Mandibular torus: what it is, causes, symptoms and treatment

A mandibular torus is a benign bony growth that appears on the inner side of the lower jaw, usually under the tongue. When there is more than one growth, they are often called mandibular tori.

Most mandibular tori are harmless and do not need treatment. However, they should be assessed if they grow, become painful, interfere with chewing, speech or oral hygiene, or make it difficult to wear dentures, mouth guards or other dental appliances.

What is a mandibular torus?

A mandibular torus, also called torus mandibularis, is a localised overgrowth of bone. It usually develops on the lingual surface of the mandible, which means the inner side of the lower jaw, close to the tongue.

It may appear as a single hard lump or as several bony prominences. In many cases, mandibular tori are bilateral, meaning they appear on both sides of the mouth.

Patients often describe them as a hard lump under the tongue, a “bone sticking out” inside the lower jaw or a firm swelling that does not feel like soft tissue.

Where do mandibular tori appear?

Mandibular tori usually appear on the floor of the mouth, near the lower premolars or canines. They are not usually visible when smiling because they sit inside the mouth, close to the tongue.

Their shape and size can vary. They may appear as:

• a single bony lump;
• several small bony nodules;
• a longer ridge of bone;
• symmetrical growths on both sides of the lower jaw.

They tend to grow slowly and may remain stable for years.

Mandibular torus causes: why do they appear?

The exact cause of mandibular tori is not fully understood. In most cases, they are considered multifactorial, meaning that several factors may contribute to their development.

Genetic predisposition

Some people are more likely to develop mandibular tori because of genetic factors. A family history of similar bony growths may increase the likelihood of developing them.

Bruxism and jaw clenching

One of the most common questions is whether there is a link between mandibular tori and bruxism. Bruxism refers to grinding or clenching the teeth, often during sleep or periods of stress.

Repeated mechanical forces on the jaw may contribute to local bone changes in predisposed patients. This does not mean that every patient with bruxism will develop mandibular tori, or that all mandibular tori are caused by bruxism. However, if there is tooth wear, jaw pain, muscle tension or temporomandibular joint symptoms, it may be useful to assess the bite and jaw function.

At Face Clinic, patients with jaw overload, clenching, tooth wear or TMJ symptoms can be assessed by our oral and maxillofacial surgery team.

Oral anatomy and bite forces

The way the teeth meet, the shape of the jaw, the distribution of chewing forces and the patient’s oral anatomy may also influence the development or growth of mandibular tori.

Age and bone-related factors

Mandibular tori may become more noticeable in adulthood. Some studies also suggest that bone density and other biological factors may play a role, although there is no single proven cause.

Mandibular torus symptoms

Most mandibular tori do not cause symptoms. Many patients only notice them when they touch the area with the tongue or when a dentist points them out during a routine examination.

When symptoms occur, they may include:

• a hard bony lump on the inner side of the lower jaw;
• difficulty moving the tongue if the torus is large;
• speech difficulties in more prominent cases;
• food trapping around the bony growths;
• difficulty brushing or cleaning the area properly;
• irritation or ulceration of the thin mucosa covering the torus;
• problems fitting dentures, mouth guards or removable dental appliances;
• discomfort when eating if the mucosa is repeatedly traumatised.

The torus itself is usually not painful. Pain, bleeding, persistent ulcers or rapid changes should always be assessed by a dental or maxillofacial specialist.

Mandibular tori pictures: what do they look like?

Patients often search for mandibular tori pictures because they want to compare what they have noticed in their own mouth. In general, mandibular tori look like firm, smooth bony bumps under the tongue, on the inner side of the lower jaw.

They are usually covered by normal-looking oral mucosa. The tissue may look red or irritated if the area has been scratched, ulcerated or repeatedly rubbed by food or a dental appliance.

However, images alone are not enough for diagnosis. Several oral lesions can look similar to patients, and a clinical examination is the safest way to confirm whether the lump is a mandibular torus or something else.

Mandibular tori and cancer: should I be worried?

One of the most common concerns is “mandibular tori cancer”. In general, mandibular tori are benign bony growths. They are not cancerous and are not considered precancerous.

However, not every lump in the mouth is a torus. You should book an assessment if you notice:

• a new lump that grows quickly;
• persistent pain;
• bleeding without a clear cause;
• an ulcer that does not heal;
• changes in the colour of the oral mucosa;
• numbness or altered sensation;
• loose teeth associated with the area;
• difficulty swallowing, chewing or speaking.

A dentist, oral surgeon or maxillofacial surgeon can examine the area and decide whether any imaging or further investigation is needed.

How are mandibular tori diagnosed?

Mandibular tori are usually diagnosed during a clinical oral examination. The specialist will assess the location, hardness, shape, size and appearance of the mucosa covering the bony growth.

In some cases, imaging tests may be recommended, especially if:

• the diagnosis is uncertain;
• the growth is unusually large or asymmetric;
• surgery is being considered;
• the patient needs dentures or another dental appliance;
• there are symptoms that are not typical of a simple torus;
• other dental or bone conditions need to be ruled out.

A CT scan or 3D imaging study may help define the anatomy and plan treatment when required.

Are mandibular tori dangerous?

In most cases, mandibular tori are not dangerous. Many people live with them without pain or functional problems.

They may become a problem when they:

• grow large enough to interfere with the tongue;
• make chewing or swallowing uncomfortable;
• cause recurrent irritation or ulcers;
• make oral hygiene difficult;
• prevent a denture, mouth guard or dental appliance from fitting properly;
• affect speech;
• complicate another dental or surgical treatment.

In these situations, removal may be considered.

Mandibular tori removal: when is surgery needed?

Most mandibular tori do not require removal. Surgery is usually reserved for cases where there is a clear functional, prosthetic or clinical reason.

Mandibular tori removal may be recommended when:

• the tori interfere with dentures or removable dental appliances;
• they cause repeated ulcers or trauma;
• they make speech, chewing or swallowing difficult;
• they prevent proper oral hygiene;
• they cause repeated discomfort when eating;
• they need to be removed before a prosthetic or rehabilitative dental treatment;
• the diagnosis needs to be clarified.

If the mandibular torus is small, stable and asymptomatic, periodic monitoring may be enough.

How to get rid of a mandibular torus

There is no home treatment that can make a mandibular torus disappear. Because it is made of bone, it does not shrink with mouthwash, medication, massage or exercises.

When removal is needed, the treatment is oral surgery. The procedure involves removing or reshaping the excess bone.

In general terms, the surgeon makes a small incision in the gum, accesses the bony growth, removes or remodels the excess bone and then closes the area with stitches. The exact surgical plan depends on the size, number and location of the tori, as well as the patient’s medical and dental situation.

Mandibular tori removal can often be performed under local anaesthesia. In selected cases, sedation may be considered to improve patient comfort, depending on the complexity of the procedure and the clinical criteria of the specialist.

How painful is mandibular tori removal?

During the procedure, local anaesthesia is used so the patient should not feel pain in the surgical area. After surgery, some swelling, tenderness and discomfort are expected during the first days.

The level of discomfort varies depending on:

• the size of the tori;
• whether they are unilateral or bilateral;
• the amount of bone that needs to be removed;
• the patient’s healing response;
• whether the procedure is part of a wider dental rehabilitation plan.

The specialist may prescribe pain relief, anti-inflammatory medication or other post-operative instructions according to the case.

Recovery after mandibular torus surgery

Recovery time varies from patient to patient. The soft tissues usually begin to feel more comfortable within the first one or two weeks, while complete healing may take longer depending on the extent of the surgery.

After mandibular torus removal, patients are usually advised to:

• take prescribed medication as directed;
• follow a soft diet during the initial healing period;
• avoid hard, sharp or crunchy foods;
• maintain careful oral hygiene;
• avoid smoking and alcohol while the area heals;
• avoid touching the wound with the tongue or fingers;
• attend scheduled follow-up appointments;
• contact the clinic if there is heavy bleeding, fever, increasing swelling or severe pain.

Can mandibular tori grow back after removal?

Mandibular tori can grow back in some cases, although recurrence is not the usual outcome for every patient. If bruxism, clenching or other mechanical factors are present, the specialist may also assess whether they need to be managed.

Addressing underlying overload, improving appliance fit and monitoring oral function may help reduce the risk of future problems.

Mandibular torus and dentures

One of the most common reasons for mandibular torus removal is difficulty fitting dentures or other removable dental appliances.

If the bony growth is located where the denture needs support, it can cause:

• instability;
• pressure pain;
• ulcers from rubbing;
• difficulty adapting the appliance;
• movement when speaking or chewing.

In these cases, torus removal may be part of a broader dental rehabilitation plan. It may be considered before designing a new denture, mouth guard or other prosthetic solution.

Mandibular torus removal cost

The cost of mandibular torus removal cannot be determined without an individual assessment. The price depends on several factors, including:

• the size of the torus;
• whether there is one torus or several;
• whether the growths are on one or both sides;
• the need for imaging tests;
• the type of anaesthesia or sedation required;
• the surgical complexity;
• whether the procedure is part of a denture, implant or rehabilitation plan.

At Face Clinic, the first step is a specialist assessment to confirm the diagnosis, define whether treatment is necessary and provide a personalised treatment plan.

Treatment for mandibular tori at Face Clinic Spain

At Face Clinic, mandibular tori are assessed from a dental, oral surgery and maxillofacial perspective. The aim is not to remove every torus, but to decide whether it is causing a real clinical problem.

During the consultation, the specialist may assess:

• whether the bony growth is truly a mandibular torus;
• whether there are signs of bruxism or jaw overload;
• whether it affects chewing, speech or oral hygiene;
• whether it interferes with dentures or dental appliances;
• whether monitoring is enough or surgery is advisable;
• whether imaging is needed before planning treatment.

Frequently asked questions about mandibular tori

Are mandibular tori cancer?

No. Mandibular tori are benign bony growths and are not considered cancerous or precancerous. However, any oral lump that grows quickly, bleeds, becomes painful, ulcerates or changes in appearance should be assessed by a dental or maxillofacial specialist.

What causes a mandibular torus?

The exact cause is not fully understood. Mandibular tori may be related to genetic predisposition, oral anatomy, bite forces, bruxism, age and other bone-related factors. In many patients, several factors may be involved.

How do you get rid of mandibular tori?

Mandibular tori can only be removed with oral surgery. There is no home treatment that makes them disappear. Surgery is usually only recommended if they cause pain, ulcers, functional problems, hygiene difficulties or issues with dentures or dental appliances.

How painful is mandibular tori removal?

The procedure is performed under anaesthesia, so patients should not feel pain during surgery. After the procedure, some swelling, tenderness and discomfort are expected for a few days. The degree of discomfort depends on the size and complexity of the case.

Is mandibular tori removal worth it?

It may be worth it when mandibular tori interfere with speech, chewing, oral hygiene, comfort or the fit of dentures or mouth guards. If the tori are small, stable and asymptomatic, removal is usually not necessary.

Medical sources consulted

• Cleveland Clinic: Mandibular Tori
• Mandibular tori. National Library of Medicine
• Association between signs and symptoms of bruxism and oral tori. PubMed
• Colgate: What Are Mandibular Tori?