Bony growths in the mouth are common findings, known medically as exostoses or tori. These firm, non-cancerous overgrowths of bone tissue develop slowly over time. They are considered benign and represent a variation of normal anatomy rather than a disease. The tissue covering these protrusions is usually thin, while the underlying material is dense, mature bone.
Identifying Common Types and Locations
These bony protrusions are classified based on their specific location. The most frequently observed type is the Torus Palatinus, which forms along the midline of the hard palate (roof of the mouth). This growth varies in appearance, presenting as a flat mass, a spindle-shaped ridge, or a lobular cluster of multiple bumps.
A second common form is the Torus Mandibularis, which develops on the lingual (tongue) side of the lower jaw. These typically appear near the premolar and canine teeth, and in approximately 90% of cases, they present bilaterally. The third category includes Buccal Exostoses, which are bony masses located on the outer, cheek-facing surface of the upper or lower jaws.
These growths often occur on both sides, usually in the premolar and molar regions. While their size can fluctuate, they typically begin to appear in late adolescence or early adulthood. Torus palatinus is generally a singular growth, while mandibular and buccal exostoses are more often present as multiple, smaller nodules. They are usually discovered during a routine dental examination because they rarely cause pain unless the thin overlying tissue is injured.
The Multifactorial Reasons for Development
The formation of these bony growths is considered multifactorial, involving an interaction between genetic and environmental elements. Genetic predisposition plays a significant role, as a high correlation exists with a family history of tori. They are observed more frequently in certain ethnic populations, notably Asian and Inuit groups.
Functional stress from mechanical forces is another primary contributor. Excessive biting forces, known as occlusal loading, stimulate the underlying bone tissue. This mechanical stimulation triggers the bone to reinforce itself in high-stress areas, following Wolff’s Law, which states that bone adapts to withstand the loads placed upon it.
Habitual parafunctional activities, such as bruxism (teeth grinding) and clenching, place immense pressure on the jawbones and are strongly associated with the growth of exostoses and tori. The constant, abnormal force encourages bone-building cells to lay down extra bone material along the jawline. These growths often appear or increase in size in early adulthood, suggesting a link to cumulative stress.
Gender shows a slight difference in prevalence, with Torus Palatinus reported more often in females, while Mandibular Torus is marginally more frequent in males. Dietary factors, such as a high intake of bone-supporting nutrients, have also been theorized to contribute to their development in genetically susceptible individuals. Ultimately, the growth is a defensive response, where the bone attempts to stabilize and strengthen the jaw against abnormal or excessive mechanical strain.
When Do These Growths Require Medical Attention?
In most cases, bony growths in the mouth are asymptomatic and require no treatment. Diagnosis is typically made through a simple visual and tactile examination by a dental professional, as the growths are distinctly hard and smooth. Since they are benign, observation is the standard approach for small, non-interfering masses.
Surgical intervention is generally reserved for specific situations where the growths negatively impact oral function or compromise dental treatment. The most common reason for removal is interference with the placement of prosthetic devices, such as full or partial dentures. The growths can prevent the denture from achieving a stable fit, necessitating their reduction.
Another indication for surgery is chronic trauma to the thin mucosal tissue covering the growth. Because the overlying membrane is delicate and poorly vascularized, it is easily injured by sharp foods or accidental biting. This repeated trauma can lead to slow-healing, painful ulcerations. In rare instances, very large tori may interfere with speech or swallowing, requiring surgical reduction performed by an oral surgeon.