Persistent cheek chewing can indicate an underlying mental-health-related response to stress and anxiety. Management may involve psychotherapy, stress-reduction techniques, and dental appliances.
Chronic cheek biting, or morsicatio buccarum, involves repeatedly gnawing or nibbling the inner lining (mucous membrane) of the mouth — including the cheeks, lips, and tongue.
It is listed as a body-focused repetitive behavior (BFRB) in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Occasional cheek bites can occur as a behavioral response during stressful life stages — for example, adolescence or pregnancy.
By contrast, BFRBs are repetitive behaviors that continue despite efforts to stop or despite causing harm and distress. They most often begin in late childhood and can persist into adulthood.
Exact prevalence figures for morsicatio buccarum are limited, but a 2013 review estimated that about 750 per 1 million people may experience chronic cheek biting.
Continue reading to explore the varieties, triggers, and treatment options for chronic cheek biting.
Types of cheek biting
Cheek biting can be divided into five main categories:
- Occasional accidental: A one-off or infrequent accidental bite. Usually not concerning, though it may produce a canker sore.
- Frequent accidental: If you bite your cheek regularly by accident, it could indicate misaligned teeth or a jaw issue. A dentist can assess the problem and suggest interventions like braces.
- During sleep: Cheek biting can occur while asleep, for example with nocturnal teeth grinding. A mouthguard may prevent direct tooth-to-cheek contact.
- Habitual: A semi-conscious repetitive action that might be substitutable with a less harmful behavior.
- BFRD: Compulsive cheek biting that persists despite attempts to quit. It resembles other compulsive actions such as nail biting or hair pulling.
What causes cheek biting?
Chronic cheek biting is most often linked to stress and anxiety.
Like many BFRBs, chronic cheek chewing frequently happens without conscious awareness. You may not realize you’re chewing your cheek when you’re bored, lost in thought, or asleep, for example.
Some individuals develop a “favorite” spot on the inner cheek that they repeatedly chew, producing a raw, uneven patch of tissue.
The TLC Foundation explains that this can create an additional urge to smooth the injured area, perpetuating a cycle of ongoing damage.
Accidental or rare cheek bites might stem from:
- talking while chewing
- participating in contact sports
- erupting wisdom teeth
- issues with dental devices, such as an ill-fitting mouthguard
A 2013 review noted that children may bite their cheeks to gain attention.
A 2019 study of 5,935 pregnant individuals reported that about 1 in 10 had morsicatio buccarum.
Is cheek biting a stimming behavior?
Stimming describes repetitive movements or behaviors people use for self-stimulation, often associated with autism spectrum disorder.
Research on cheek biting as stimming is limited, but it may fit this category because it’s a repetitive action frequently used to soothe anxiety, stress, or intense emotions.
What are the complications of cheek biting?
Ongoing cheek chewing produces inflammation, lesions, and nodules inside the mouth that can progress to sores and ulcers.
These oral injuries can raise the likelihood of infection and scarring inside the mouth, causing pain and discomfort.
The TLC Foundation also highlights potential psychological and emotional consequences of chronic cheek biting.
Compulsive chewers may feel guilt and shame about their self-harming BFRB, leading to despair. They might hide the behavior from others, which can restrict social engagement.
Can chronic cheek biting cause cancer?
Long-term chewing can severely damage the mouth’s inner lining, a phenomenon called chronic mechanical irritation (CMI).
A 2017 study found that tooth-related CMI alone does not cause oral cancer. However, if cancer exists from other factors, CMI may promote its progression.
How to stop cheek biting
Approaches to treating cheek biting vary depending on the root cause and how often the biting occurs.
Habitual cheek chewing can sometimes be managed with gentle guidance, self-control, and time. The TLC Foundation emphasizes that distraction is a key strategy. Possible tactics include:
- chewing sugar-free gum
- eating healthy, crunchy snacks
- staying well hydrated
- taking deep breaths when you feel the urge to chew your cheek
- recognizing triggers and replacing cheek chewing with another action, such as squeezing a stress ball or using tape on fingers
Treatment for BFRB-related cheek biting should address emotional and behavioral elements to reduce stress and alter habits.
Recommended measures may include:
- reducing stress and anxiety
- mindfulness practices like yoga and meditation
- talk therapies, for example cognitive behavioral therapy
- habit reversal methods, such as awareness training and competing-response training
If these strategies are ineffective, a clinician might suggest dental devices such as a mouth guard or, in rare cases, surgical options.
The bottom line
Chronic cheek biting is a body-focused repetitive behavior that can lead to oral inflammation, lesions, and discomfort.
If you frequently chew the inside of your cheek, consult a healthcare provider. They can help identify triggers and work with you to create a plan to manage and reduce the behavior.
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