Mandibular Tori ,TMJ, and Hypermobile Ehlers-Danlos Syndrome. What is The Connection?

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Mandibular tori and temporomandibular joint (TMJ) disorders often appear as separate issues in dental and medical fields. Yet, for people with Hypermobile Ehlers-Danlos Syndrome (hEDS), these conditions may be linked in ways that affect diagnosis and treatment.

Mandibular tori are bony growths that develop on the inner surface of the lower jaw, near the tongue. These growths are usually harmless and painless but can vary in size and shape. They often appear in adulthood and may remain stable or grow slowly over time.

Key Features of Mandibular Tori

• Located on the lingual side of the mandible, typically near the premolars

• Usually bilateral but can be unilateral

• Composed of dense, compact bone

• Often discovered during routine dental exams or X-rays

  
  

Mandibular tori do not require treatment unless they interfere with oral function, cause discomfort, or complicate dental procedures such as fitting dentures.

Understanding TMJ Disorders

The temporomandibular joint connects the jawbone to the skull, allowing movements needed for chewing, speaking, and yawning. TMJ disorders involve pain, restricted movement, or clicking sounds in this joint.

Common Symptoms of TMJ Disorders

• Jaw pain or tenderness

• Difficulty opening or closing the mouth

• Clicking, popping, or grating sounds

• Headaches or earaches related to jaw movement

  
  

TMJ disorders can result from trauma, arthritis, teeth grinding, or muscle tension. In people with connective tissue disorders like hEDS, joint instability plays a significant role.

How Mandibular Tori and TMJ Disorders Relate to hEDS

People with hEDS often experience joint instability, including in the jaw. This instability can lead to TMJ disorders due to excessive movement or strain on the joint. At the same time, the presence of mandibular tori may be more common or pronounced in this population, although research is still emerging.

Possible Connections

• Joint hypermobility in hEDS increases stress on the TMJ, causing pain or dysfunction.

• Mandibular tori can develop as a response to abnormal forces on the jawbone, possibly linked to joint instability.

• Connective tissue abnormalities in hEDS affect bone remodeling, potentially influencing the formation of tori.

• TMJ disorders in hEDS patients often present with more complex symptoms and may require specialized management.

  
  

Recognizing the link between mandibular tori, TMJ disorders, and hEDS can improve care for affected individuals. Here are some practical points:

For Patients

• Report any jaw pain, clicking, or difficulty moving the jaw to your healthcare provider.

• Inform dentists and doctors about any known connective tissue disorders.

• Avoid excessive jaw movements or habits like teeth grinding that may worsen TMJ symptoms or contribute to the development of Tori.

• Seek evaluation from specialists familiar with hEDS for tailored treatment plans.

  
  

  For Healthcare Providers

• Consider hEDS in patients presenting with unexplained TMJ disorders or mandibular tori.

• Use a multidisciplinary approach involving dentists, rheumatologists, and physical therapists.

• Monitor mandibular tori for changes that might affect oral health or prosthetic treatments.

• Educate patients on joint protection strategies and pain management.

  
  

Managing TMJ disorders in hEDS requires careful attention to joint stability and pain control. Treatment may include:

• Physical therapy focused on strengthening jaw muscles and improving joint function

• Use of splints or mouthguards to reduce strain and prevent teeth grinding

• Pain relief through medications or alternative therapies like acupuncture

• In rare cases, surgical intervention for severe joint damage or problematic tori

  
  

Mandibular tori usually do not need removal unless they interfere with dental work or cause discomfort.