Expert: Mark Bornfeld DDS - 1/2/2009

Question
I have had these bumps in my mouth which has gotten increasing larger over time, now they are almost touching each other in my lower jaw. I recently learned they are called torus mandibularis. When they grow they are very sensitive and painful. What can I do about the pain other than surgery? I also recently had to have my teeth removed and dentures made. I found an older dentist who has been able to make them for me and they are comfortable, but because my tori seems to be growing again, it is making it difficult for me to wear them all day. Any suggestions? I realize surgery may be my only option but I hope it's a last resort. Also what does such a surgery involve?

Answer
Dear Mac,

Mandibular tori are seldom an issue unless dentures are worn. The gum that overlies these bony prominences is stretched thin, which makes it vulnerable to abrasion and other physical injury. Complete lower dentures are particularly problematic with mandibular tori, because they interfere with proper extension of denture borders, and cause the dentures to be less stable and less comfortable.

You should not think of the surgical removal of tori as a last resort in the sense that it is not the daunting ordeal you seem to imply. It is also not a last resort-- it is really the only resort to reliably rid yourself of the inconvenience they have caused. Your dentist could theoretically carve back your denture to avoid impinging on those tori, but this would only serve to further weaken and de-stabilize the prosthesis.

Surgical removal of tori is quite routine, and will not present you with much of a challenge. True, you will be uncomfortable for about a week and need to go without your lower denture while the surgical wound heals, but the rewards are well worth it when compared with the years of additional inconvenience these things would otherwise cause. Surgury involves making a horizontal incision above the bony prominences, and re-contouring the bone with various motorized and manual surgical instruments; the incision is closed with one or two stitches. The procedure may be performed with local and/or general anesthesia or sedation.

I would recommend that you consult with an oral surgeon for more specific guidance relevant to your particular condition.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY