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Torus Palatinus : Causes, Sysmptoms, and Treatment

Torus palatinus comes from Latin word, which is the “Torus” and “Palatinus”. If you check this word meaning on a Latin-English dictionary, you’ll find the “Torus” as bull, lump, or stand out. “Palatinus” itself can be translated to the palate.

The palate is an important part of the mouth that split the nasal cavity from the oral cavity and located in the midline of the roof of the mouth. Torus palatinus also have other synonyms such as pronounced with “Tori Palanitus”, “Palatal Tori”, “Palatinus Torus” or “ The bump at the roof top and mass of the palate”.

Torus palatinus may form from the multiple tiny outgrowths unite together and create a larger bump form that sometimes non-expert people would guess it as a tumour or oral cancer, but actually, in most cases, Torus palatinus is just a benign growth of bony protrusion.

It happens due to the formation of new bone. Normally, if the formation of new bone previously exist the new bone, it will deliver very painful sensation depends upon the shape, size, and location. The exostoses (it is a medical term that defines the formation of new bone on the exterior of a previous bone), usually occur in ribs, knees, ankles, elbows, hips, shoulder, and even the oral cavity has the exostoses.

Palatal exostoses (affecting the palatal maxilla which happened on the roof of the mouth called “palate” or “palatal”) and buccal exostoses (which is affecting buccal area –the area of lower jaws) are some other less commonly occurred types of intraoral exostoses.

The Torus palatinus may look like a tumour or even cancer due to the huge bulbous shape that growing in the midline of your palate, but however Torus palatinus just non-cancerous bony protrusion that doesn’t cause any pain, numbness, devoid lymph nodes, not painful and sore, or devoid of lymph nodes. However, sometimes, when it grows larger it can cause irritation in your mouth.

So as the result, it can be concluded that “Torus palatinus“ is a serious Dentistry medical condition that sign by the growing of a type of bony protrusion occurs in the midline of the roof of the mouth (the palate) and grows slowly throughout life.

It is a size in most cases, are dynamic. They are less than 2 cm in diameter, but their size can change during re-absorption of your bones at later stages. Torus palatinus commonly occurs in humans and other mammalian organisms.

Torus palatinus actually isn’t classified as a life threatening disease –it is clinical finding, and actually and any specific treatment is not necessary. On the other hand, it is also a serious condition which the special attention is needed.

It can cause ulceration at the area of palate or tori which can also cause complication during the fabrication of dentures. Many Torus palatinus’ patients said that their large bump which appears on their top of their mouth (The Torus palatinus) isn’t hurt but feels very abnormal.

Its growth is solid and can’t be removed or moved with fingers. At the first time, they took a look at it as just a normal protrusion which may be can shrink during the time. But the Torus palatinus’ patient will feel distracted while they were chewing, slowing, talking and chatting.

They feel distracted due to the Torus Platinus that had been sized into huge bulbous shape.

Although Torus palatinus are considered to be a small or usual thing, not all of people especially the Torus palatinus’ patient will have information about it and they can get very scared by seeing an overgrowth in their mouth. Torus palatinus’ lack of information may lead people to panic.

Stressed may be happening to the Torus palatinus’ for the first time due to the over thinking when they see the huge bony protrusion in their midline of the roof of their mouth. They might be in chaos when they heard the diagnosed. So, the Torus palatinus’ knowledge is very important to be well informed, not only for the dentist but also public, in order to take proper care.

Many patients have been misconception about Tori as cancer or tumour. Actually, when a huge ulcer appears on your top of your palate, it isn’t always meaning as you have threatening cancer which had to be removed as soon as possible.

The presence of cancer in the mouth especially palate are actually rare, while tori are common to classify rather than cancer or tumour. Cancer is found in the soft tissues (the alliance of the same cells) of the tongue, the cheek, red coloured and is asymmetrical.

They are also associated with the enlargement of the regional lymph nodes, numbness, and tingling sensation in the tongue or the lower lips.

Meanwhile, Torus palatinus occurs as midline structures of the palate and does not have lymph node involvement nor tingling sensation of the tongue or lower lips and also doesn’t cause numbness. The outgrowth of Torus palatinus that isn’t normal at the middle part of palate looks like massive cancerous tissues.

But, the massive outgrowths are benign (non-cancerous). The massive outgrowths can develop any time, and they are non-pathological clinical findings which occasionally cause serious concern to people who will mistake them as a form of oral cancer.

The large bump (or we can call it Tori) not only can grow in the midline of the roof of the mouth (the palate), it also on others. Usually, the classified is based on the appearance or morphology of massive bony structures of Torus palatinus.

They are classified into different subtypes, which commonly are categorised by their appearance and where it is growing. They are Flat tori, Spindle tori, Nodular tori, and Lobular tori which each of them have their specific characteristic.

First, Flat tori which are located on the midline of the palate –as suggested by its name this type has a flat appearance and once it appears,  it is started to broaden in size by expanding symmetrically to both side, not only that Flat Tori also has a broad and smooth base.

Second, Spindle tori outgrowth usually appeared as slender shaped rod furnished with tapered ends. They appear as ridge located at midline. Third, is called by Nodular tori. These Nodular tori are looked alike as small nodules and round nodules as multiple structures or outgrowths.

Every each nodule has their own base, then at severe cases, those multiple nodules amazingly become associated with each other which is the result makes a large massive nodular outgrowth. And the last but not the least is called Lobular tori. Lobular tori have lobe like structures which share a common base and arises from the midline of the palate.

If there is a question about whether Torus palatinus is contagious or not, the answer is no. Torus palatinus aren’t contagious at all. It is caused by certain genetic factors, environmental or physical factors It is a clinical manifestation rather than a disease. Commonly, it is hereditary or ethnic, which is restricted to certain groups and not separated in all population.

Torus palatinus has the specific feature that differentiates it from other lesions. One of them is the thin layer of tissue’s gum which covers the surface. Not only the thin tissue gum layer but also it is also as hard bone and couldn’t be compressed.

The other lesions which might be appeared in the mouth such as fibroma, neuro-fibroma, papilloma, or mucous cyst are might be movable and also compressible, but it may have abnormal tissue on its surface. These lesions might also be ulcerated and roughed different from any normal gum tissue.

The causes of Torus palatinus

causes

Torus palatinus basically is outgrowth that emerges on the firm region of the palate. Although many research about Torus palatinus have been observed, the exact what the causes of Torus palatinus are is yet to be determined. Torus palatinus aren’t bone structures but bony growths which occur inside of the palate. The ulcers can form on the area of tori growth due to repeated trauma.

Some researchers generally believed that Torus palatinus are caused by several factors. They believe one of them is due to the outgrowth which is the increase in size with age and the hereditary factors –which you can say by the genetic cause.

The backgrounds of the Torus palatinus’ genetic cause, is based on medical observation which suggested that the torus follows by the prototype that belongs to autosomal dominant inheritance. Autosomal dominant inheritance is some genetic phenomena which a trait is inherited from one generation to another by depending on the type of the chromosome affected (for the example the autosome or sex chromosome).

It also has been observed that genetic inheritance of it’s from affected parents to their progeny is fifty percent (50 %). This genetic phenomenon also explains the limited occurrence of Torus palatinus seems more common among certain conditions such as Torus palatinus occurs twice often in female rather than male, and it happens in certain ethnic like Asian, Native American or Mongolia.

That fact also strengthens the hypothesis of the Torus palatinus’ causes.  On the other hand, there is no certain cause of the Torus palatinus and it has yet been established. If you read the case history and some literature studies of those cases, the following are some common factors which supported to be the possible cause of Torus palatinus.

Hereditary or Genetic factors will lead to the ethnic cause –it tells why some ethnic tribe, mostly have Torus palatinus. The ethnic cause tells that, based on the case history and literature database it has been suggested that Torus palatinus is transmitted genetically from parents to their offspring.

The chance of a child being diagnosed with Torus palatinus if the parent diagnosed with this condition, is usually forty to sixty-four percent (40-64%), while this percentage reduced to five to eight percent (5-8%) when the parents carry no one of the diseases.

Besides of the genetic or the heredity factor why the Torus palatinus’ causes, they are some several possible aspects that may lead to Torus palatinus, they are including:

  • Tooth abrasion: the Toruspalatinus happens due to the tooth abrasion which example by grinding, clenching (static contact of the upper and lower teeth), cleaning your teeth, or when you decide to use denture.
  • Lack of Vitamin and mineral: vitamin and mineralare needed for your body. The Vitamin and mineral deficiencies can cause Torus palatinus
  • Some of Toruspalatinus symptoms: one of them is the growing of bony protrusion on the palate.
  • Chewing excessively especially while you were eating. So, if it is possible, try to avoid chewing forcefully.
  • Environmental factors such as the habitual.
  • Using certain drugs such asphenytoin (an anticonvulsant medication used to manage certain types of seizures).
  • OnPhenytoin therapy.
  • Trauma to the bones of the oral cavity
  • Have superficial trauma: it is a damage or injury (trauma) in any part or bones of the oral cavity.

The Symptoms of Torus palatinus

symptoms

The Torus palatinus’ symptoms can be diagnosed by several signs. Actually, there are no specific sign and symptoms of Torus palatinus like the disease of the other. But one potential symptom that we have to know that, the patients have an unusual hard bony protrusion growing in roof top or palate region ( it usually a diameter of two centimetres. but it is dynamic).

The bony protrusions are made of bone covered by pink, firm tissue of the palate, and non-resilient. It can be bigger since it tends to grow slowly through time. The bony protrusion growths are usually not painful and no sore, but it has a possibility of presenting irritation.

The growth can be enlarged from a small nodule to a big colossal bump. The growth is slow and takes long times to be flat. One another potential problem is that the tissue has injured around so it will be harder for the person to get dentures.

The main symptom is Torus palatinus sometimes make someone difficult to eat and drink for one to eat and drink. At that time, they also have a difficulty in swallowing their food and drinking water as the swollen-bony protrusions had to get bigger.  The huge bony protrusions form blocked the food pieces. Also, Torus palatinus make the chewing harder.

In some cases, Torus palatinus might also cause infection and spread to the other region of oral cavity such as palate or bone itself. In such cases will affect by the ulcerations and pain frequently experienced by the individuals.

In babies appearance of the torus has been reported by birth, but Torus palatinus mostly appear at age of six (6) to twelve (12) months. A palatal torus which is being large that might prevent a person from brushing their teeth, indicated that a surgery is needed to reduce or correct the torus.

The Treatment of Torus palatinus

treatment

Since Oral exostosis or Torus palatinus isn’t life-threatening disease and only a clinical medical condition, so a special treatment of Torus palatinus may be none.  However, if the Torus palatinus growth bigger, require medical attention is needed.

Moreover if your Torus palatinus is due to the placement of your dentures which means you would need to see your dentist as soon as possible for medical treatment. If the torus palatinus isn’t block your food or water while you were eating and drinking is best to leave it alone and surgery actually doesn’t needed.

However if the Torus palatinus has blocked your food and water while you were eating and you feel its disturbance, the best treatment of Torus palatinus is by doing surgical treatment.

Actually, the main method of treatment of Torus palatinus is surgical treatment. During the surgery, a certain bone from the palate will be removed. Therefore the surgical removal may offer a solution to people whom the condition causes a problem.

This procedure is one of the treatment of Torus palatinus and can be done under local or general anaesthesia. The surgery is done by a maxillofacial surgeon. Before the surgery the general anaesthesia and maxillofacial surgeon will make the bony growth more visible by staining it.

They will then make an incision over the area to expose the underlying tissue and then the torus palatinus will be removed.

The surgery is often excellent and has very minor post-operative complications like swelling, bleeding, and infection. Patients often will recover fully within 3 to 4 weeks.

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