Torus palatinus is a benign bony growth that develops on the hard palate, the roof of the mouth. This condition is a common anatomical variation. It is a non-cancerous overgrowth of bone tissue that is generally painless and harmless. Estimates suggest it occurs in approximately 20% to 40% of the United States population.
Physical Characteristics and Location
This bony protrusion is located along the midline of the hard palate, where the two halves of the upper jaw bone meet. The growth, which is covered by a thin layer of oral mucosa, is composed of dense, slow-growing bone. Torus palatinus often begins to appear during adolescence but may not become noticeably larger until middle age.
The size of the growth can range significantly, with most being less than two centimeters in diameter. Torus palatinus is classified based on its shape, which can be flat, nodular, or lobular. A flat torus has a broad base and a smooth surface, while nodular forms feature multiple bony growths that each have their own base.
Lobular tori present with multiple bony growths originating from a common base, and spindle tori have a distinct ridge located at the midline. Because the overlying tissue is thin, the growth often appears paler than the surrounding mucosa due to reduced blood flow. In most cases, the torus remains asymptomatic, causing no pain or functional issues.
Factors Contributing to Formation
The exact cause of Torus palatinus is not fully understood, but current research indicates a multifactorial etiology involving both genetic and environmental influences. Genetic predisposition is a significant factor, as the condition frequently runs in families. Some studies suggest it may follow an autosomal dominant inheritance pattern.
Environmental and mechanical stress factors also play a role in the development and growth of the torus. Habits that place repeated pressure on the palate, such as bruxism or teeth grinding and clenching, are commonly associated with the condition. These masticatory forces may stimulate the slow, continuous overgrowth of bone tissue at the midline suture.
Prevalence data suggests that Torus palatinus is more common in women and certain ethnic groups, such as those of Asian descent. A diet rich in vitamin D and polyunsaturated fats has been proposed as a possible contributing factor. The interplay of these factors likely determines if and when the bony protrusion manifests.
When Treatment is Necessary
Since Torus palatinus is a benign and usually asymptomatic condition, the standard approach is observation without intervention. Treatment, which involves surgical removal of the excess bone, is reserved for instances when the growth begins to cause functional problems. One of the most common reasons for surgical removal is interference with the fitting of dental prosthetics, such as full or partial dentures.
The presence of a large torus can prevent the denture from creating a stable seal, compromising its fit and function. Surgery may also be recommended if the growth becomes so large that it interferes with speech or swallowing. Chronic irritation or ulceration of the thin overlying mucosa, often from trauma while eating hard foods, can also necessitate removal.
The surgical procedure, known as torus reduction or excision, is usually performed by an oral surgeon under local anesthesia. The surgeon makes an incision to access the bone and carefully removes the excess bony tissue. The procedure is generally straightforward and offers an effective solution for functional issues caused by the growth.