Mandibular tori are abnormal growths of mouth bones on the lower jaw under the tongue. They grow slowly and are usually asymptomatic. That is why you may discover them only coincidentally.
In most cases, they grow in twos. Often their growth stalls spontaneously. You do not need to remove them surgically, but an operation may be required if they get infected or interfere with your speaking ability and removable dentures.
Mandibular tori is the plural form of torus mandibularis. A single outgrowth may be called a mandibular torus.
Types of Oral Tori
One may have the following three types of tori in their mouth.
- Torus Palatinus: It is one of the most common tori one may have. It grows on the midline of the hard palate or roof of the mouth and is more common in females than males, according to the Journal of the International Society of Preventive and Community Dentistry.
- Torus Mandibularis: (The topic of this article) It grows in the canine and premolar areas on the lower jaw. It is as common as torus palatinus and happens more to males than females.
- Buccal Tori: They are rare. They appear in the premolar-molar area. Dental professionals would like to call them buccal exostoses.
Torus Palatinus may also appear in the premolar to molar and incisor to premolar areas. Similarly, the location of the mandibular tori has been recorded as incisor to canine, molar and premolar and canine to premolar.
Characteristics of Mandibular Tori
- They are hard bony mass.
- The mucosa layer covering them may be stretched.
- They do not appear in a different color than the color of the inside soft layer of the mouth.
- Mandibular tori appear during adolescence but continue to grow larger with time.
- They may stop growing spontaneously.
- 1% to 10% of people may have mandibular tori, while 38% to 68% of people may have palatinus tori outgrowths.
- Most mandibular tori may be of medium size.
- They grow mainly in the canine to premolar area.
- They may stop growing after you become 30 years of age.
What Causes Mandibular Tori
According to recent research in the field of dentistry, the following have been connected to the appearance and growth of the mandibular tori:
- Genetic Factors. It may result from the impact of the Y chromosome on your growth and may be passed on from generation to generation.
- Functional Factors. If you do not have teeth, or if you do not have enough teeth left in your mouth for chewing food effectively, you may grow mandibular or palatinus tori.
- Abnormal Growth of the Jawbone. Your jawbone may not stop growing with age and may grow tori in your mouth.
- Masticatory Muscle Disorder. The hyperfunction of your mouth muscles may be behind your mouth tori. According to Acta Odontologica Scandinavica, an increase in the activity of the mouth muscles may increase bone apposition.
- Local or Ethnic Factors. If you belong to a location where people consume a lot of fish and other calcium-rich diets, you may have mouth tori.
- Mouth Injury. A serious trauma or injury to the mouth’s interior may result in mandibular or palatinus tori.
- Bruxism. You can grind or clench your teeth while awake and asleep. Both may change the behavior of your jawbone. Putting your jawbone under heavy stress can result in mouth tori, either mandibular, palatinus or buccal.
How Dangerous are Mandibular Tori?
Mandibular tori are usually asymptomatic and painless. That is why it is hard to know when they begin to develop. However, if you have them already, it is good to know that they are not cancerous, and you do not need to remove them until you have to.
However, mandibular tori can cause several problems at the height of their growth.
- You may find it challenging to keep your dentures in place. Mandibular tori will push them away from their position.
- You may feel particular irritation in your gums. Your dentist can tell you whether that irritation results from mandibular tori or other oral complexities.
- According to Clinical otolaryngology, the official journal of the Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, the tori may occupy the space reserved for the tongue, thus influencing the airway volume and creating sleep apnoea.
- Mandibular tori may interfere with your articulation. Your speech may turn slurry, although such a case is rare.
- Food items may be locked between or behind the tori, thus contributing to bacterial growth in your mouth.
- Can they cause throat ache? Sure, they can. Throat pain may be why your dentist examines your mouth to determine if you have mandibular tori.
- Although their growth is painless, mandibular tori may pressure your jawbone while chewing food.
- Large tori may make intubation difficult for some patients.
How to Remove the Mandibular Tori?
If the mandibular tori interfere with your speech or dentures, you may want to remove them. You cannot remove them at home. You have to see a dentist to remove them for you.
A dentist has two options to remove a Torus Mandibularis:
- Surgery. A dental surgeon can remove your mandibular or palatinus tori using standard surgical tools. The surgery will involve thoroughly examining your oral cavity to locate the tori, measure their heights, and decide how much of the bone has to be removed.
- Laser Technique. Your dentist may use a Solea CO2 laser or an Erbium YAG laser to remove the tori bone. The laser will cut 90% of the bony growth. The rest of the bone will be removed by using an instrument called the elevator.
Mandibular Tori Removal: Surgical Procedure Step-by-Step
The removal of the tori is a standard surgical procedure. It includes the following steps:
- Evaluation of your medical history
- Application of local anesthesia at the spot of the surgery
- Opening the thin skin covering the mandibular tori to access the bone
- Removal of the tori bone
- Application of saline to clean the wound
- Stitching of the thin skin to close the wound.
Costs of mandibular tori removal
The surgical removal of a mandibular torus may cost you as much as $700. However, the costs may increase based on how big the torus is. Removing a bigger torus may require a longer time. If you choose the laser technique, the costs may be higher. Besides, the expertise of your dentist and the place you live may also influence the costs.
How long does it take to recover from the tori removal?
A tori removal surgery requires 6-8 weeks to heal. In the week following the surgery, you may have some pain and swelling in your jaw. They should be gone soon if you follow the post-op instructions thoroughly. The spot of the wound will still require care and attention. Your dentist may prescribe amoxicillin and Ibuprofen until your wound is completely healed.
Does the bite force influence the size of the mandibular tori?
According to research published in Cranio, the Journal of Craniomandibular Practice, an increase in the bite force may proportionately increase the size of the mandibular tori. The study, however, did not connect the tori types with the bite force.
Mandibular Tori: Insightful Facts
- According to Canadian Medical Association Journal, the prevalence of mandibular tori is the lowest in whites (8%). The rate is 16% for blacks and the highest for Asian and Inuit populations.
- The growth of the tori is very slow.
- Most of the tori remain less than 2mm in size.
- The consumption of saltwater fish in Norway may have been behind the increased number of tori among dental patients there.
- There may be no mouth swelling or Lymphadenopathy involved in the growth of the tori.
- The tori are an anatomical variation and not a pathological situation, according to research published in Meandros Medical Journal in 2016.
- The number of teeth in the mouth may be related to the presence of mandibular tori.
- Half of the tori are round in shape.
- The highest number of tori was seen in the 40–60 age group, according to research published in Homo in 2006.
- V. K. Hiremath, A. Husein, and N. Mishra. Prevalence of torus palatinus and torus mandibularis among Malay population. Journal of the International Society of Preventive and Community Dentistry. Accessed: October 2, 2022.
- S Kiliaridis. Masticatory muscle influence on craniofacial growth. Acta Odontologica Scandinavica. Accessed: October 2, 2022.
- Maxime Mermod, MD and Remy Hoarau, MD. Mandibular tori. CMAJ – Canadian Medical Association Journal. Accessed: October 2, 2022.
- Sarah Unterman, MD and Margaret Fitzpatrick, MD. Torus Mandibularis. The western journal of emergency medicine. Accessed: October 2, 2022.
- Torus mandibularis affects the severity and position-dependent sleep apnoea in non-obese patients. Clinical otolaryngology. Accessed: October 2, 2022.
- A. O. Ihunwo P. Phukubye. The frequency and anatomical features of torus mandibularis in a Black South African population. Homo. Volume 57, Issue 4, 3 November 2006, Pages 253-262.