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Dear Patient: What's that thing in your mouth?

May 9, 2023
Mandibular tori, linea alba, scalloped tongue—these are some of the things people have going on their mouths that they might not even know about. Should you have them examined? And if so, when?

Do you ever have a lump or a bump in your mouth and wonder if it’s normal? There are certainly huge variations of “normal,” but there are also some things in your mouth aren’t necessarily so. And while they shouldn’t prompt you to make an emergency appointment at your dentist, they could be clues to something else and are worth getting checked out.

Mandibular tori

Torus or tori (meaning more than one) are extra bony growths that can grow under your tongue or at the roof of your mouth. These growths can range from a small bump to a rather large protuberance. Funny enough, I didn’t realize that everyone didn’t have these until I went to dental hygiene school and learned about them. Back then, we learned they were completely benign and didn’t know what caused them. They only became an issue if you needed partials or a denture because they could get in the way.

Now there’s some thought that these bony growths could be a result of clenching and grinding. This could lead a clinician to look further into evaluating your sleep and breathing.

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Linea alba in the mouth

Linea alba is a horizontal line that forms on the inside of your cheek where your teeth come together, sometimes referred to as a cheek bite line. While also common and benign, it can be annoying if that white callus grows and you bite it hard, causing trauma. Back in hygiene school, we would note this in your chart as something unique about you, and that’s it.

But dental professionals’ ideas are also shifting about this condition. While they’re still benign, we’re starting to question why people with linea alba are biting their cheeks. Could it be an underdeveloped jaw that, once again, might lead to an airway evaluation?

Scalloped tongue

Scalloped tongue refers to a wavy appearance on one or both sides of the tongue. While the condition itself is not cause for concern, it could give clues to other things happening in the body. Those waves form because the tongue is pressing into the sides of your teeth, and it’s leaving an indent. In a healthy mouth, there's room for the tongue to rest on the roof of your mouth and not press into the teeth. So why the big tongue?

Low thyroid levels can cause swelling of the tongue, as can some genetic conditions and xerostomia (dry mouth).  And once again, airway enters in: Clenching and grinding can cause excessive pressure against the teeth, as can an underdeveloped upper jaw. If you have all three of the above (like me), you might want to seek an airway consult.

Sloughing cheek skin

Sloughing of the tissue in your mouth can look a little like wiping spider webs from the inside of your cheeks. The stringy material can line the gums, tongue, and cheeks. It is often caused by acidic foods or a reaction to certain toothpaste and mouthwashes. Many people are sensitive to sodium laurel sulfate (SLS), so check your list of ingredients. Aside from being annoying, it can also be a sign of an autoimmune disease, so don’t ignore it.

Cold sores

Cold sores always seem to come at the wrong time. That’s because they often come on in times of stress, illness, or hormone fluctuations. Approximately 75% of the population is affected by the herpes simplex virus (HSV). If your dental home has a laser, give them a call, and they can zap it into faster healing. If not, there are over-the-counter remedies to help it heal up. Please keep in mind an active lesion is contagious, so don’t go kissing any babies! And reschedule that routine hygiene appointment if you have one.

None of this is to say don’t worry about lumps or bumps in your mouth. In fact, according to the Oral Cancer Foundation, in the US, 145 mouth cancers are diagnosed daily, and when you include head and neck cancers, that number soars to 1.1 million annually. A good rule of thumb is if it doesn’t heal in seven to 10 days, get it checked out. And insist on an oral cancer exam at every visit.

About the Author

Amanda Hill, BSDH, RDH, CDIPC

Amanda Hill, BSDH, RDH, CDIPC, is an enthusiastic speaker, innovative consultant, and award-winning author who brings over 25 years of clinical dental hygiene and education to dentistry. Recipient of OSAP’s Emerging Infection Control Leader award and an active participant with the advisory board for RDH magazine, DentistryIQ, and OSAP’s Infection Control in Practice Editorial Review Board and membership committee, Amanda (also known as the Waterline Warrior) strives to make topics in dentistry accurate, accessible, and fun. She can be reached at [email protected].