Management
Currently, buccal exostoses do not commonly require treatment. If there is neither pain nor sensitivity, the buccal exostosis simply needs to be monitored with routine dental check-ups. Patients are given oral hygiene advice and are advised to cleanse above and below the growth with a mouthwash once a day to remove any food debris. Due to it being difficult to clean around the exostosis, periodontal disease can often occur as a result, and so this should be treated by the dentist or dental hygienist/therapist. There are, however, some occasions were treatment is required, for example;

If the skin overlying it is continually experiencing trauma due to sharp foods,
A prosthesis, such as a denture, is required and cannot be adapted to the exostosis,
The growth reaches an unmanageable size,
Aesthetic reasons.If the growth needs to be removed then a simple surgical procedure can be carried out under local anaesthetic with no recurrence in the long-term follow up. This is done by reflecting the mucoperiosteal flap in order to expose the extended bone for complete excision. This bone will then be sent for histopathological examination to differentiate from benign to malignant neoplastic processes. Routine post-operative instructions are given to the patient and occasionally antibiotics may be prescribed. The patient will then be recalled after 1 week in order to remove the sutures and often after a few months for post-operative follow up. Epidemiology
They are more common in males than females, occurring in a ratio of about 5:1. They are strongly associated with the presence of torus mandibularis and torus palatinus.
A buccal exostosis is an exostosis (bone prominence) on the buccal surface (cheek side) of the alveolar ridge of the maxilla or mandible. More commonly seen in the maxilla than the mandible, buccal exostoses are considered to be site specific. Existing as asymptomatic bony nodules, buccal exostoses don’t usually present until adult life, and some consider buccal exostoses to be a variation of normal anatomy rather than disease. Bone is thought to become hyperplastic, consisting of mature cortical and trabecular bone with a smooth outer surface. They are less common when compared with mandibular tori. Signs and symptoms
Buccal exostoses are bony hamartomas, which are non- malignant, exophytic nodular outgrowths of dense cortical bone that are relatively avascular.’Symptoms:
Buccal exostoses generally tend to be asymptomatic and are usually painless. However, they may increase patient concern about poor aesthetics, inability to perform oral hygiene procedures due to difficulty in cleaning around the area with a toothbrush, and compromised periodontal health by causing food lodgement, which could lead to patients reporting increased bleeding when tooth brushing. Signs:

They tend to appear in early adolescence and may very slowly increase in size with time. Buccal exostoses generally occur bilaterally. Found usually in the premolar and molar region. These benign growths affect both the jaws. The maxilla is shown to display a higher prevalence rate of 5.1:1 in comparison to mandible. Males also are afflicted more than females with a prevalence rate of 1.66:1, in all intraoral locations.The overlying mucosa appears to be stretched but intact and normal in colour.