Oral bone spurs are common bony lumps, often discovered during routine dental examinations. These growths are classified as hyperostosis, a non-cancerous overgrowth of bone tissue on the jawbones. They are typically firm, covered by normal gum tissue, and usually painless. These formations are a normal anatomical variation, occurring in a significant portion of the population, and are categorized based on their location on the upper or lower jaw.
Identifying the Types: Tori and Exostoses
Oral bone growths are categorized into tori and exostoses, reflecting their position in the oral cavity. A Torus Palatinus is a nodular mass of bone found along the midline of the hard palate (the roof of the mouth). Its prevalence ranges widely, often presenting as a single, symmetrical lump.
A Torus Mandibularis is a similar bony protuberance in the lower jaw that develops on the lingual side, adjacent to the tongue, most commonly near the premolar and canine teeth. Approximately 90% of these cases occur bilaterally. Buccal Exostoses are bony extensions that grow on the buccal side, the outer, cheek-facing aspect of either the upper or lower jawbone. Despite differing locations, these three types are histologically identical, consisting of dense, mature bone tissue.
Etiology: The Primary Causes of Oral Bone Growth
The formation of these bony growths is multifactorial, stemming from a complex interplay of genetic and mechanical factors. There is a strong inherited component, as the presence of tori often follows a familial pattern, suggesting a genetic predisposition for their development.
The most accepted environmental influence is mechanical stress, specifically excessive force placed upon the jawbones. Parafunctional habits, such as bruxism (the involuntary clenching or grinding of teeth), are strongly associated with the increased size and incidence of tori and exostoses. The sustained pressure triggers the underlying bone to reinforce itself, a process known as buttressing bone formation. Studies estimate that environmental influences, particularly occlusal stress, may account for approximately 70% of the cause, with genetic factors contributing the remaining 30%.
The concentration of stress is relevant in areas where the jawbone is naturally thinner, such as the midline of the palate or the lingual side of the mandible near the premolars. The combination of an inherited tendency for bone overgrowth and the physical stimulus of heavy chewing or grinding leads to the expression of the bony spur. Less frequently, researchers have explored the potential influence of high bone density or specific nutritional factors, such as a diet rich in calcium, which could contribute to the increased rate of localized bone growth.
Clinical Significance and Management
For the majority of people, the presence of tori and exostoses is entirely asymptomatic, requiring no medical or dental intervention. These growths are benign and pose no threat to overall health. However, the growths can slowly enlarge over time and may eventually require attention when they begin to interfere with daily function or necessary dental procedures.
Interference with the construction of removable dental prosthetics, such as partial or complete dentures, is the most common reason for surgical removal. A large torus on the palate can prevent a denture from achieving the necessary tight seal for suction, while growths in the mandible can compromise the stability of a lower denture. Other functional problems that warrant intervention include chronic irritation or ulceration of the thin tissue covering the bone, often caused by trauma from sharp foods. Surgical excision is the standard management when the growths impede speech, obstruct necessary periodontal procedures, or cause persistent discomfort.