Tori (or a single torus) are bumps in the mouth made of bone tissue covered by gum tissue. They grow slowly and some people have them without ever noticing them! There are three kinds of tori, each named differently based on their location:
The growths can appear as single or multiple nodules in a range of shapes: regular or irregular, flat, spindle-shaped, or nodular. Inside your mouth, mandibular tori emerge on the backside of your lower gums – with the bony growths developing on either or both sides.
Mandibular tori symptoms may include: One or more bony growths on your lower jaw, under your tongue. (This can happen on one side or both.) Difficulty chewing or swallowing.
Torus mandibularis is thought to be caused mainly by environmental factors, such as bruxism, vitamin deficiencies and calcium-rich supplements, although genetic background also plays a key role. Clinical diagnosis is usually straightforward, and investigations are generally not required.
Common Symptoms
The fact that their growth occurs so slowly over the years, mandibular tori can pop up without you ever thinking about them. It might take a comment from your dentist or hygienist for you to realize that they're even there.
Unfortunately, tori do not shrink over time. They will grow to a certain point, and then stop growing. A surgical team will need to remove them if your dentist deems it necessary.
Tori—Disease Fact Sheet
These lesions can present at any age but are usually noted in early adult life. They are common, detected in 25% to 40% of the Unites States population (higher incidence in torus palatinus).
Stress in the jaw bone and bruxism are other factors. This condition is more common in early adult life, and consequently, it is believed that mandibular tori are the result of local stresses and not solely on genetic influences.
In most cases tori are benign and do not require treatment. However, tori will need to be surgically removed to accommodate upper or lower dentures and upper or lower partial dentures (flippers). Tori may also be removed to aid in minimizing food impaction under the excess bone, which will promote improved home care.
In most other cases, such as the presence of small tori that does not cause pain or obstruct dental prosthetics, most dentists will recommend not removing the tori and simply keeping a watchful eye on it. In most cases, the presence of tori is completely harmless.
Mandibular tori are very slow-growing, so much so that it can be challenging to identify what causes tori to grow. There is some evidence that bruxism can speed up the growth of tori. Diet may play a role in the growth cycle. Some tori also grow for a period of time, shrink, and then begin to grow again.
Is mandibular tori caused by stress? The causes of mandibular tori are not fully understood, although environmental factors and diet are generally thought to be factors in developing these growths. Jaw stress is also related to tori growth, and emotional stress can be a contributor to jaw stress.
The size of the tori may fluctuate throughout life but they do tend to get bigger over time. In some cases the tori can be large enough to touch each other in the midline of mouth. Consequently, it is believed that mandibular tori are the result of local stresses and not solely on genetic influences.
The patient receives general anesthesia, and the dentist uses a scalpel to access the bone and a drill to remove it. Although the surgery is not necessarily more uncomfortable than a wisdom tooth extraction, the oral surgeon may need to use chisels and mallets to loosen the bone to remove it.
Tori are considered normal and harmless. Phew! Tori may, however, get in the way of dentures or orthodontics in some cases. Or they may grow to a point and touch in the middle of the mouth.
Tori, or mandibular tori to give it its full name, are small growths of bone that tend to grow on the tongue side of our gums where teeth grinding is present. They are harmless but do indicate that the patient may be grinding their teeth.
Especially large tori can get in the way of proper eating. Chips, crusty bread, and other crunchy foods present real difficulty. Food particles may become lodged in the tori, causing discomfort or bad breath.
Removal is recommended. Smaller cysts can often be removed under a local anesthetic. Larger cysts, however, may require a more involved procedure and the reconstruction of the missing bone mass. If you are concerned about any growths of excess bone in your mouth, it is important that you have them examined right away.
Similar to enlarged tonsils or adenoids, a large tongue, or an enlarged uvula, large mandibular tori can contribute to breathing obstructions, making one more susceptible to snoring and sleep apnea. That's why a surgical correction should be done prior to oral appliance or CPAP machine therapy.
Mandibular tori can be a painful condition that causes your throat and jaw to hurt, your gums to get inflamed, and even your teeth to come loose. Typically, these bony growths appear inside your mouth on the lower jaw. These growths often appear on both sides of the jaw.
Tori usually become apparent during the second or third decade of life. Tori may develop at the midline of palate (torus palatinus [TP]) or the lingual aspect of the mandible (torus mandibularis [TM]).
Mandibular tori usually are present near the premolars and above the location on the mandible of the mylohyoid muscle attachment. In 90% of cases, a torus is on both inner sides of the mandible (left and right), however, they may differ in size.
The prevalence of mandibular tori in the population can range from 5%-40% and is less common than tori on the palate. Tori has been shown to be more common in Asian, Native American, and Inuit populations.
We may apply a periodontal dressing to protect the surgical site and keep you comfortable. The dressing will harden in a few hours. In most cases the dressing is left in the mouth for a period of 7-14 days and may be changed once or more by the doctor during this time.