Tori are benign bony outgrowths that develop in the mouth, usually on the roof of the mouth or along the inner side of the lower jaw. Tori removal surgery, known as toriplasty, eliminates these growths primarily when they interfere with fitting dentures or other dental appliances. Surgery is also performed if the tori become so large that they interfere with normal speech, eating, or oral hygiene. The procedure involves making an incision in the overlying gum tissue, smoothing the excess bone, and then repositioning the soft tissue flap with sutures.
Identifying Post-Surgical Bone Exposure
Post-surgical bone exposure occurs when the sutured gum tissue opens, revealing the underlying jawbone contoured during the procedure. This complication is technically called wound dehiscence, meaning the premature separation of the wound edges. The exposed bone appears white, hard, and distinct from the surrounding soft tissue. It often feels rough or sharp to the tongue, causing significant irritation and discomfort.
A specific form of exposure is bone sequestration, where a small piece of cortical bone loses its blood supply and becomes necrotic. This dead fragment, known as a sequestrum, eventually separates from the healthy bone underneath. The exposed bone is painful because the delicate periosteum, the membrane covering the bone, is no longer protected by the soft tissue.
The cause of exposure is the inherent thinness of the mucosa covering tori, which often has poor blood supply. Post-surgical swelling or excessive tension on the soft tissue flap can prevent the incision edges from healing together. Trauma, such as pressure from a new denture or abrasive foods during recovery, can also cause the fragile, newly sutured tissue to tear open.
Immediate Care and Symptom Relief
If you suspect bone exposure, contact your oral surgeon for an urgent evaluation immediately. While awaiting your appointment, the goals are managing pain and preventing infection. Although the exposed bone is painful because it is irritated and unprotected, the condition is rarely an immediate emergency.
Gentle oral hygiene is essential to keep the exposed area clean and prevent infection. Rinse your mouth gently with a warm salt water solution—one teaspoon of salt dissolved in eight ounces of warm water—four to six times a day, especially after meals. Your surgeon may also prescribe a medicated rinse, such as 0.12% chlorhexidine, to be used for 60 seconds twice daily, typically 30 minutes after brushing.
For pain control, a combination of over-the-counter medications is highly effective. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (600 to 800 milligrams every six hours) should be alternated with acetaminophen, as directed by your surgeon. Adhere strictly to a soft, non-abrasive diet, avoiding anything hard, sharp, or hot that could traumatize the tissue flap.
Definitive Professional Treatment Options
The definitive management approach is determined by the size of the exposed area and whether the bone is stable or a separating fragment. Treatment generally involves either a conservative approach or a secondary surgical intervention. Conservative management is preferred for small, localized areas of exposure or when a sequestrum is already loose.
The surgeon may smooth the sharp edges of the exposed bone using a dental burr under local anesthesia, which quickly removes the irritant. A protective surgical dressing or paste is often applied over the site for several days to shield the bone and promote gum tissue healing. This conservative approach allows the exposed bone to be covered by mucosal healing or for the sequestrum to naturally exfoliate.
If the exposed area is large or conservative treatment fails, secondary surgical closure is required. This involves the surgeon re-opening the site, removing necrotic bone fragments, and further contouring the underlying bone for a smooth surface. The soft tissue flap is then repositioned and advanced to fully cover the defect, and new sutures are placed for a tension-free closure. This procedure aims to eliminate irritation and provide the best environment for complete soft tissue coverage.
The Full Healing Timeline
The time required for complete resolution varies significantly based on the chosen treatment method. If the conservative approach relies on natural bone sequestration, the process takes longer. It may take four to eight weeks for the small bone fragment to fully detach and for the adjacent gum tissue to cover the defect.
Pain and sensitivity should decrease once the sharp edges are smoothed and a protective dressing is applied. If secondary surgical closure is performed, initial recovery is similar to the original surgery, with primary discomfort lasting three to five days. The site is immediately protected by the re-sutured tissue, and pain is typically resolved more quickly than with the slow sequestration process.
The goal is complete re-epithelialization, meaning the gum tissue fully grows over the site. This milestone is usually reached within two to four weeks following the final successful intervention. While soft tissue heals relatively fast, the underlying bone continues to remodel for several months, and the long-term prognosis for a comfortable surgical site is excellent.