In about five percent of patients, bony growths are found that are normal variants.  An exostosis is a thickening of bone around the teeth.  A torus (plural tori) is a larger area of bone, and can appear in two forms:
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- Found on the middle of the hard palate (first picture)

​These bony growths appear to have a genetic link, but environmental situations tend to make them larger.  Bruxism (tooth grinding) and ice chewing especially seem to make them worse.

Exostoses, the growths directly adjacent to the teeth, can make it more difficult to keep the teeth clean, since the bone’s overgrowth makes it more difficult to position a toothbrush and floss properly around the teeth for good home care.

Tori are generally not a problem, except when a removable prosthesis, such as a partial denture or complete denture has to be fabricated.  Tori can cause these problems with a prosthesis:
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• Tori have very thin gingiva over them, and movement of a prosthesis can rub sore spots.
• The position of the bone gets in the way of the prosthesis.
• A palatal torus keeps a complete denture from accomplishing a tight suction.

For these reasons, it is especially important for patients that have tori to keep their teeth and gums in excellent shape.  Many people have had tori most of their life with no problem, and just assumed everyone had the same thing!

In cases where tori or exostoses are in the way for a prosthesis, a minor surgical procedure is used to remove them so that the complete denture or partial denture can be fabricated without problems.  Mandibular tori and exostoses can be removed by most general dentists, while a palatal torus is often referred to an oral surgeon when a complete denture is needed.

It is also possible to have a bony growth that doesn’t belong there.  Cancers called osteomas and sarcomas can form cause unusual bone growth in the mouth.  In virtually all cases, these growths lack symmetry, growing on just one side of the mouth or notably large on one side than the other.

Of the three causes for tooth loss, the one that surprises most people is excessive bite forces.  The American Dental Association says that approximately one in three adults grind their teeth when they sleep. 

The condition, called bruxism, places unhealthy forces on teeth that can cause flattened or worn-down teeth, chipped areas at the gumline, loose teeth, and damages to your jaw joint.
 
The most frequent causes of bruxism are stress and bite discrepancies.  In a healthy bite, the teeth come together in harmony to protect the teeth and your jaw joint.  That harmony can be lost when you have periodontal disease, tooth crowding, or missing teeth that have allowed the remaining teeth to shift or tilt.  Even if your bite is perfect, stress can cause you to grind your teeth.  Of people that are restless sleepers, 95% grind their teeth.  The same brain activity that causes you to toss and turn also causes the bruxing.

Let’s look at an example of bruxism.  In the first photo, the teeth have already been shortened by at least one-fourth of their length.  Often patients with problems even this severe are not aware that they are bruxing, and many will even deny it when shown the severity of the problem.   And if your spouse sleeps more soundly that you, he or she may also be unaware of the problem.

As a dentist, I hear patients make comments like “I sleep with my mouth open, so that can’t be happening.”  Bruxing doesn’t occur constantly when you sleep, but if it’s happening, it still will cause damage.

Below are some questions that may tell you a problem is present:

• Have you noticed worn teeth that seem to be getting gradually worse?
• Do your teeth feel like they have more than one place that feels like a “home base” to touch when all of the teeth come together?
• Do your jaws feel tired at the end of the day or when you awaken in the morning?
• Do you sometimes awaken with headaches?
• Do you avoid eating foods like bagels because it’s not comfortable?

​One treatment for bruxism is the use of a bite guard.  A bite guard is a plastic appliance that fits over your teeth and protects them from damaged that’s caused by grinding.  The kind of bite guards sold at the pharmacy can actually make things worse.  Custom nightguards can be made that are extremely comfortable, and the newest designs, like the one shown here, actually have a relaxing effect on the muscles.

​If the arrangement of your teeth lacks harmony, there may be advantages to changing how your bite comes together.  Orthodontic treatment (“braces”) can make dramatic changes, or your dentist can use a process called equilibration to reshape the biting surfaces of your teeth to improve the way they come together.

Those in and around Fleming County, suffering from tooth grinding and other issues from Bruxism, should contact Dr. William Moorhead, at Flemingsburg Dental care.  If you’re suffering headaches, or see tooth wear that you’re concerned about, give us a call at 888-733-3163.   Your teeth and your mouth will thank you!