Mouth is a unique part of our body. It consists of a wide range of oral tissues that have different presentations, functions, and characteristics.
The palate forms the essential part of our oral cavity. It is hard and concave in shape and is covered by a layer of soft oral tissue.
It plays multiple roles like separating the oral cavity from the nasal cavity, acting as a support for the soft palate, helps us in our speech and many more.
In some instances, a bony growth commonly in the form of the nodule may present around the midline of the palate.
These bony overgrowths may look concerning, and if significant, it may cause a little discomfort but are usually harmless and painless.
Such bony overgrowths on the palate are called as Torus Palatinus. They are not life-threatening by nature but may require attention if they get infected or cause a severe problem in the daily functions of the mouth.
In this article, we will unfold the facts about Torus Palatinus and learn about its causes, symptoms, complications and treatment options.
What is Torus Palatinus?
Torus Palatinus is clinically defined as a bony protrusion on the surface of the hard palate, usually present on the midline of the palate.
It is typically small in size, i.e. less than two centimeters in diameter, but it may vary in rare instances. (1)
Torus Palatinus is considered as a non-neoplastic oral lesion which means that it is not a malignant lesion and is harmless and painless by nature.
The bony outgrowths are often referred to as exostoses. (2)
This condition can be noticed at an early age as 11 years up till 20 years and usually starts to shrink in size over time as a result of natural bone growth and accommodation.
What causes Torus Palatinus?
The exact cause of this oral condition is often unknown, but there are suggested causes that may lead to the formation of this bony overgrowth.
- Hereditary factor – It is considered to be autosomal dominant and can present in patients who have a family history of Torus Palatinus. The prevalence is around 40-60% in such individuals.
- Trauma – Any accident that involves the bony structure of the oral cavity may result in a bony overgrowth.
- Bruxism/clenching – Sometimes the forces applied by the teeth during clenching may impact the surrounding bone and chewing muscles.
- Nutritional deficiency – Inadequate amount of calcium and vitamin D that is essential for the proper growth of teeth and the bone may become a reason for this abnormal outgrowth.
- Medications – In patients suffering from seizures or muscle spasms, anticonvulsant medications like phenytoin may sometimes cause Torus Palatinus to form on the palate.
- Blocked salivary glands.
What does a Torus Palatinus clinically look like?
As the name suggests, Torus which means lump and Palatinus which refers to the palate in the mouth.
Torus Palatinus presents as a single or multiple nodular outgrowths of the bone, covered with the soft oral tissue of the palate and occurs in the midline.
The growth can vary in shape. It can be flat, spindle-shaped with a midline ridge or nodular. This overgrowth is generally small in size and may measure up to 2 cms in diameter. (3)
Torus Palatinus are usually painless and do not interfere with functions like chewing, swallowing or speaking. But may cause discomfort if they grow bigger.
Large overgrowths may sometimes irritate the mouth and if injured may take a long time to heal.
One of the significant problems that Torus Palatinus creates is during the fabrication of a dental appliance like a denture or a removable orthodontic retainer.
An infection in the Torus Palatinus may cause ulcerations and pain and may even spread to the surrounding bone and soft tissue.
Who is at risk?
Torus Palatinus is a common oral condition which is prevalent in about 20% of the population in the United States. (4)
Most commonly women around 30 years of age are prone to development of this oral condition. Hereditary plays a significant role in the occurrence of Torus Palatinus within the family.
Although it is a benign condition, any trauma or alteration in the growth of Torus Palatinus may predispose it to a malignant lesion. The occurrence is as low as 0.07% in women and 0.11% in men. (5)
How is it diagnosed?
An oral surgeon or a dentist may diagnose this condition as follows –
- A positive family history of Torus Palatinus
- A complete oral examination including the soft and hard tissues
- Dental x-rays or CT scans to check the palatal surface
How can it be treated?
Usually, a Torus Palatinus doesn’t interfere with the activities of the mouth but if you notice any symptoms of changes in the lesion, consult your dentist immediately.
- Oral surgery to remove the lesion is the standard treatment used to treat Torus Palatinus. The surgery is performed under local anesthesia.
- An incision is made in the middle of the palate, the bony growth is excised in its totality, and the soft tissue is placed back and sutured to heal.
- Recovery after surgery takes around 3-4 weeks. The surgeon may prescribe certain pain medications, diet modifications, and oral antiseptics to help ease the pain and help in fast healing.
Precautions to be taken
- Maintain good oral hygiene especially after the surgery to aid in the healing of the tissues
- Take time to relax and reduce stress
- Follow proper diet advised by the doctor. Avoid eating hot and spicy food that may irritate the tissue
- Keep yourself hydrated all the time
What are the complications associated with Torus Palatinus?
There are certain risks associated with post-surgery. Although the rate of these complications is low, they may include:
- Oral infection especially around the surgical site
- Post-operative swelling
- Bleeding from the surgical site
- Affect to the nasal cavity during excision of the lesion
Take away message
Always keep a check on the changing conditions of your oral cavity. An early detection still reduces the complications.
Even though conditions like Torus Palatinus don’t pose a threat to your oral health, it is essential to maintain good hygiene and consult a dentist is required.
If you plan on to get it surgically removed, make sure that you are informed about the complications and associated risks before the procedure.
Follow your doctor’s advice and take necessary precautions to help in fast recovery. Stay informed about your oral conditions.