Everything you need to know about cheek biting

Mental Health
While most people have accidentally bitten the inside of their cheek before, some people bite their cheek compulsively over a long period. Chronic cheek biting is a body-focused repetitive behavior that has an association with obsessive-compulsive disorder.

Cheek biting and the biting of other areas in the mouth affect 750 out of every 1 million people. Research suggests that this behavior is more common in females than in males.

Cheek biting can affect people of all ages, but it may be more likely in children. In an older survey from 2005, researchers showed that the prevalence of cheek and lip biting in children between the ages of 2 and 17 years in the United States was slightly under 2%.

Keep reading to learn more about the causes and complications of cheek biting and when to see a doctor.


What is cheek biting?

a woman experiencing pain from cheek biting.
A person may bite their cheek because of a minor accident or a mental health condition.

There are many reasons why people bite their cheek. Cheek biting can sometimes be a minor accident, but it may also be due to a mental health condition.

Careless chewing or talking while eating can sometimes result in someone biting their cheek accidentally. Accidental biting can cause injury and inflammation at the location of the bite.

If someone is regularly biting their cheek accidentally, they may wish to discuss it with a dentist. This symptom may be due to the teeth or implants becoming misaligned in the mouth. People with temporomandibular disorders may also frequently bite their cheeks.

People who chronically bite their cheek may be experiencing a body-focused repetitive behavior. Cheek biting may also occur during sleep.

Chronic cheek biting is a more serious condition that requires appropriate medical attention. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes it among obsessive-compulsive and related disorders.

Other body-focused repetitive disorders include hair pulling, nail biting, and lip biting.


Causes

Unless the behavior is due to an ill-fitting dental device or another dental problem, chronic cheek biting often has a psychological cause.

Some researchers think that body-focused repetitive behaviors may have a genetic factor. If this is the case, having an immediate family member, such as a parent or sibling, with body-focused repetitive behavior may increase a person’s risk of the condition.

Researchers are currently trying to determine which genes may play a role in body-focused repetitive behaviors, which may help doctors diagnose and treat these behaviors in the future.

Many other factors may also contribute to a person developing chronic cheek biting. These include stress, as well as emotional and environmental factors.

Complications

When someone repeatedly bites their cheek, the area can become thick, scarred, and paler than the surrounding tissue. Sometimes, the affected area may become inflamed with purple spots.

When the lining of the cheek becomes irregular, the person may have the desire to continue biting the area to try to create a smooth surface.

In more severe cases, dentists may notice eroded tissue in the cheek.

The complications of chronic cheek biting are not only physical. People who chronically bite their cheek may stop engaging in social activities to prevent others from observing the behavior.

Some people may feel shame, isolation, and low self-esteem in relation to their body-focused repetitive behaviors, which can affect their overall well-being.


How to stop

If a person is regularly biting their cheek, they may want to speak to a dentist to ensure that their teeth or implants remain properly aligned. If necessary, the dentist may advise a person to visit an orthodontist, who can repair a misalignment to prevent regular cheek biting.

Sometimes a dentist will prescribe a mouthguard to a person who regularly bites their cheek. A mouthguard can prevent any further damage to the tissue and give it a chance to heal. Dentists will recommend using the mouthguard until the tissue has completely healed.

People who chronically bite the inside of their cheek should speak to a doctor about whether they have a body-focused repetitive behavior.

A doctor may suggest one of the following types of therapy:

  • cognitive behavioral therapy (CBT)
  • habit reversal training
  • comprehensive behavioral treatment
  • acceptance and commitment therapy
  • dialectical behavioral therapy, or DBT

Sometimes, doctors may recommend medication in addition to psychotherapy.

The most effective treatment that a person can receive is one that addresses both the behavior and the underlying cause. A therapist will help a person discover what is driving their need to chew their cheeks and develop a plan for managing the cause.

There is no robust evidence to show that special diets, electrical stimulation, hypnosis, massage, or other practices are effective in treating body-focused repetitive behaviors.

When to see a doctor

young man speaking to his doctor
A person should speak to a doctor if they are regularly biting their cheek by accident.

If a person is regularly biting their cheek by accident, they should consult a dentist. The dentist will be able to determine the reason and help correct any misalignments.

Chronic cheek biting requires medical attention to address the cause of the behavior. Some people for whom cheek biting is a self-injurious behavior are unaware of the problem and may not seek medical attention.

The loved ones of a person with body-focused repetitive behaviors can maintain a supportive relationship with the individual and encourage them to speak with a doctor or therapist if they have concerns.


Summary

Cheek biting may occasionally be a harmless accident or the result of misaligned teeth, but many people experience chronic cheek biting. Chronic cheek biting is a body-focused repetitive behavior that relates to obsessive-compulsive disorder.

Doctors prescribe psychotherapy to help people resolve chronic cheek biting. Sometimes, people may also need to take medications.

The complications of chronic cheek biting are not only physical. Many people feel shame and low self-esteem because of this behavior, which may lead them to avoid social and career-related interests.

A therapist will aim to treat both the chronic cheek biting and the underlying cause of the behavior.

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