Chronic cheek biting, formally known as morsicatio buccarum, is a common, often unconscious, body-focused repetitive behavior (BFRB) involving repeatedly chewing or biting the inner lining of the mouth. This habit can range from a nervous tic to a compulsive action, leading to persistent irritation and injury of the buccal mucosa. Understanding the underlying causes and implementing targeted strategies is the most effective way to address this behavior. This guide provides actionable steps for self-management and outlines when professional intervention is warranted.
Understanding Why You Bite
The compulsion to bite the inside of the cheek stems from psychological and physical factors. Psychologically, the behavior often functions as an automatic coping mechanism in response to internal states like boredom, anxiety, or high stress. The repetition provides a momentary distraction or a self-soothing sensation, classifying it as a BFRB similar to nail-biting. For many, the behavior begins accidentally, perhaps during eating, and then becomes a habit as the tongue or teeth seek out the newly created, irregular tissue patch.
Physical causes frequently involve issues with the alignment of the teeth or jaw, medically termed malocclusion. If the upper and lower teeth do not meet correctly, the cheek tissue can be consistently caught and traumatized during normal functions like chewing or speaking. Sharp edges from a broken tooth, a poorly fitted crown, or dental appliances can also create an uneven surface that invites repeated biting. The resulting trauma causes the tissue to swell, which ironically makes subsequent biting more likely and perpetuates the cycle.
Immediate Techniques for Breaking the Habit
The first step in stopping the habit is heightening your awareness of when the biting occurs. Awareness Training involves tracking the specific times, locations, and emotional states that precede the behavior, often using a journal or phone note. Identifying these triggers—such as sitting in traffic or watching television—transforms the unconscious action into a conscious one, creating a window for intervention.
Once a trigger is recognized, the strategy shifts to implementing a Competing Response, which is a physical action that interrupts the urge. When you feel the urge to bite, immediately introduce a substitute behavior, such as gently pressing your tongue against the back of your front teeth or keeping your mouth slightly open. Chewing sugar-free gum can also serve as an effective substitute, redirecting the oral fixation to a safe, non-damaging activity.
Sensory Management techniques can help disrupt the habit loop by changing the tactile sensation of the inner cheek. Applying petroleum jelly to the irritated area creates a smooth, slippery barrier that reduces the desire to pick at or chew the rough tissue. When the urge is triggered by anxiety, employ quick techniques like deep, controlled breathing to regulate the nervous system and decrease the compulsion’s intensity. Maintaining these substitute responses for a full minute or two is often enough to successfully override the urge until it passes.
When Dental and Medical Intervention is Necessary
If self-management techniques do not stop the biting within a few weeks, or if the habit causes bleeding and persistent pain, professional help is necessary. When the root cause is physical, a dentist can perform procedures to eliminate the trauma. This may involve smoothing down sharp edges on teeth or fillings, or correcting malocclusion through orthodontic treatments like braces or clear aligners.
For cases where biting occurs primarily at night or during periods of intense focus, a custom-fitted oral appliance can provide a physical barrier. This appliance, similar to a mouthguard, is worn over the teeth to shield the delicate cheek tissue from direct contact with the biting surfaces. These dental solutions address the mechanical issue, ensuring the teeth cannot physically reach the tissue to cause injury.
For severe, compulsive morsicatio buccarum, a mental health professional can offer specialized behavioral therapies. Habit Reversal Training (HRT) is a structured approach that teaches recognition of the subtle sensations preceding the biting, replacing the action with a healthier, competing response. Cognitive Behavioral Therapy (CBT) may also be used to address underlying factors, such as anxiety or obsessive-compulsive tendencies, that fuel the repetitive behavior.
Health Risks of Persistent Cheek Biting
Continuous trauma to the inner cheek tissue can lead to morsicatio buccarum lesions. The repetitive mechanical irritation causes the buccal mucosa to thicken and develop white, shaggy, or ragged-looking patches. This tissue change is essentially a protective response by the body, but it creates an uneven texture that increases the desire to chew or smooth the area, trapping the individual in a self-injurious cycle.
The constant open wounds created by the biting increase the risk of localized oral infection. These lesions, which may develop into painful ulcers or sores, provide an entry point for bacteria present in the mouth. Ongoing inflammation and swelling are common consequences, leading to chronic discomfort and making activities like eating and speaking difficult. Any chronic irritation should be monitored by a healthcare professional, as persistent trauma requires assessment to rule out serious tissue changes.