Introduction

Torus palatinus affects between 20 and 30% of people, though it is not very well-known.¹ 

Torus palatinus is the most common benign (non-harmful) bony growth of the mouth.² 

We don’t know what causes torus palatinus, but it’s thought that a mixture of inherited tendencies and factors in a person’s environment contribute to the development of the condition.³

What is Torus Palatinus?

Torus palatinus causes bony lumps to grow on the roof of your mouth, which is also known as the hard palate.¹ It is usually a harmless condition that doesn’t cause any pain to those who have it.¹

Torus palatinus does not go away by itself, but usually, no treatment is required³, though surgery is sometimes needed if people experience symptoms.¹

If you have torus palatinus, you should tell your doctor or dentist immediately if:¹

• Your mouth begins to bleed
• You notice new growths on your palate
• You experience pain in your mouth
• The lumps increase in size
• There is a change in colour of the bumps on your palate
• The roof of your mouth becomes painful

What does Torus Palatinus look like?

Torus palatinus growths are usually symmetrical lumps which usually appear along the midline of the palate, which begins just behind the front teeth and goes back towards the throat. These can be lobe-shaped, flat, raised, or spindle-shaped. They are covered with the skin of the mouth (known as mucosa) so they may blend in well with the rest of the palate.²

Symptoms of Torus Palatinus

Individuals with torus palatinus can experience many symptoms. These include:

• Difficulty fitting false teeth including dentures⁴
• Discomfort if the bony growths become large enough that the person can’t close their mouth comfortably¹
• Trouble chewing if the growths are large enough, or if they have gaps where the food can get stuck¹
• Individuals whose growths get in the way of their tongue movements may experience difficulty in speaking¹
• If the lumps are close to the back of the throat, the person may have trouble swallowing¹
• Bacteria and plaque can build up in the mouth when the bony growths are near to the mouth as it becomes difficult to clean or floss¹
• Food can become stuck around the lumps, which can cause discomfort and problems with hygiene¹
• Some people with torus palatinus get anxiety which can be due to the other symptoms, eg. struggling with speaking and chewing¹ 

Risk Factors for Torus Palatinus

Certain factors increase the likelihood of developing orus palatinus. These risk factors include:

• Anatomy of mouth 

If you have an unusual jaw shape, if your teeth do not line up or if your teeth are crowded, this can make it more likely that you will develop torus palatinus.¹

• Hereditary

Torus palatinus can run in the family. Therefore, if your siblings, parents or grandparents have it then you are more likely to get it too.¹

• Bruxism, also known as grinding your teeth, can mean that you are more likely to develop torus palatinus¹
• If your bone density changes, or you have a higher than normal bone density, you are more likely to get torus palatinus¹
• Individuals over thirty years old are more likely to have torus palatinus than younger people¹
• Individuals who are assigned female at birth (AFAB) are more likely to have the condition than others¹
• Individuals with certain heritage, for example West Africans, East Asians and Europeans, are more likely to have Torus Palatinus than other people¹

Aetiology of Torus Palatinus

The aetiology (otherwise known as the causes) of torus palatinus are not fully understood.¹ However, certain things make it more likely that a person will develop the problem. Most clinical studies agree that the cause is likely to be a mixture of the person’s genetics and their environment.² 

Environmental Causes

Some studies have found that certain chewing muscles being too active (also known as masticatory hyperactivity)⁵ may cause torus palatinus.² 

Eating certain foods, specifically those with a lot of calcium and unsaturated fatty acids, may also have a role in causing torus palatinus.⁵ 

Genetic Causes

Studies have found that several genes (the information passed down from parents to children)⁶ are involved in the inheritance of torus palatinus.⁷ 

One study found that the CAPS2 gene likely has something to do with people developing torus palatinus.⁷ 

Another study has found that the WLS gene is probably involved with torus palatinus being passed down in families.¹⁰

Is Torus Palatinus Preventable?

Unfortunately, there’s nothing that can be done to prevent torus palatinus.¹ If you have the condition, you should keep checking your mouth and let your dentist and health team know of any changes.¹ If you let your medical professionals know about problems early, there is more of a chance of treating them before it becomes a big issue.¹

Diagnosis of Torus Palatinus

Torus palatinus are usually identified by your dentist.¹ Sometimes no extra tests are needed, but occasionally you will need a Computed Tomography (CT) scan.¹

CT Scan

These scans are normally done in a hospital by a radiographer (someone who specialises in taking medical images).⁸ They usually take between ten and twenty minutes and do not hurt.⁸

The radiographer will ask you to lie on a bed while they take the scans - it is important that you lie still.⁸ The machine will move over you to take the scans while the radiographer talks to you to explain what is going on.⁸

Your health team will get back to you to explain the results of the test, which can take up to four weeks.⁸

Treatment of Torus Palatinus

Most people with torus palatinus don’t require any treatment.^1,2 If the issue is causing a negative change in the person’s everyday life, however, surgery might be the best option to make sure the patient stays comfortable.¹  

The operation involves anaesthesia (drugs which mean that you don’t feel anything during the surgery.)^1,9 This numbing can be done just in the mouth,¹ or you may have a general anaesthetic which means you will be asleep during the procedure.⁹

The surgeon will cut the mucosa so that they can get to the extra bone and remove it.¹ Following this, they will stitch the mucosa back together.¹

Your health team will review you as you heal to make sure that the surgery was a success.¹ You should allow at least a month to heal after the surgery.¹ While you are recovering, your healthcare team may recommend that you:

• Use antibacterial mouthwash to help make sure your mouth doesn’t get infected¹
• Take medications to keep you comfortable and reduce the chance of infection developing¹
• Eat soft foods and avoid hard or crunchy foods to avoid damaging the mouth as it heals¹

As with all surgeries, there is a chance of complications. These can involve:

• Though rare, t he patient having an allergic reaction to the drugs used to numb the area or make them sleep through the surgery¹ 
• People can catch an infection during or after the procedure¹
• Bleeding a lot from the surgery site¹
• In some cases, a hole can be made between the mouth and the inside of the nose (the nasal cavity) when removing the torus palatinus¹
• Swelling¹
• Though rare, the bony lumps growing back after the surgery¹ 

Conclusion

Torus palatinus is the most common bony growth and is not harmful. Most people with torus palatinus do not need any treatment, although if it affects your everyday life then your health team may perform a surgery to remove the growths.

Mandibular tori also exists - this is when growths develop on the floor of your mouth or the tongue. If you think you may have torus palatinus, you should book an appointment with your dentist.