Bony Protrusions Under Tongue

The presence of bony protrusions under the tongue can be a cause of discomfort and concern for many individuals. These protrusions, medically referred to as sublingual exostoses, are abnormal growths of bone that occur on the underside of the tongue, specifically on the mandible (lower jawbone). They are usually benign (non-cancerous) but can cause symptoms such as pain, difficulty swallowing, and changes in speech.

Causes and Risk Factors

The exact cause of sublingual exostoses is not well understood, but several factors are thought to contribute to their development. These include genetic predisposition, where individuals with a family history of exostoses are more likely to develop them. Trauma to the jaw or tongue, chronic inflammation, and certain medical conditions like osteochondroma (a type of bone tumor) may also play a role. Additionally, the presence of other bony growths in the mouth or face can increase the risk of developing sublingual exostoses.

Symptoms and Diagnosis

Symptoms of sublingual exostoses can vary in severity and may include:

• Pain or discomfort under the tongue, especially when eating or speaking
• Difficulty moving the tongue or swallowing
• Changes in speech or pronunciation
• Visible bumps or masses under the tongue

Diagnosis typically involves a physical examination by a healthcare provider, who will look for visible signs of the exostosis and assess the patient’s symptoms. Imaging tests such as X-rays or a CT scan may be ordered to confirm the presence and size of the bony growths. A biopsy might be necessary to rule out other conditions, although this is less common due to the benign nature of most sublingual exostoses.

Treatment Options

Treatment for sublingual exostoses depends on the size of the growth, the severity of symptoms, and the individual’s overall health. Small exostoses that do not cause significant discomfort may not require treatment beyond regular monitoring by a healthcare provider. However, larger growths or those causing substantial symptoms may need surgical removal. Surgery is typically performed under local anesthesia, and the procedure involves making an incision under the tongue to remove the bony growth. Recovery usually takes a few weeks, during which time patients may need to follow a soft-food diet and practice good oral hygiene to prevent infection.

Prevention and Management

While there are no guaranteed methods to prevent sublingual exostoses, maintaining good oral health can reduce the risk of complications associated with these growths. Regular dental check-ups can help identify any oral health issues early on, including the detection of bony growths. Practicing a healthy diet, avoiding tobacco products, and limiting alcohol consumption can also contribute to overall oral health and potentially reduce the risk of developing sublingual exostoses.

Complications and Prognosis

In most cases, sublingual exostoses do not lead to serious complications. However, if left untreated, large growths can cause significant discomfort, affect eating and speaking, and potentially lead to secondary infections or other oral health issues. The prognosis for individuals with sublingual exostoses is generally good, especially when appropriate treatment is sought. Surgical removal of the growths typically results in the resolution of symptoms, although there is a small chance of recurrence.

Conclusion

Bony protrusions under the tongue, or sublingual exostoses, are benign growths that can cause discomfort and affect daily activities. Understanding the causes, recognizing the symptoms, and seeking appropriate medical care are crucial for managing these growths effectively. With proper treatment and care, individuals with sublingual exostoses can experience significant improvement in their quality of life.