What are Tori and Exostoses?

In hard palate.

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)

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On the gums, by tongue

- Or, on the gums adjacent to the tongue. (second picture)

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​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.