A Guide to Torus Mandibularis: Dealing with Bony Bumps in Your Mouth

Torus mandibularis (or mandibular tori) are bony, flesh-covered bumps that develop on the inside of the lower jaw. Most people who get them will have one on each side of their mouth, but they sometimes develop one at a time instead.

The growths are usually less than 2mm in size and are located near the person’s lower premolars.

Mandibular tori are almost always harmless, but they can cause pain and irritation in the area around them or make it hard to chew or wear a dental prosthetic. In these cases, the growths can be surgically removed.

In the meantime, people can treat any irritation in their mouths with some simple home remedies.

How Many People Are Affected?

Scientists recognize mandibular tori as a common occurrence, but they have had trouble figuring out exactly how many people have them. The studies that have been done on this topic have found prevalence rates as low as 0.5 percent and as high as 63.4 percent.

The condition appears to be more common among Asian and Inuit populations, according to various studies. Prevalence estimates for other countries are usually much lower. For instance, an estimated 7 to 10 percent of the U.S. population will develop mandibular tori in their lifetime.

Causes 

Researchers do not know exactly what causes mandibular tori to develop. Their best guesses based on currently available evidence include: 

• Trauma in the affected area

• Diet (especially diets high in saltwater fish)

• Vitamin deficiencies

• Excess calcium from supplements or environmental exposure

Some scientists believe that it is a combination of these factors that causes a person to develop mandibular tori. However, they have not identified exactly how the interaction of these factors prompts excess bone growth.

Symptoms & Diagnosis 

Mandibular tori are usually easy to spot and do not require any special investigation to diagnose. They are not easily be identified on X-rays, so dentists typically settle for a visual examination rather than resort to more invasive testing.

However, there are other uncommon bony growths that might be mistaken for mandibular tori, including: 

• Fibromas

• Osteomas

• Mucoceles

• Osteochondromas

These growths have different implications for your overall health and may require different treatments to keep them under control.

Your dentist may biopsy the growths to determine what they are and decide if a different course of treatment is needed.

Risk Factors

The following factors are associated with an elevated risk for developing mandibular tori: 

• A heavy, forceful bite

• Bruxism (teeth grinding)

• Young age (under 40)

• Being male

• Being of Asian or Inuit descent

However, because the exact causes of the condition are not known, there may be other factors that influence a person’s likelihood of developing mandibular tori. More study is needed to determine what makes a person vulnerable to this condition.

Treatment Options

Mandibular tori do not usually cause problems to the point that they require a treatment plan. However, some people find that their tori trap food and make it difficult to keep their mouth clean. When this happens, you might develop painful inflammation around the growths. 

Because mandibular tori are bone growths, you cannot get rid of them without surgical treatment from your dentist. If your mandibular tori are causing irritation in your mouth or are interfering with your ability to wear your dentures, night guard or other dental prosthetics, an oral surgeon can surgically remove them for you. Your health insurance may cover the cost of this surgery if it is believed to be medically necessary.

Dentists perform the surgery with either a drill or a laser. Most modern surgeons prefer to use lasers because they produce cleaner cuts that bleed less and are less prone to infection. After your procedure, your doctor may recommend: 

• Pain medication 

• Salt water rinses to control infection 

• A soft diet to minimize discomfort while you heal 

After a few weeks, your bone and oral tissue will heal and there will be no remaining trace of your mandibular tori. 

If you do choose to have your mandibular tori removed, it may be possible for your oral surgeon to use them as donor material for a dental bone graft. This bone material’s high density makes it excellent for this purpose, and because it is part of your body, it less likely to be rejected than donor tissue.

This material is rarely saved after removal unless the patient requests it, so be sure to tell your surgeon that you want to do this before your procedure begins. It may even be possible for them to complete the bone graft during the same procedure as the tori removal.

Home Remedies 

There are things you can to at home to reduce any gum inflammation in the area of the growths. 

• Swish a saltwater solution around in your mouth. To make your solution, add half a teaspoon of salt to a glass of warm water and stir. Swish this mixture thoroughly around your mouth, taking at least 30 seconds to ensure it reaches all the nooks and crannies around your tori.

• Swish with a 3 percent hydrogen peroxide solution. You can make this solution by mixing equal parts water and peroxide. Be careful not to swallow any of this mixture; you may make yourself sick or cause damage to your internal organs.

• Use a cold compress. The cold will compress the blood vessels in the area and help take some of the pain away.

• Take over-the-counter pain relief medication. NSAIDs like ibuprofen, naproxen, and aspirin work well, but should not be taken by children under 12 or by people with stomach problems, high blood pressure, or heart disease. These individuals can take acetaminophen for relief instead.

• Try some natural solutions. Natural substances like peppermint, vanilla extract, garlic, and clove oil can all help to disinfect the area and relive some of your pain.