Biting Inside Of Cheek: Causes, Effects, And How To Stop This Anxiety-Related Habit

If you find yourself repeatedly biting the inside of your cheek, you may be wondering why it keeps happening. For some people, it can be an occasional accident while eating. For others, it may be a habitual cheek biting behavior connected to stress, anxiety, or an underlying dental issue. Understanding the difference between accidental and habitual cheek biting can help you determine the best approach for addressing it.

Signs you may have a cheek-biting habit

Occasional cheek biting while chewing food can happen to anyone and typically resolves on its own. However, when cheek biting becomes a pattern, it may indicate something more than a simple accident. Recognizing the signs of habitual cheek biting can help you determine whether it might be time to seek support.

Some indicators that cheek biting may have become a habit include:

• Biting your cheek without realizing you are doing it
• Noticing that you bite your cheek more often during stressful situations
• Visible tissue damage, rough patches, or sores on the inner cheek
• Feeling an urge or compulsion to bite your cheek
• Difficulty stopping the behavior even when you want to
• Experiencing temporary relief from tension or anxiety after biting

If several of these signs resonate with you, your cheek biting may be a behavior that warrants closer attention.

Accidental vs. habitual cheek biting

Frequent accidental cheek biting can sometimes be a sign of dental problems like misaligned teeth. Wisdom teeth sometimes grow at an angle that can lead to chronic cheek biting, especially of the inner cheek. A dentist can diagnose accidental bites resulting from dental issues. They can also help with accidental cheek biting during sleep by providing a device or mouthguard to help prevent the teeth from biting the cheek during sleep. In many cases, dentists can also screen for oral cancers that may arise from damage to the inside of the mouth.

In contrast, habitual cheek biting often occurs as a semiconscious response to emotions like stress or anxiety. This type of body-focused repetitive behavior may provide temporary relief but can lead to ongoing tissue damage if left unaddressed. Recognizing which type of cheek biting you experience can guide you toward the most appropriate solutions.

Why might a person bite the inside of their cheek?

Cheek biting can occur for multiple reasons, ranging from physical factors to psychological ones. A systematic review of body-focused habits suggests that accidental biting of the cheek can occur occasionally when chewing food, while habitual cheek biting may be indicative of anxiety or stress, compulsive behaviors, or an orthodontic issue such as tooth deflection. Understanding the root cause of your cheek biting can help you find the most effective way to address it.

Dental and physical causes

Some people bite their cheeks accidentally due to the structure of their mouth. Misaligned teeth, an uneven bite, or wisdom teeth growing at an angle can all contribute to frequent accidental cheek biting. These physical factors can make it easier for the teeth to catch the inner cheek tissue during chewing or speaking. If you suspect a dental issue may be contributing to your cheek biting, a dentist can evaluate your mouth and recommend appropriate treatments, such as orthodontic adjustments or a protective mouthguard.

Cheek biting anxiety and stress connection

For many people, cheek biting serves as a coping mechanism for managing uncomfortable emotions. When anxiety or stress builds up, some individuals may unconsciously bite their cheeks as a way to release tension or self-soothe. This pattern can develop over time, eventually becoming an automatic response to stressful situations. Anxiety and cognitive stress symptoms may manifest emotionally or physically, and cheek biting can be one way the body attempts to regulate these feelings. Addressing any underlying anxiety may help reduce the urge to engage in this behavior.

Morsicatio buccarum and body-focused repetitive behaviors

The clinical term for chronic cheek biting is morsicatio buccarum, which often qualifies as a body-focused repetitive behavior (BFRB). Other body-focused repetitive behaviors may include:

• Chronic skin picking
• Nail biting
• Lip biting
• Hair pulling
• Cuticle picking

Although BFRBs may be similar to obsessive-compulsive disorder (OCD) compulsions, they are not the same. People with BFRBs typically engage in the behavior to relieve feelings of tension or discomfort, while those with OCD carry out their repetitive behaviors, like hand washing or checking things, because of unwanted thoughts that make them feel as though something bad will happen if they don't perform these actions. Understanding this distinction may be helpful when seeking appropriate treatment.

How to stop biting the inside of your cheek

If you want to reduce or stop cheek biting, several approaches may help. The most effective strategy often depends on whether your cheek biting stems from dental issues, anxiety, or habitual patterns. Combining professional treatment with practical self-help strategies can often create a comprehensive approach to addressing this behavior. Relaxation exercises, meditation, and other cognitive and behavioral therapies or self-help practices may be beneficial for anxiety-related cheek biting.

Habit reversal therapy and CBT

Habit reversal therapy is a specific form of cognitive behavioral therapy (CBT) that has shown effectiveness for treating body-focused repetitive behaviors like cheek biting. This approach typically involves several components. First, awareness training may help you recognize when and where you engage in the behavior. Then, competing response training can teach you to substitute a different, less harmful action when you feel the urge to bite your cheek. For example, you might learn to press your tongue against the roof of your mouth or clench your fist gently instead of biting.

CBT more broadly may help address the anxiety or stress that is often driving habitual cheek biting. By identifying and challenging unhelpful thought patterns through CBT, you may be able to cope more effectively with the emotional factors that lead to the behavior. Working with a therapist trained in these approaches can offer personalized guidance for your specific situation.

Practical strategies to reduce cheek biting

In addition to professional treatment, several practical strategies may help you manage cheek biting on your own.

These strategies can be part of a comprehensive treatment plan that may help you reduce biting and regain a sense of control over your behavior. Finding what works best for you may take some experimentation.

When to see a dentist or doctor

While many cases of cheek biting can be managed with self-help strategies and therapy, some situations may require professional medical attention. Consider seeing a healthcare provider if you notice signs of infection such as increased swelling, prolonged pain, or discharge from the affected area. A dentist can also help if you suspect that misaligned teeth or other dental issues are contributing to your cheek biting. Appropriate medical attention may be required for symptoms like broken skin or moderate to severe bleeding inside the mouth to support proper healing.

Potential effects and damage from chronic cheek biting

Regular cheek biting can cause damage to the oral mucosa, or mouth tissue, in the inner cheek. Over time, this repeated trauma may lead to rough, uneven tissue, painful sores, or areas of thickened skin inside the mouth. These injuries can create a cycle where the damaged tissue becomes easier to bite again, leading to further irritation and prolonged healing times.

How long does a cheek bite take to heal?

The inner lining of the cheek can heal more quickly than other areas of the body due to the microbiome of the oral cavity. That's why oral wounds may heal faster than wounds on the skin, which means a minor cheek bite may heal within a few days to a week or so. However, if you continue to bite the same area, healing can be significantly delayed, and the tissue may remain irritated for weeks.

Can cheek biting lead to infection or other complications?

It is possible that regularly biting your cheek could lead to an infection. Open wounds inside the mouth can become vulnerable to bacteria, especially if the area is repeatedly injured before it has a chance to heal. If you experience swollen lymph nodes, prolonged pain, or signs of infection from your cheek biting, consulting a medical doctor for an exam and treatment may be important. They might also offer dental appliances or other treatments and interventions that provide relief and protect the cheek from further injury.

The relationship between cheek biting and mental health conditions

Cheek biting can sometimes be connected to various mental health conditions beyond general stress and anxiety. Understanding these connections may help you identify whether your cheek biting might benefit from specific types of support or treatment.

Is cheek biting a sign of anxiety?

Some people may have habits they fall into when they are feeling particularly anxious. As an example, you might see some people rapidly bouncing one of their legs up and down while sitting as a sign of nervous energy. For some individuals, cheek biting serves a similar function, providing temporary relief from anxious feelings. These feelings may be occasional, or they may stem from a diagnosable anxiety disorder.

Cheek biting and ADHD stimming

Cheek biting can sometimes occur alongside self-stimulatory or repetitive behaviors associated with ADHD, such as twirling hair, tapping feet, scratching, or skin picking. Some individuals may also chew on the inside of the mouth or tongue as part of these behaviors. If you have ADHD and notice that you frequently bite your cheeks, this connection may be worth exploring with a healthcare provider.

How cheek biting differs from OCD compulsions

A repeated behavior like cheek biting can be considered one of the body-focused repetitive behaviors, but it differs from OCD compulsions in important ways. People with BFRBs typically engage in the behavior to relieve feelings of tension or discomfort, while those with OCD perform their compulsions in response to intrusive thoughts and fears about what might happen if they don't complete the action. Understanding this distinction can help guide appropriate treatment approaches.

How online therapy may help with cheek biting

If anxiety or stress may be contributing to your cheek biting, working with a therapist can often help you address the underlying causes. Online therapy through a platform like BetterHelp can make it easier to access this kind of support from the comfort of your home, which may feel less intimidating than visiting an office. Additionally, BetterHelp offers the ability to message your therapist between sessions, which can provide ongoing support when you notice urges to engage in cheek-biting behaviors.

Research on online therapy's effectiveness

While there may not yet be specific evidence on the effectiveness of online therapy for treating cheek-biting habits, there's lots of research on the effectiveness of online therapy for anxiety symptoms. For example, a 2021 study suggests that online therapy can often create "equivalent overall effects" to in-person therapy when it comes to treating anxiety. For people who want help addressing cheek biting alongside anxiety, online therapy can be one option to consider.

BetterHelp also now offers psychiatry services through Uplift as an additional care option alongside therapy. For some people, a psychiatric consultation may be helpful as part of a broader mental health treatment plan, and medication management may be considered when clinically appropriate based on a licensed psychiatric provider's evaluation. Medication availability and coverage may vary by member location, clinical appropriateness, and individual pharmacy/insurance benefits. Prescribing decisions are made by the treating clinicians. We do not guarantee that any specific medication will be prescribed or covered by a member's insurance plan. To learn more about getting started, visit this page.