The Bumps in My Mouth...

I saw two patients within the past 2 weeks with the same question: what are these bumps in my mouth? They are painful when brushing as the brush head is hitting them; they feel like bone... And in both cases we were looking at tori (read as torAy).

Exostoses or tori are bony protrusions of the bone in either the upper or the lower jaw. Part of their presence is due to genetics, exacerbated by clenching/grinding or excessive forces in the mouth where bone is trying to fight back the pressure being exerted, and sometimes (not often) they are enlarging due to neoplastic/malignant/cancerous type situations in the bone. Typically, these bony structures don't grow fast. It takes years for them to get big. most times people don't really notice their presence even until it's brought up to their attention by the dentist or hygienist, especially if they're not really large of course. But sometimes, they do enlarge fast (within 4-6 months, they become double the size that they were before). In those cases, typically we want to make sure that there is no malignant cause behind the situation (rule out cancer type growth) and so do biopsy.  But as mentioned, it's not often that such situation arises. What is typically the case though is that they become bothersome to the person since food gets trapped around them or certain things like the head of the toothbrush or even certain types of food hit them often. And because the gum over those areas is not very thick, the pressure exerted, is felt majorly. If these structures are on the lower jaw towards one's tongue, they could even tighten up the space for the tongue.

It is quite easy to remove them of course; however there is a chance for recurrence since they are in the genes of the patients to begin with or that they are caused by excessive forces like clenching/grinding as mentioned. Is that reason enough to leave them alone? If they are not uncomfortable and one is not about to get a partial or denture, then leave them alone. But if they are causing issues with hygiene or tongue space or food packing, surely remove them. There is gonna be some soreness for a few days after the procedure since it involves the bone, so plan accordingly.