A hard lump discovered in the mouth can be a source of worry. The term “bone spur” refers to a common, benign, localized bony overgrowth on the jawbones or the roof of the mouth. These growths are dense nodules of normal bone tissue, not true spurs caused by inflammation. They are almost always harmless and represent a variation of normal anatomy. Their presence is a frequent finding during routine dental examinations, typically requiring no intervention unless they interfere with daily life or necessary dental treatments.
Understanding Oral Bone Spurs
These non-pathologic bony masses are officially classified as exostoses or tori, depending on their specific location. They are composed of dense, mature cortical bone and represent an excess accumulation of bone tissue. The two most frequent types are named for the structures they affect: the palate and the mandible.
The Torus Palatinus is a bony prominence found along the midline of the hard palate (the roof of the mouth). This growth can appear as a single flat mound, a ridged spindle, or a cluster of lobulated nodules. The Torus Mandibularis is typically a bilateral growth, located on the inside surface of the lower jaw, often in the premolar region.
A third common presentation is the Buccal Exostosis, a bony nodule that forms on the outer, cheek-facing surface of the upper or lower jaw. All these formations are covered by normal gum tissue, which is often thin and tightly stretched over the hard surface underneath. Despite their varying locations, these growths are histologically identical, representing a localized overproduction of bone.
Factors Contributing to Bone Spur Formation
The exact cause of these oral bony growths is multifactorial, involving a combination of genetics and environmental influences. A significant number of cases are linked to hereditary factors, suggesting a genetic predisposition for their development that often runs in families.
A major environmental trigger is biomechanical stress, specifically heavy chewing forces on the jawbone. Habits like bruxism (chronic teeth grinding) or constant clenching of the jaw stimulate the underlying bone to reinforce itself. This process, where bone tissue responds to increased mechanical loading, results in the formation of these dense surface growths. These growths are slow-developing, often appearing or becoming noticeable during late adolescence or early adulthood, and usually grow slowly throughout life.
When Removal Becomes Necessary
For the vast majority of people, oral bony growths cause no symptoms and are simply monitored during routine dental visits, never requiring removal. However, surgical intervention is indicated when the bony mass begins to significantly compromise a patient’s health or quality of life.
The most common clinical reason for removal is to prepare the mouth for a dental prosthetic, such as a complete or partial denture. A large torus on the palate can prevent an upper denture from achieving a proper suction seal, while mandibular tori can interfere with the stability and comfort of a lower denture.
Another primary indication for surgery is chronic trauma to the overlying gum tissue. Because the mucosa covering the bony growth is thin, it can be easily injured during normal chewing, especially by hard or sharp foods. This repeated trauma can lead to painful, slow-healing ulcerations, as the thin tissue has poor blood supply compared to other gum areas. Removing the growth eliminates the source of this recurrent irritation.
Removal is also considered if the growths become large enough to interfere with basic oral functions, such as proper speech articulation or comfortable eating and swallowing. Furthermore, an oral surgeon may remove the bone to facilitate other necessary procedures, such as when a large growth complicates periodontal surgery or the placement of dental implants.
The Removal Procedure
The surgical procedure itself involves exposing the bone, carefully reducing the excess bone with a rotary bur or chisel, and then smoothing the surface before closing the gum tissue. Recovery is typically straightforward, and the removed bone can sometimes be repurposed as a source of autogenous bone graft material for other reconstructive needs.