Dental Tori: Lingual, Bilateral, and Sub Torus

Tori or “Dental Torus” are benign bony growths of the mouth, especially of the lower mandible. Tori of the lower jaw are called mandibular torus or bone exostoses. Tori bumps can grow high or low in the mouth, and don’t require removal except in preparation of denture fitting. These abnormal bone protrusions grow larger with age. Large tori in older patients can interfere with fitting upper or lower dentures, and should be removed.

Three common types of dental torus are:  lingual, bilateral, and sub tori. Growths of the upper, soft palate are called Palatal Tori.

1.) Lingual/Mandibular Torus

dental toriLingual or “tongue tori” is a dental term for a singular mandibular torus. Mandibular (or lingual tori) form on the bottom jaw, under the tongue.

These single (one-sided) growths are made of bone – non-movable, smooth, and hard to the touch. Lingual torus starts in the teens as a small bump on the mandible, and grows larger in older dental patients. Removal of lingual torus is not necessary unless:

  • The bumps grow so large they touch and irritate each other
  • The tori are interfering with speech or oral hygiene
  • They become bruised and painful from brushing, sharp foods, or dental trauma
  • The patient needs braces, dentures or other dental fittings
2.) Bilateral Mandibular Tori
tori and teethLingual/mandibular tori may grow on one side of the mandible, or both sides. When growth occurs on one side, it’s called a singular lingual torus. Multiple growths of bone are called the plural, “tori.” Growth on both sides of the jaw line is called bilateral mandibular tori.
Bilateral mandibular tori makes up 90% or more of all tori growths – it’s the most common type of dental tori. Bilateral growth should be even, with both sides growing the same size (or roughly the same size.) One side being bigger than the other, or one torus growing fast in a short time period could indicate cancerous growth. Bilateral tori are benign, and can be smooth or rough (like a cauliflower), but both should be even in size, texture, and growth.

3.) Sub Mandibular Tori

sub mandibular tori
Sub Mandibular Growths

Sub mandibular tori is the technical definition for any torus of the lower jawline. “Sub” is latin for “lower” – a lower bony growth affecting the jaws and gums.

Sub defines all types of lower torus: mandibular tori, bilateral tori, and exostoses. Sub tori are distinct from Palatal Tori, which are bony growths attached to the nasal septum, in palate of the the upper mouth. 

What Causes Dental Tori?

Causes include genetics (torus growth being higher in Asian and Eskimo populations), gender causes (more males than females develop torus) and bruxism. What is bruxism? Bruxism is a dental term for grinding teeth – normally at night. It’s thought that bruxism damages the dental nerves, causing the nerves to grow outward instead of downward. This puts stress on the teeth and gum bone, causing the bony growth on the gums. Bruxism is a less serious forum of TMJ, which requires wearing a mouth guard at night.

Is Dental Tori Cancer?

Dental tori are benign – meaning non-malignant, non cancerous tumors. Patients often worry about the sudden appearance of dental tori. However, it’s nothing to worry about. Signs of oral cancer include:

  • Sudden, rapid growths in the mouth (on bone or soft tissue)
  • Spots that “squish” when you push them (soft growths)
  • Pain, swelling, or numbness of the jaw, cheek, or tongue
  • Discoloring/dark/black/white spots on the tongue

Contrast this with mandibular tori, which is slow growing, hard bone, that normally causes no pain (except under abrasion/dental trauma.) Tori are not dangerous, but check with your dentist for a proper diagnosis of dental torus. Even bone cancer, a rare cancer which causes rapid bone growth, makes the bone “spongy,” soft and movable.

Tori Removal/Dental Insurance

tori removal surgery
Torus removal surgery

Removal of all tori types is a procedure done by a maxillary surgeon under local anesthetic. The specialist surgeon removes the thin gum flap covering the bone, and uses a rotary dental chisel to smooth the excess growth. The smooth jawline is then sutured closed with dissolving stitches.

Patients report the most painful part of the surgery is insurance – dental insurance doesn’t cover removal surgery in most cases, since tori removal is optional. Medicare/Medicaid is reported not to cover the surgery. Recovery time for tori removal surgery lasts a few weeks, and the patient is advised to gargle with salt water to prevent infection.