Tori Actually Are
Oral tori are slow-growing bony bumps that develop along the surfaces of the jaw inside the mouth. They come in two main varieties. A torus palatinus forms along the midline of the hard palate, the roof of your mouth. A torus mandibularis shows up on the tongue side of the lower jaw, usually near the premolar teeth. Some people develop both types. These growths are made of normal, healthy bone covered by a thin layer of oral tissue, and they are not cancerous or precancerous. Tissue analysis of removed tori consistently shows regular bone with normal fat and blood-vessel structures and no signs of malignancy.1J Oral Med Oral Surg. Palatal torus: etiology, clinical aspect, and therapeutic strategy
Most tori cause no symptoms at all. People often discover them by running their tongue along the roof of their mouth or feeling a hard ridge behind their lower front teeth. They can range from barely noticeable ridges to large, lobulated masses that significantly alter the shape of the oral cavity. Because they grow slowly over years, many people live with tori their entire lives without needing any treatment.
How Common They Are and Who Gets Them
Tori are far more common than most people realize. In a study of over 1,100 patients using CT imaging, roughly 28% had mandibular tori, and nearly 80% of those had them on both sides of the jaw.2PubMed Central. Computed Tomographic Analysis of Mandibular Tori and Their Relationship to Remaining Teeth The prevalence peaked among people in their 40s, where nearly half had detectable mandibular tori, and stayed elevated through the 30s and 50s before declining in older age groups. Palatal tori are similarly common, with reported rates varying widely depending on the population studied.
The question of why some people develop tori and others don’t has been debated for decades. Genetics play a role, and the trait appears to follow a pattern consistent with dominant inheritance, though the picture is more complicated than a single gene flipping a switch.3PubMed. The tori of the mouth and ear: a review One study estimated that genetics account for only about 30% of the variation in torus development, with the remaining 70% attributable to environmental factors, particularly the mechanical stress placed on the jaw from clenching and grinding.4PubMed. Torus mandibularis: an estimation of the degree of genetic determination People who grind their teeth tend to develop more prominent tori, which makes sense given that the bone is responding to repeated mechanical loading.
Reasons for Removal
Since tori are benign, there is no medical obligation to remove them. Most removals happen for practical reasons rather than health emergencies. The single most common reason is that the tori get in the way of dentures or other dental prosthetics. A large palatal torus can make it impossible to fit an upper denture properly, and mandibular tori can block the flanges of a lower denture from seating against the jaw.5PubMed Central. Surgical removal of mandibular tori and its use as an autogenous graft
Beyond denture fit, there are several other scenarios where removal makes sense:
- Recurring sores: The thin tissue covering a torus is vulnerable to trauma from hard or sharp foods, leading to painful ulcers that keep coming back.
- Speech interference: A large palatal torus can alter tongue placement enough to affect speech clarity.
- Food trapping: Lobulated tori create crevices where food debris collects, making oral hygiene difficult and increasing the risk of gum problems.
- Cancer anxiety: Some patients notice a hard lump in their mouth and understandably worry it could be something serious. Even after being told it is benign, the anxiety persists, and removal provides peace of mind.6PubMed Central. Multiple bony overgrowths in the mouth – report of two cases
- Bone grafting needs: When a patient needs bone grafting elsewhere in the mouth, the torus can be harvested and repurposed, solving two problems at once.
If none of these situations apply to you, leaving the tori alone is perfectly reasonable. They are not going to become dangerous over time.
How the Surgery Works
The traditional approach to tori removal is a well-established surgical technique. For a palatal torus, the surgeon makes an incision along the midline of the palate, peels back the thin tissue covering the bone, and then reduces the bony mass using a combination of chisels, mallets, and rotary instruments called burs.7Clinical Medicine and Health Research Journal. Treatment of Torus Palatinus: An Overview For larger tori, the surgeon may section the growth into pieces before removing each segment, which reduces the force needed and protects the surrounding bone. Once the mass is removed, the bone surface is smoothed, and the tissue flap is sutured back into place.
Mandibular tori follow a similar pattern. The surgeon creates a flap on the tongue side of the lower jaw, exposes the bony protrusion, and reduces it with burs or chisels. Because mandibular tori sit close to the floor of the mouth and the lingual nerve, the surgeon works carefully to avoid damaging these structures.
Most cases are performed under local anesthesia. For palatal tori, blocking the greater palatine and nasopalatal nerves provides complete numbness in the area. General anesthesia is generally reserved for unusually large tori or growths positioned far back on the palate where access is difficult.8J Oral Med Oral Surg. Palatal torus: etiology, clinical aspect, and therapeutic strategy Conscious sedation is another option for patients with dental anxiety, though it is not strictly necessary from a surgical standpoint.
Newer Surgical Approaches
The chisel-and-bur technique has been the standard for decades, but two newer technologies have entered the picture. Piezoelectric surgery uses ultrasonic vibrations to cut through bone with high precision. The advantage is that piezoelectric instruments only affect hard tissue and largely spare soft tissue like nerves, blood vessels, and the thin mucosal lining. This selectivity translates to less collateral damage during the procedure.7Clinical Medicine and Health Research Journal. Treatment of Torus Palatinus: An Overview
Laser surgery using erbium-doped YAG (Er:YAG) lasers is another alternative. These lasers can vaporize bone layer by layer and are considered safe for tori removal. The tradeoff is time: laser excision takes longer than conventional instruments because it removes bone more gradually.9PubMed Central. Er:YAG Laser: A New Technical Approach to Remove Torus Palatinus and Torus Mandibularis Whether the potentially gentler tissue handling justifies the longer procedure time depends on the individual case and the surgeon’s preference. Neither piezoelectric surgery nor laser removal has become the default standard, but both are available and gaining traction at specialized centers.
Risks and Potential Complications
Tori removal is considered a low-risk procedure, but it is still surgery on bone, and complications can happen. For palatal tori, the list of known risks includes perforation of the nasal cavity (because the palatal bone can be thin beneath the torus), damage to the greater palatine artery leading to bleeding, nerve injury, bone necrosis from overheating during drilling, and tearing of the palatal tissue, which is notoriously thin and fragile over a torus.10Revista de Odontologia da UNESP. Surgical management of palatine Torus – case series Fracture of the palatal bone itself is also a rare but documented possibility.
For mandibular tori, the primary concern is the lingual nerve, which runs along the floor of the mouth close to where these tori sit. Damage to this nerve can cause numbness or altered sensation on the affected side of the tongue. Infection is a general surgical risk that applies to both locations. The likelihood of these complications drops substantially with an experienced surgeon and careful technique.
One complication specific to patients taking certain medications for osteoporosis or cancer deserves mention. Medication-related osteonecrosis of the jaw, a condition where bone fails to heal after exposure, occurs more frequently at tori sites. In one study of patients with tori who were on these medications, over half developed osteonecrosis at their tori, making it a real concern for this specific population. Surgical or prophylactic removal of tori in patients starting such medications resulted in healing in the vast majority of cases.11Springer Link. Surgical and conservative treatment outcomes of medication-related osteonecrosis of the jaw located at tori: a retrospective study If you are on bisphosphonates or similar drugs, this is worth discussing with your oral surgeon before any procedure.
What Recovery Looks Like
Recovery from tori removal is typically measured in weeks, not months, though the timeline varies with the size and location of the torus removed. The palate tends to heal more slowly than the lower jaw because the tissue covering a palatal torus is often paper-thin and the blood supply is less generous than in other parts of the mouth. Swelling peaks in the first two to three days and then gradually subsides. Pain is usually manageable with over-the-counter anti-inflammatory medications, though your surgeon may prescribe something stronger for the first few days.
Diet is the biggest practical adjustment. You will be eating soft foods for at least a week, sometimes two. Hot foods and drinks are particularly uncomfortable against a healing palatal wound. Most people return to work within a few days, but it can take three to four weeks before the surgical site feels fully normal. Stitches are typically dissolvable and do not need to be removed separately.
For mandibular tori removal, the recovery tends to be slightly easier because the tissue on the tongue side of the jaw is thicker and heals more predictably. Swelling under the chin and mild bruising are common. Numbness of the tongue on the affected side can persist for days to weeks if the lingual nerve was stretched during the procedure, though permanent nerve damage is rare.
Can Tori Come Back After Removal?
Recurrence after tori removal is uncommon but not impossible. Case reports exist of tori regrowing after complete surgical excision, sometimes surprisingly quickly.12International Journal of Surgery Case Reports. Early recurrence of mandibular torus following surgical resection: A case report The regrowth makes sense when you consider that the underlying causes, particularly jaw stress from clenching and grinding, persist after surgery. If the mechanical forces that contributed to the original torus formation are still present, the bone may respond by building up again in the same location. Wearing a night guard after tori removal is sometimes recommended to reduce this risk, though no controlled studies have confirmed that it prevents regrowth.
When You Can Skip Surgery Entirely
Surgery is not the only option for managing tori, particularly when the main concern is denture fit. Dental practitioners have developed several workarounds that avoid the operating room entirely. These include modifying the impression technique used to create the denture, changing the denture design so it avoids covering the torus altogether, or using different denture materials that can accommodate the irregular contour.13Scientific Dental Journal. Nonsurgical Approach for Torus Palatinus Management in Full Denture Rehabilitation
A flangeless or horseshoe-shaped upper denture, for example, can be designed to leave the palatal torus completely uncovered while still providing adequate retention and stability.14Dental Update. Flangeless horseshoe maxillary complete denture: a prosthodontic solution to maxillary tori This approach requires more careful planning and may not work for every patient, but when it does, it eliminates surgical risk entirely. If your dentist says tori removal is necessary for dentures, it is worth asking whether a modified denture design could work before committing to surgery.
Using Removed Tori as Bone Graft Material
One of the more practical aspects of tori removal is that the bone you are getting rid of does not have to go to waste. Autogenous bone, meaning bone harvested from your own body, is considered the gold standard for grafting because it contains living cells that promote new bone growth. The torus is a convenient source because it is already inside the mouth, close to common graft recipient sites, and the patient needs it removed anyway.
Mandibular tori in particular have been used successfully as graft material for periodontal defects. In one reported case, tori were removed, ground into particles, and used to fill bone defects around teeth with advanced gum disease. Follow-up X-rays at six and twelve months showed good bone fill, and previously deep pockets around the teeth no longer probed after treatment.15PubMed Central. Mandibular Tori: A source of autogenous bone graft Tori have also been used in implant site preparation and sinus augmentation procedures, sometimes mixed with synthetic or animal-derived bone substitutes to increase volume.16International Dental Journal. The Use Of Mandibular Tori In Bone Augmentation Procedures
If you need both tori removal and a bone grafting procedure, combining them into a single surgery saves you a second surgical site and a second recovery. Not every torus provides enough bone for every grafting need, but for small to moderate defects, it can be a perfect match.
Tori in Human History
Tori are not a modern phenomenon. They show up consistently in archaeological skeletal remains, and their frequency across different populations has given anthropologists a useful marker for studying diet, jaw use, and population genetics. Among prehistoric Jomon populations in Japan, for instance, mandibular tori were remarkably prevalent: over 87% of individuals had palpable tori, and over 81% had tori large enough to be seen visually. Frequencies declined steadily through subsequent historical periods, from the Yayoi through the Edo era and into modern times.17Elsevier / Quaternary International. Frequency of mandibular tori in prehistoric and historic Japanese island populations
The decline tracks with changes in diet and food preparation. The Jomon people were hunter-gatherers who ate tough, unprocessed foods requiring significant chewing force. As Japanese populations shifted toward agriculture and softer cooked grains over the centuries, the mechanical demands on the jaw decreased, and tori became less common. This pattern supports the idea that jaw stress is a major driver of tori formation, independent of genetics. It also helps explain why modern prevalence varies so much between populations: groups with historically tougher diets or higher rates of bruxism tend to show more tori.