Have you ever found a growth inside your mouth while you were brushing your teeth? Thought you felt a bump under your tongue that wasn’t there before? You may have a torus mandibularis. Many people may mistake a bump under their tongue for a sign of oral cancer, but sometimes that’s just not the case. In fact, torus mandibularis is far more common than oral cancer, and a lot less dangerous. It is not a symptom of a more serious illness or disease, but if the bump it creates is large, you may have trouble wearing dentures. If you think you may have this condition, keep reading to learn more.
What Is Torus Mandibularis?
Tori (plural for torus) are bony growths that develop inside of the mouth, commonly on the inside of the lower jaw or on the roof of the mouth. If the torus develops on the lower jaw, or mandible, it is called a torus mandibularis. A torus that develops on the roof of the mouth, or palate, is called a torus palatinus. These are both examples of intraoral exostosis, which means an overgrowth of calcified bone in the mouth.
A torus mandibularis generally develops beneath and on the sides of the tongue, in the jawline near the premolars and molars. The tori most often occur on both the left and right sides of the mouth. You may have one growth, or you may have multiple tori at any given time. Many people have small tori without even noticing, or your dentist may find one during a routine oral exam. Most of the time, a torus mandibularis is benign and does not require any treatment. However, there may be some situations when your dentist may recommend removing the growth.
Causes, Symptoms, and Cures
A torus mandibularis usually does not present with a whole litany of symptoms like other conditions do. However, it is important to know what it looks like so that you can differentiate it from other more serious conditions like gingivitis or oral cancer.
The direct cause of a torus mandibularis is unknown although it is believed that genetics play a prominent role. Teeth grinding and hard chewing (masticatory stress) or clenching the teeth are also possible contributing factors. These behaviors can increase stress on the jaw, put pressure on the periodontal ligament, and encourage new bone formation next to the tongue. It is not a contagious condition, so you cannot catch this from someone who already has one.
Torus mandibularis is fairly common, occurring in about 10% of the general population, although some communities may experience higher incidences. For example, this is more likely to occur in certain ethnic groups, such as Inuit Eskimos. The incidence of torus mandibularis in the Inuit population, according to some studies, is between 50 and 90 percent. It also predominantly occurs in middle-aged men and is rare in children.
When examining the growth, your dentist may perform tests to rule out other potential issues. They may consider whether the growth may be a dental abscess, a salivary gland tumor, a vascular tumor, or a fibroma. CT scans and x-rays are helpful to your dentist in examining the nature of the bumps and making a more definitive diagnosis.
The primary indication is a hard bump or series of hard bumps on the inside (tongue side) of the lower jaw. These bumps are light pink in color and may be about two centimeters in width or diameter, and one centimeter in elevation. These are slow growing, so it may take several years to develop bumps that are noticeable enough for you to feel and see. If the tori grow large in the space underneath the tongue, you may notice slurred speech.
Since it is an instance of a slow-growing bone, it usually doesn’t pose patients with any problems, although they may feel the growth from time to time. Denture wearers may be more likely to experience problems with a torus mandibularis since the growth might interfere with the fit of the lower denture. There are no blood vessels in the actual torus, but the soft tissues covering the bone may become ulcerated. If this happens, the patient may experience discomfort or pain. If the torus is injured, it can become painful to eat or swallow.
Sometimes people mistake other symptoms as being caused by a torus mandibularis. If you are experiencing inflamed gums or tender gums, receding gum lines, or loose adult teeth, this is not likely to be caused by tori. If you have these symptoms, you will want to consult your dentist, as these are more likely to be caused by gingivitis rather than a torus mandibularis.
If there are no symptoms and the growth is not causing any problems, your dentist may recommend leaving it well enough alone. If the growth is small, this may not be an issue, but larger growths may be distracting. If the torus becomes painful or begins causing problems with chewing or with the fit of your denture, your dentist may recommend having it removed.
The only way to “cure” it is to have it surgically removed, although there are a few things you should do if your dentist recommends against removal. It is always important to have good oral hygiene—brush and floss regularly and make sure that you see a dentist at least twice a year. By keeping your mouth clean, you can reduce the chances of tori becoming irritated or ulcerated, which can be painful.
By making sure your dentist regularly examines your mouth, you can keep track of any growths inside your mouth and see how slowly or quickly they develop. Your dentist will also be able to make better recommendations if they are able to track the progression of your dental health over time.
Removal of the growths is generally recommended if the tori are interfering with dental procedures, such as crown placements, or if they are large enough to impede a denture fit or even chewing.
A surgery for removal can be performed by an oral surgeon. The patient is placed under general anesthesia, and then the growth is removed from the jaw. The oral surgeon may use a variety of tools to remove the growth, including a mallet and chisel, a reciprocating saw, or a bur technique to grind down the bone and smooth it. In some cases, your dentist may recommend newer techniques, like lasers. Because the bone growth has no blood vessels, blood loss during this surgery is minimal.
Removing it through oral surgery, one must note, that there is a recovery period after the procedure. Your oral surgeon will give you instructions on what to do and what to expect after the procedure. If you have questions, make sure to ask them before you leave the office.
You may want to take a day or two to rest after the procedure to speed up the recovery process, and pain medication like ibuprofen may ease any pain or discomfort you experience. Your oral surgeon may recommend that you eat soft foods after the procedure, in order to avoid irritating the inside of your mouth. They may also recommend a salt water rinse to help clean the area and make sure that food does not get trapped in any stitches used during the procedure.
Is a Torus Mandibularis Cancerous?
The short answer is no. A torus mandibularis is not oral cancer, and it does not turn into oral cancer.
Oral cancer is rare, while torus mandibularis is fairly common, and the growths involved in each condition are very different. Cancer is found in the soft tissues of the mouth, such as the tongue or cheek. Most often, it appears red in color and may be asymmetrical, appearing on only one side of the mouth. Cancer of the lower jaw will also present with more symptoms than benign tori, including numbness of the lower lip or hard swelling of the lymph nodes under the jaw. A torus mandibularis does not cause any lymph node swelling or any numbness in the lip or tongue, being a simple bone growth instead of a soft tumor.
If you have a bump in your mouth but have no pain or inflammation, it is more likely to be a torus mandibularis than oral cancer.
If you detect a hard growth inside your mouth, it is far more likely to be a torus mandibularis than oral cancer. The chances are that it is benign, but it is always best to consult an expert when it comes to your health. An oral cancer exam should be part of your routine dental exam, and you should always have any abnormal growths checked by your dentist. They are specially trained to detect oral cancer and are best suited to tell you whether that bump in your mouth is a simple torus mandibularis or something more serious. If you have any concerns about anything unusual in your mouth, your dentist is in the best position to help you.