Oral tori are common, non-cancerous bony growths (exostoses) that develop in the mouth. While they are a normal anatomical variation for many people and typically cause no issues, they can sometimes grow large enough to require intervention. The surgical procedure to remove these growths is known as a toriectomy, a routine form of minor oral surgery. This procedure is only undertaken when the tori begin to affect a patient’s oral function or health.
Understanding Oral Tori
Tori are dense masses of mature bone tissue covered by normal gum tissue, and they grow slowly over an individual’s lifetime. They are benign and pose no risk of becoming cancerous, which is an important point of reassurance for patients.
There are two primary forms of oral tori, categorized by their location. Torus Palatinus is found along the midline of the hard palate (the roof of the mouth). Torus Mandibularis presents as a bony elevation on the inner (lingual) side of the lower jaw, most often near the premolars.
The precise cause of these formations is not entirely understood, but evidence suggests a multifactorial origin. Genetics plays a substantial role, as tori often run in families. The growth is also associated with localized masticatory stress, such as the forces generated by teeth grinding or clenching (bruxism).
When Removal Becomes Necessary
Most tori are small and asymptomatic, meaning they do not require treatment. Surgical intervention is reserved for specific circumstances where the bony mass causes functional impairment or compromises necessary dental treatment. The most common reason for a toriectomy is interference with the construction and fit of removable dental prosthetics, such as dentures.
A large torus can prevent a denture base from seating securely, causing instability and chronic irritation of the gum tissue. Removal may also be necessary if the tori interfere with normal oral functions, such as proper tongue movement, which affects speech or swallowing. Additionally, the thin tissue covering a large torus is susceptible to recurrent trauma and ulceration from food abrasion.
If the torus surface is lobulated or irregular, it can create deep crevices that trap food debris and harbor bacteria, making effective oral hygiene difficult. Removal is sometimes required as a pre-prosthetic procedure to prepare the mouth for other treatments, such as dental implants or bone grafting. The surgery aims to create a smooth, functional bony contour that supports prosthetic stability.
The Surgical Procedure
The tori removal procedure is typically performed in an outpatient setting. The surgical site is first thoroughly numbed using a local anesthetic injection to ensure patient comfort. Light sedation may also be offered to help anxious patients relax during the process.
Once the area is anesthetized, the surgeon makes a small incision in the gum tissue over the bony growth. This tissue flap is carefully lifted to expose the underlying dense bone. The bone reduction process then begins to remove the excess tissue.
The surgeon uses specialized instruments, such as high-speed rotary burs or surgical chisels, to carefully shave and smooth the bony projection. The bone is reduced until the surface contour is flat and smooth, eliminating interference or sharp edges. Constant irrigation with a sterile saline solution is used to cool the bone and flush away fragments.
After the bone is removed and the area is smooth, the gum tissue flap is repositioned. The incision is then closed using sutures, often made of a dissolvable material. The entire procedure is relatively quick, often taking less than an hour, depending on the size and location of the tori.
Recovery and Aftercare
Following the toriectomy, patients should expect a period of immediate recovery that involves managing predictable post-operative symptoms. Swelling is a common response and is typically most noticeable within 48 to 72 hours after the procedure. Applying a cold pack to the cheek area in 20-minute intervals during the first day helps minimize this swelling.
Pain management usually involves a combination of over-the-counter pain relievers, such as alternating doses of ibuprofen and acetaminophen, to control discomfort. Patients must maintain a soft food diet for at least the first week to prevent irritation and promote healing. Recommended foods include soups, mashed potatoes, and scrambled eggs.
Proper oral hygiene is maintained by gently brushing the teeth away from the surgical area using a soft-bristled brush. Starting 24 hours after surgery, gentle rinsing with a warm saltwater solution four to six times a day is advised to keep the site clean and reduce infection risk.
Vigorous rinsing or the use of a straw must be avoided, as the suction created can dislodge the blood clot and disrupt the healing process. Initial healing of the gum tissue typically takes one to two weeks, though complete tissue maturation can take several weeks longer.