Q: A few months ago, I had an extra bone suddenly (decide to) grow sideways out of my jaw and I experienced a SHARP pain. I have this excess bone on both sides of the jaw, under my tongue. The doctor was only surprised at how sharp the growth was, but she agreed that it happens all the time, and for no real reason. I currently have two under my tongue which sometimes get in the way of x-ray film. What is causing this excess bone in my mouth?
A: That is called Exostosis. If there is extra bone growth under the tongue, along the jaw line, then the lump may be a maxillary Tori. From your description you are identifying what is called a "Tori". If they are bilateral they are tori growths, for sure. It is very common to have it, and is nothing to worry about. I have seen many patients that have this.
The ADA Says: "The remedy is to have these bone growths removed. Although bony growths are not in themselves harmful (benign,) most dentists and oral surgeons suggest their removal, since as they expand they can weaken or damage surrounding nerve tissue and bone or affect the position of surrounding teeth."
I know this because I work as a Dental Assistant.
Extra Bone in Mouth Under the Tongue
Many people have mandibular tori (about 10% of the North American population.) These common bone growths can be on the inside of the jaw between the gums under the tongue, or they can be on the outside between the gums and the cheeks.
Its called tori (to-ri) and it is a bony projection in your mouth (located under the tongue.) It is removable by oral surgery, but commonly everyone gets it. As a rule they pose no issues and are not dangerous health wise.
In later years when your likely to have to wear a dental appliance they can then be a problem in that they can prevent the fit of an appliance or even prevent wearing one at all. It depends on how crooked your teeth are. If your ortho recommends tori surgery to fit a dental appliance, then the tooth is probably under bone and won't erupt, so your surgeon will have to go in and get it.
Extra Bone in the Roof of the Mouth
Bone growths are also found on the roof of the mouth. Some people do have extra bone on the roof's of their mouths, which is called palatal tori. It's simply an extra hard bone that grows on the palate, like an extra tooth. Some are large, some have lobes, or some can be very small. Some hurt, while others just might get in the way. If the lump is in the middle of your palate (or roof of your mouth), then it is likely a benign growth, and I wouldn't worry.
Bone Growth (Tori) Removal Procedure
It's not a complicated procedure and once removed they don't come back. How hard they are to get out depends on where they are in your mouth and under how much bone they are. An Oral surgeon can normally remove them quickly. Dental schools often remove tori, and you can be a practise patient for a reduced surgery cost.
Recovery after tori removal: Tori scraping/surgery would be similar to getting an impacted wisdom tooth out. Pain can last many hours or days after the procedure. In general, for faster recovery:
- Do not use alcohol based mouth wash. Use a good mouth wash containing antibacterial and antiviral medications.
- Try to rinse only with salted water and try to brush your teeth everywhere else but the removal sites.
- Try not to eat on the side of extraction.
- Try ice on your cheek for a while.
- Try to wash this area by a soft tooth brush, and avoid injuries.
- Try drinking warm, not too hot, tea, and doing something you find relaxing.
Extra Bone Growths Caused by Cysts
Like mandibular tori growths, cysts can cause hard lumps that look like bone on the jaw and tongue. The most common kinds of cysts that form in the oral cavity are periapical cysts, which are caused by infections spreading to the pulp of a tooth, or dentigerous cysts, which usually form around impacted wisdom teeth.
Oral Biopsy and Cyst Removal: Usually, a cyst can be removed with a simple surgical procedure. Cyst removal can usually be done under local anesthesia. If the cyst is very large, more extensive surgery may be required to reconstruct the bone after the cyst has been removed. Follow-up will with your dentist or oral surgeon will probably be necessary for some time afterwards to make sure that the cyst does not grow back.
Other Causes of Oral Bone Growth
Teeth buried inside bone pushing the other teeth, inadequate growth of either of the jaws, even tumours and cysts pushing the teeth can cause excess growth. An odontoma is a rare tooth related type of benign tumor, which can create bony lesions on the jaws.
Extra tooth Growing from Gums/Mouth Palate
Supernumerary (extra) teeth happen sometimes. In these cases, the tooth should be removed so that your other teeth can move through your bone unimpaired. If you have several of these mini-teeth, they may damage the roots of your full-size teeth if they're allowed to go rampant.
Surgery to remove extra teeth will retract the gums, and take out a little bone and probably section the tooth up so that it can come through a smaller hole in your bone, and then just get it out and stitch the wound closed.
Getting Bone Growths Tested
If you or your dentist or oral surgeon notes any irregular skin patches or oral growths of any kind, a biopsy will be done to diagnose the condition. If the lump is white, it could indicate and oral wart that needs to be biopsied.
While the large majority of such growths are benign (not cancerous), it is very important to determine this for sure with a biopsy laboratory test. To perform a biopsy, your dentist or oral surgeon will surgically remove a small piece of bone tissue from the area in question. This bone sample will be sent to the lab, where it will be examined under a microscope and analyzed according to the kinds of cells it contains.
Furthermore, many benign growths may require treatment, removal or monitoring as well. Your dentist or oral surgeon will inform you when the results of the biopsy are ready, and will then speak with you about what kind of treatment, of any, is necessary.
In general, you should take note of any changes occurring in the skin of the gums, the skin on the inside of the cheek, the tongue, or the floor or roof of the mouth, or any swelling in the bony areas of the mouth or face. If this is a new excess bone growth, make an appointment to have your mouth checked and followup with your general dentist.
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