Simply put, a torus is a hard bony growth. It is called torus mandibularis when it is seen in the lower jaw, on the floor of the mouth or the sides of the tongue. In most cases, a torus is a harmless growth and can be left untreated if it is asymptomatic.
The condition is rare as compared to other dental pathologies. Causes of tori mandibularis are heredity, bruxism, psychological stress, etc. There is no treatment available for torus mandibularis other than surgical intervention.
Let’s understand torus mandibularis in detail from different perspectives like cause, features, symptoms, and complications.
Note: Torus mandibularis, mandibular torus, tori mandibularis or mandibular tori are all same. Tori is the plural form of the torus.
Causes of Tori Mandibularis
Heredity is the most commonly associated etiology with tori. A genetic predisposition for developing tori is seen in Asians more than other populations.
Psychological stress is another factor linked to the growth of tori. No definite cause or origin is yet known for tori formation. (2)
Features of a torus
Research shows that torus mandibularis is more common in males than females. Also, this condition is seen more in adults than in children. Tori are also found to be more common in twins.
They are bilateral most of the times, seen near the lower premolars as small bony growths. The size of the tori can fluctuate, but most of them are the size of a small pebble.
If larger, the bilateral tori will meet at the midline of the mouth. Healthy gum tissue covers the bony growth.
Symptoms of tori mandibularis
- Large tori cause interference if you are a denture wearer, or wear any other prosthesis. Tongue movements also become difficult or painful. (3)
- Another problem that they cause is an accumulation of food in that region and difficulty in cleaning it.
- It is imperative to visit a dentist, even if there is no pain or interference in your regular oral habits because of the torus. A dentist will examine it, get some radiographs if needed, rule out any tumor or malignancy.
- If you ever notice a sudden pain, change in size, or discharge from the torus, you must report to this to your dentist for further investigations.
- Microscopically, a torus shows a typical bony pattern consisting of the bone cells, called osteocytes.
- Though a torus is asymptomatic in the majority of the cases, it may sometimes show inflammation, swelling, bleeding or even slurred speech.
- Occasionally, these tori may interfere in dental procedures like scaling or extraction. Then, the only option is to have them surgically removed.
- You may also experience difficulty in keeping the area clean due to the toothbrush angulation being unsuitable in the presence of the tori.
Classification of tori
Tori can be classified in various ways, depending on their appearance or size. One such classification is according to their size.
- Grade 1 tori are up to 3mm in diameter
- Grade 2 tori are up to 6mm in diameter
- Grade 3 tori are larger than 6mm in diameter
Living with a torus mandibularis
As we learned, unless the torus is bothering you, no treatment is required. But despite that, you may occasionally face some minor problems. Here are some tips to help you feel comfortable and avoid problems.
- Maintain good oral hygiene in the area of the tori. To prevent any food accumulation, you may have to use a smaller toothbrush to brush that part.
- When you are experiencing pain or redness over the torus, avoid spicy and acidic food including citrus fruits.
- Rinse your mouth with an antibacterial mouthwash to keep the area clean.
- Keep up with your regular dental appointments to check for any decay, secondary growth, ulceration or discharge.
Surgical Removal of a torus
If the torus is causing any problems like pain or interference, your dentist will advise you to surgically remove it, since there is no other available treatment. (4)
The surgical procedure, performed under anesthesia, primarily involves drilling out the bone. A bur, similar to the one used for drilling cavities, is used to drill out the bone and cut the mass.
Nowadays, oral surgeons also use newer methods like lasers, which are less invasive. (5)
The salivary ducts are close to the tori near the premolars. Therefore, a risk of injury to the ducts during surgery is always there.
Similarly, there is a possibility of lingual nerve damage, though quite rare. Sometimes, the surgery may affect the blood supply to the teeth, rendering them non-vital.
Over to you on torus mandibularis
A torus is a rare bony growth seen in about twenty percent of the total population. If you are lucky enough to have an asymptomatic torus, there is no treatment needed. If not, a simple surgical procedure can help you get rid of torus mandibularis.