What Are Tori?
Tori (singular: torus) are bony protrusions that grow on the surface of the jawbone inside the mouth. They are not tumors and they are not cancerous. Tori develop slowly over years and are one of the most common bony abnormalities found in the oral cavity.
There are two main types. Torus palatinus grows along the midline of the hard palate (roof of the mouth). Torus mandibularis grows along the inner surface of the lower jaw, usually near the premolar teeth. Some people develop tori in both locations at the same time.
How Common Are Tori?
Tori are more common than most people realize. Studies estimate that torus palatinus occurs in roughly 20% to 35% of the population, while torus mandibularis affects about 5% to 40%, depending on ethnicity and geographic region. They are more frequently seen in women for palatal tori, and in men for mandibular tori. Tori often appear in early adulthood and grow slowly over decades.
What Causes Tori to Develop?
The exact cause of tori is not fully understood, but research points to a combination of genetic factors and environmental influences. If one or both of your parents had tori, you are more likely to develop them.
Genetic and Environmental Factors
Studies of twins and family groups show a strong hereditary component. Certain populations, including those of Asian, Inuit, and Scandinavian descent, have higher prevalence rates.
Mechanical stress on the jaw may also play a role. People who clench or grind their teeth (bruxism) appear to develop mandibular tori at higher rates. The repeated pressure on the jawbone may stimulate extra bone growth over time.
Diet and Other Contributing Factors
Some researchers have proposed that diets high in saltwater fish or foods rich in certain minerals may contribute to tori formation, based on the higher prevalence seen in coastal populations. However, this connection is not firmly established. Vitamin and mineral intake, particularly calcium and vitamin D, may influence bone growth patterns in the jaw.
What to Expect During Tori Removal Surgery
Tori removal, also called a torus reduction or torus excision, is a straightforward outpatient procedure. It is most often performed by an oral surgeon, though some general dentists with surgical training also perform the procedure.
Before the Procedure
Your oral surgeon will examine the tori and may take X-rays or a CBCT scan to see the size and shape of the bony growths. You will discuss anesthesia options. Most tori removals use local anesthesia with optional conscious sedation. Your surgeon will review your medications and health history to plan for a safe procedure.
During the Surgery
Once the area is numb, the surgeon makes an incision in the tissue overlying the torus. The tissue is folded back to expose the bone. The surgeon then removes the bony growth using a combination of surgical burs, chisels, or a piezoelectric device. Piezoelectric instruments use ultrasonic vibrations to cut bone precisely while protecting soft tissue.
After the excess bone is removed, the surgeon smooths the remaining bone surface and repositions the tissue. Stitches close the incision site. The entire procedure typically takes 30 to 60 minutes, depending on the size and number of tori being removed.
Anesthesia Options
Local anesthesia is the standard choice for most tori removals. For patients with dental anxiety or those having multiple tori removed at once, IV sedation or oral sedation may be added. General anesthesia is rarely needed but may be considered for very large or complex cases.
Recovery and Aftercare
Most patients describe the recovery as manageable, similar to recovering from a tooth extraction. The first week is when most healing takes place.
The First Week After Surgery
Swelling is normal and peaks around 48 to 72 hours after surgery. Applying ice packs to the outside of the face for 20 minutes on and 20 minutes off during the first day helps control swelling. Some bruising may appear around the jaw or chin area.
- Eat soft foods such as yogurt, mashed potatoes, smoothies, and scrambled eggs for the first 5 to 7 days
- Avoid hot, spicy, or crunchy foods that could irritate the surgical site
- Rinse gently with warm salt water starting 24 hours after surgery
- Take prescribed pain medication as directed; over-the-counter ibuprofen often provides adequate relief
- Avoid using straws, as the suction can disturb the healing site
Weeks Two Through Four
Stitches typically dissolve or are removed within 7 to 10 days. The gum tissue continues to heal and reshape over the underlying bone. Most patients feel comfortable returning to their normal diet within 2 to 3 weeks. Complete bone remodeling underneath the tissue may take several months, but this process is painless and does not limit daily activities.
Potential Complications
Complications from tori removal are uncommon. The most frequent issue is a small area of exposed bone at the surgical site if the tissue covering is thin. This usually heals on its own. Infection is rare when patients follow aftercare instructions. In cases involving palatal tori removal, there is a small risk of creating a communication between the mouth and the nasal cavity, though this is very rare with experienced surgeons.
Cost of Tori Removal Surgery
The cost of tori removal depends on several factors, including the number and size of tori, the type of anesthesia used, and the geographic location of the practice. Costs vary by location and provider.
Typical Price Range
Most patients can expect to pay between $500 and $2,500 per site. Removing a single small torus on the lower jaw with local anesthesia is at the lower end. Removing large palatal tori or multiple mandibular tori with sedation is at the higher end. If the procedure is done in a hospital or ambulatory surgery center rather than an office, facility fees will add to the total.
Insurance Coverage
Dental insurance may cover tori removal when the procedure is deemed medically necessary. Common qualifying reasons include tori that prevent proper denture fit or tori that cause recurring ulceration of the overlying tissue. If the surgery is considered elective, insurance is less likely to cover it. Medical insurance may apply if the procedure is performed in a surgical setting. Always verify coverage with your insurer before scheduling.
When to See an Oral Surgeon About Tori
Many people live with tori for years without any problems. However, there are specific situations where evaluation by an oral and maxillofacial surgeon is a good idea.
Signs That Removal May Be Needed
You should consult a specialist if your tori are large enough to interfere with denture placement or fit. Tori that make it hard to eat, speak clearly, or maintain oral hygiene are also worth evaluating. Frequent sores or ulcers on the tissue covering the tori, caused by food or normal chewing, are another reason to seek a consultation.
- Tori that prevent a denture or partial from fitting properly
- Difficulty eating because food gets trapped around the bony growths
- Repeated irritation or sores on the tissue over the tori
- Speech changes caused by large palatal tori
- Tori that are growing rapidly or changing in appearance
Find an Oral Surgeon for Tori Removal
Tori removal is a routine procedure for oral and maxillofacial surgeons. When choosing a provider, look for a surgeon who is board-certified and experienced in dentoalveolar surgery. Ask how many tori removal procedures they perform each year and what anesthesia options they offer.
Your general dentist can provide a referral, or you can search for oral surgeons in your area who specialize in minor office-based surgical procedures. If you need tori removed before getting dentures, your prosthodontist and oral surgeon should coordinate the treatment plan together.
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