Saturday, February 17, 2024

Early Stage Mandibular Tori Cancer

Issues Related To Tori

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If mandibular tori are benign and asymptomatic, how could they cause troubles for your dental health? The soft tissue covering tori is fragile, so scrapes and bumps can cause pain and open the door to infection. Large mandibular tori can make it tough to clean nearby teeth, which might increase your risk of tooth decay. To make matters worse, they may interfere with your dentist’s efforts to take X-rays, which can make it tougher to identify dental issues while they are smaller and easier to treat. In addition, these growths can make it impossible to wear dentures or other fitted oral appliances. In fact, if mandibular tori get large enough, they can interfere with the tongue’s movements, impacting speech and making eating a challenge.

Fortunately, torus mandibularis and other types of tori grow very slowly. Patients generally have time to explore the available treatment options and decide which one best suits their unique circumstances.

Do I Have A Mandibular Tori

Mandibular tori symptoms do not often include pain. Indeed, pain may be an indication of a different condition altogether.

Symptoms of mandibular tori are largely visual. The presence of bony growths bilaterally on the inner arch of your lower teeth is the best indication of mandibular tori. You may not notice them at all until your dentist or dental hygienist points them out.

Sometimes as they grow, your tongue will feel them or your toothbrush may slip and scrape them. Otherwise, there are really no standout symptoms of mandibular tori.

Leukoplakia Erythroplakia And Oral Cancer

Precancer and early oral cancer can be subtle and asymptomatic. A lesion may begin as a white or red patch, progress to an ulceration, and later become an endophytic or exophytic mass .

Oral leukoplakia, the best-known pre-malignant oral lesion, is defined by the World Health Organization as a white patch or plaque that cannot be characterized clinically or pathologically as any other disease.15 Analogous red lesions are called erythroplakia, and combined red and white lesions are known as speckled leukoplakia or erythroleukoplakia. Erythroplakia and speckled leukoplakia are more likely than leukoplakia to exhibit dysplasia or carcinoma microscopically.16

In the United States, cancers of the oral cavity and oropharynx are the ninth most common cancer, accounting for approximately 3 percent of malignancies among men and 2 percent of malignancies among women.17 Prevalence increases with age. Approximately 90 percent of oral cancers are squamous cell carcinomas. They occur most commonly on the tongue, floor of the mouth, and vermilion border of the lower lip. Sixty percent of oral carcinomas are advanced by the time they are detected, and about 15 percent of patients have another cancer in a nearby area such as the larynx, esophagus, or lungs. Tobacco use and heavy alcohol consumption are the two principal risk factors, accounting for 75 percent of oral carcinomas.18

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What Are The Causes And Risk Factors For Mouth Cancer

Although oral cancer’s exact cause is unclear, certain lifestyle factors can put someone at risk for this disease. Some of these factors cannot be changed. For example, most oral cancer patients are older than 55 because the disease takes years to develop. However, others are related to personal choices, and lifestyle changes may help decrease a person’s risk.

  • Tobacco use. A majority of people with oral cancers use tobacco, and the risk increases depending on how long they have used it. According to the ACS, tobacco chemicals can damage the cells lining your mouth and throat, and some can even damage the cell DNA directly.
  • Alcohol use. According to the ACS, about 7 out of 10 patients with oral cancer are heavy drinkers, and the risk of developing oral cancer is as much as 100 times higher if a person is a heavy drinker and smoker than the risk for someone who does not drink or smoke.
  • Human papillomavirus . Certain types of sexually-transmitted diseases can cause cancers of the mouth and throat. Most people with HPV infections of the mouth and throat have no symptoms, and only a tiny percentage develop oral cancer. The type linked to throat cancer is HPV16.
  • Sun exposure. Lip cancer tends to be more common in people exposed to ultraviolet light for long periods. People who spend a lot of time outdoors should take steps to protect their lips and all other exposed skin.

What Are Oral Tori

What are mandibular tori?

Tori are bumps in the mouth made of bone tissue covered by gum tissue. They grow slowly and some people have them without ever noticing them! There are three kinds of tori, each named differently based on their location:

  • Buccal exostoses: tori on the back, upper gums, on the cheek side
  • Maxillary/palatal tori: on the roof of the mouth
  • Mandibular lingual tori: on the lower jaw, under the tongue

Tori are more common among males than females. They appear to be genetic. Tori can appear in groups of various shapes and sizes, or you can have just one torus. If you have a torus on one side of your mouth, its likely that youll also have another one on the other side.

Tori have been referenced and studied for at least 100 years, but truth be told, we dont totally understand what causes them. Some dentists believe that people who grind their teeth and clench their jaw are more likely to develop tori. Others believe that tori result from facial or jaw injuries or trauma.

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What Causes Tori Growth

What spurs the growth of tori? Experts point to a variety of factors, but genetics often tops the list of possible causes. These growths are more common in certain ethnicities, and a tendency towards tori seems to run in families. In fact, a study of twin siblings reported by the National Institutes of Health provides a strong argument for a genetic role. Researchers examined identical and fraternal twins, checking to see if tori were either present or absent in both or present in only one of the pair. Among identical twins, only 6% of pairs saw only one twin impacted. For fraternal twins, who have more genetic differences, the percentage of pairs where only one twin had tori more than tripled, rising to 20%.

What other things might contribute to tori growth? Trauma to the jaw is a possible culprit. Dietary factors like fish consumption, a calcium-rich diet, certain vitamin deficiencies, and the habitual chewing of meats that are dried or frozen may also increase the risk of tori development.

Dental issues may also trigger tori growth. While it’s just a theory, some experts suspect that these growths are a kind of natural defense intended to provide extra support and stability to teeth that are under strain. Therefore, conditions that stress the teeth like a misaligned bite or bruxism, which involves habitual grinding of the teeth and clenching of the jaw, may spur the growth of tori.

They Usually Exist In Pairs

The existence of torus mandibularis is not all too common its estimated that 12 to 25% of the adult population has these bony overgrowths in the lower jaw. People who have this tori mandibularis usually have two, but they can exist on their own. 90% of tori exist in both sides of the mouth and they can be extremely uncomfortable when getting dental x-rays and or getting dentures or implants.

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Their Size May Fluctuate

Throughout a lifetime, the size of the tori may fluctuate. At their biggest, they can actually meet in the middle and that means theyre really big. Especially large tori can get in the way of proper eating. Chips, crusty bread, and other crunchy foods present real difficulty. Food particles may become lodged in the tori, causing discomfort or bad breath.

What Are Tori And Why Do I Have Them

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More prominent lingual mandibular tori

Tori are simply bony growths in the upper or lower jaws. A Torus mandibularis in English) is a bony growth on the Mandible or the lower jaw. Mandibular tori are usually present on the tongue side of the jaw near the bicuspids . They usually 90% of the time occur on both sides of the mouth .

Mandibular tori are not particularly common about 5 10% of the population will have noticeable mandibular tori. Some estimates are as high as 40% but we are not seeing that in our office. If a tori occurs on the palate of the upper jaw, it is known as a torus palatinus and they are usually near the midline of the palate. Tori can also occur on the cheek side of upper and lower teeth as well and they are usually seen by the molars and premolars. In these areas tori are almost always present on both sides . Tori are slightly more common in males.

It is believed that tori are caused by several factors but there is not one thing that always causes tori. They may be associated with bruxism or tooth clenching and grinding however no. The size of the tori may fluctuate throughout life but they do tend to get bigger over time. In some cases the tori can be large enough to touch each other in the midline of mouth. Consequently, it is believed that mandibular tori are the result of local stresses and not solely on genetic influences.

Tori on lower jaw below tongue .

A torus is a harmless growth of bone. Tori tend to grow in three parts of the mouth:

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They Can Be Removed At Smiles By Hanna

When the bony growths present a problem or are large enough to inhibit proper eating, we may recommend removing them. Unlike the old fashioned way of removal with the knife, chisel and hammer. Dr. Hanna uses the Waterlase Laser and Peizotomes to remove the tori. Its a simple procedure in which Dr. Hanna removes the excess bits of bone tissue to help return your smile to its normal state. However, many times, the tori can exist without issue in the mouth. We will evaluate the areas and determine whether or not their removal is recommended.

Family History And Genetics

Genetics is the most likely cause of mandibular tori, as they seem to run in families. Researchers investigated this hypothesis by studying identical and non-identical twins.

Among the 81 sets of twins they recruited, almost 57% had mandibular tori. In the identical twins, almost 94% of the tori affected both or neither twin. In the non-identical twins, this number fell just below 80%. These results indicate a strong genetic link.4

Mandibular tori are also more common in certain groups of people, including Inuit, Norwegian, Thai, and Indigenous American descents. They can also affect people with certain genetic conditions, such as Turner syndrome.

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What Is Mandibular Tori Symptoms

The first and most obvious sign of this mandibular lingual tori is the bony growth on and beneath the side of your tongue. You need to be well aware that you may have more the one skeletal growth on the side of the mouth, and it can be present on both sides as well. This disease mentioned earlier is in no way dangerous, but that does not mean it can not cause some health issues. Firstly, the soft tissues covering the growth can become ulcerated. Secondly, wearing dentures can interfere with their fit due to bone growth, cause discomfort, and may not stay in place. The most common symptoms of mandibular tori are:

All these symptoms can show that you are suffering from this condition and causing pain or discomfort. If you are still not sure if you are feeling any symptoms, then look up mandibular tori pictures to compare with your condition and know if you have it.

Treatment For Jaw Cancer

Hard palate anatomy, hard palate function, hard palate cancer &  bump

If the biopsy is benign, the first treatment step is almost always complete surgical removal of the tumor with one of the procedures below. If it is malignant, the modern treatment ismultidisciplinary approach, meaning a team specialists including a head and neck surgeon and radiation oncologist will talk with you and come up with the best approach. For example, oropharyngeal cancer rarely requires surgery, but radiation or chemoradiation is a possibility. And in some advanced cases, medical therapy such as chemotherapy to shrink the tumor might be necessary before surgery.

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A Case Of Oral Tori In A 60

Tejaswi Marri, BS Cameron Dodd, BA and Lynnette Mazur, MD, MPHMcGovern Medical School at the University of Texas Health Science Center, Houston, Texas

Citation:Marri T, Dodd C, Mazur L. A case of oral tori in a 60-year-old woman. Consultant. 2020 60:45-47, 50. doi:10.25270/con.2020.02.00002

A 60-year-old woman presented for a routine checkup. She had no medical concerns but wanted to discuss treatment options for her oral tori . The bony lesions had first appeared in her 30s and had remained asymptomatic until the past 2 or 3 years. During that time, they had progressively grown and multiplied to the point that she was unable to eat without pain and/or bleeding. For the past several weeks, she had limited her diet to milkshakes and smoothies. Because of her worsening symptoms, she was referred to an oral maxillofacial surgeon for further evaluation and management.

Figure 1. Torus palatinus visible along the hard palate.

DISCUSSION

Their prevalence varies by ethnicity and geographical region, but tori are more commonly found in Eskimos, Native Americans, Norwegians, and Thais.4,5 Prevalence ranges from 12% and 14% in patients from Trinidad and Tobago, respectively, to 27% in patients from Thailand.1,6,7 In the United States, TP is the most prevalent torus, occurring in 20% of the population, while TM has a prevalence of 6%.8,9 TM is more common in men, whereas TP is more common in women.2,5,8,10 Concurrence of TP and TM ranges from 3% to 23%.1,7,11,12

What Is An Exostosis & Torus

These are bony swellings that develop in the mouth.

These are not that unusual. They come in a number of shapes, sizes and positions .

These bony swellings are given the technical names of exostoses or tori.

The torus is considered to be a developmental anomaly, although it does not present until adult life and often will continue to grow slowly throughout life.

The Torus Palatinus commonly forms towards the back of the hard palate in the midline. The swelling is rounded and symmetrical, sometimes with a midline groove. It is not usually noticed until middle age and, if it interferes with the fitting of a denture, it can be removed.

Most palatal tori are less than 2 cm in diameter but their size can change throughout life.

The prevalence of palatal tori ranges from 9% 60% of the population and are more common than bony growths occurring on the mandible , known as torus mandibularis .

The prevalence rate for tori is 27 / 1,000 adults. These bony lumps are not present until the late teen and early adult years and many, if not most, continue to slowly enlarge over time. Fewer than 3% occur in children. Taken as a group, these bony lumps are found in at least 3% of adults and are more common in females than in males.

Tori mandibularis form on the tongue-side of the lower jaw, in the region of the premolars / bicuspids . They are typically bilateral forming hard, rounded swellings. The management is the same as that of the same as that of the torus palatinus.

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Oral And Jaw Cancer Signs And Symptoms

The signs and symptoms of oral cancer or jaw cancer vary depending by stage. For example, in the early stages, you may feel no symptoms, or you may begin to feel some pain. Some jaw cancer symptoms you may experience include:

  • Pain or difficulty swallowing
  • Painful mouth sores or ulcers that dont heal
  • Difficulty opening the mouth
  • Red or white patches in the mouth that persist for weeks
  • Bleeding from the mouth that is recurrent
  • Halitosis, or bad breath
  • Swelling that causes difficulty swallowing
  • Numbness in the mouth or tongue
  • Jaw or ear pain
  • Dentures that dont fit any longer
  • Damage to bones, such as loose teeth

Oral cancer treatment: The care you need is one call away

Your multidisciplinary team will work with you to develop a personalized plan to treat your oral cancer in a way that fits your individual needs and goals.

In Which Area Are Tori Usually Seen

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In the maxilla or the upper jaw, the tori are usually seen arising from the midline of the hard palate . In the mandible, the origin of tori is from the inner aspect of the alveolar bone of the mandible above the origin of the mylohyoid muscle. Bony exostosis also may rarely occur on the buccal aspect of the maxilla or mandible but is less reported than the dental tori.

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What Is Mandibular Tori Treatment

Suppose you have the slightest doubt that you may be suffering from this condition. Its symptoms are not much visible in the initial stage, so it is best to concern your dentist to confirm the issue and get the best possible treatment in case of a problem.

If the dentist detects tori growth, he would be against treating it if the small mandibular tori is painless and is not causing any disturbance, as many people having this condition never get troubled. However, this may not be the case if your situation is terrible.

If the growth of tori is causing you pain or is causing your dentures a problem, then it is best to perform a mandibular tori removal surgery. In this case, you need to be well aware of mandibular tori removal. It simply removes the excess bone by cutting it or reducing it to a smaller size by shaving it. Your dentist will know how to remove mandibular tori and will advise if you need the removal surgery or not.

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