Biting or chewing the delicate inner lining of the cheek, known as the buccal mucosa, is a common occurrence. This behavior ranges from a brief, painful accident to a persistent, unconscious habit. It is divided into two categories: involuntary trauma from physical factors and a repetitive compulsion driven by psychological triggers. Understanding these causes is the first step toward finding a lasting solution. This article explores the root causes, the resulting physical damage, and methods for habit reversal.
Accidental and Habitual Triggers
The reasons people repeatedly bite their cheeks fall into two distinct groups: mechanical and behavioral. Accidental biting often occurs during activities like eating or speaking when the jaw moves suddenly, momentarily trapping the cheek tissue between the teeth. This involuntary action is frequently a symptom of an underlying physical irregularity in the mouth.
Physical alignment issues, or malocclusion, can predispose a person to repeated accidental biting because the upper and lower teeth do not meet correctly. Misaligned or sharp teeth, or newly restored fillings or crowns, may create a pinch point along the occlusal plane where chewing surfaces meet. Talking while chewing food also increases the likelihood of an accidental bite.
When the behavior is not accidental, it is often classified as a Body-Focused Repetitive Behavior (BFRB). This chronic cheek chewing is formally known as morsicatio buccarum, and it is typically a subconscious response to internal states. The habit is strongly associated with stress, anxiety, boredom, or deep concentration.
For individuals with morsicatio buccarum, chewing the cheek provides temporary self-soothing or stimulation. The behavior can become a self-perpetuating cycle. Initial trauma creates roughened tissue, which the person then feels a subconscious urge to smooth out by continuing to chew. This repetitive compulsion is often unconscious, occurring when the person is distracted, deep in thought, or during sleep.
Physical Consequences of Chronic Chewing
Repeatedly subjecting the buccal mucosa to trauma leads to physical damage within the mouth. The immediate result is localized inflammation and the formation of painful open sores, or ulcers, which make eating and speaking uncomfortable. Since these injuries break the tissue barrier, they increase the risk of a secondary bacterial infection.
Chronic, repetitive chewing causes the oral tissue to thicken and harden in a process known as hyperkeratosis. This manifests as distinct, thickened white patches on the inner cheek lining, which is the hallmark of morsicatio buccarum. The surface of these patches often appears shredded or irregular due to constant frictional damage.
Continuous irritation can lead to the formation of scar tissue and a change in the texture of the affected area. The presence of this damaged, uneven tissue can trigger the compulsion to chew further, sustaining the damaging cycle. Chronic mechanical irritation should be monitored by a dental professional to rule out compounding issues.
Effective Methods for Habit Reversal
Addressing the habit requires a two-pronged approach targeting both physical causes and underlying behavioral triggers. For mechanical issues, consulting a dentist is the first step to identify misaligned teeth, sharp edges, or ill-fitting dental appliances causing accidental bites. A dentist can smooth sharp cusps or adjust restorations to eliminate the pinch point.
If biting occurs primarily during sleep, a custom-fitted night guard or oral splint can create a protective barrier between the teeth and the cheek tissue. This physical separation prevents teeth from contacting the inner cheek, allowing existing sores to heal and breaking the nocturnal cycle of trauma.
For the habitual component, Habit Reversal Training (HRT) is a highly effective behavioral strategy, often guided by a therapist. HRT begins with awareness training, where the individual learns to recognize the specific feelings, thoughts, and situations that precede the urge to chew. Tracking these triggers in a journal increases mindfulness of the unconscious behavior.
The next step is implementing a competing response, which is an action incompatible with cheek chewing performed immediately upon feeling the urge. Simple, discrete alternatives include actions that occupy the mouth or the hands:
- Gently placing the tongue on the cheek.
- Lightly resting the jaw.
- Chewing a piece of sugar-free gum to occupy the mouth.
- Squeezing a stress ball or making a tight fist for a minute.
For those whose habit is rooted in stress or anxiety, incorporating relaxation techniques like deep breathing or seeking therapeutic guidance for managing emotional triggers can provide significant relief.