What is Morsicatio Buccarum, Why Does It Occur, and How to Stop It?

Morsicatio buccarum is a behavioral disorder in which a person constantly bites the inside of the cheek. It is a deliberate and subconscious action and is also known as constant cheek biting.

According to the Diagnostic and Statistical Manual of Mental Disorders, morsicatio buccarum is classified as a body-focused repetitive disorder, which is a subcategory of obsessive-compulsive and related disorder. It is known to affect 750 in 1 million people and is more common in females than males.⁽¹⁾

Cheek biting can be of the following types:

• Accidental: It can happen to anyone. Accidentally a person may bite the inside of the cheek while eating, talking, or doing any sport.
• Regular Accident: A person with a jaw or dental problem may accidentally bite the cheek regularly. A doctor or a dentist should be consulted in such cases.
• Sleep biting: Some people bite their cheek often while asleep.
• Habitual Cheek Biting: Some people have a behavior of biting their cheek subconsciously. This behavior can be corrected with behavior therapy.
• Chronic Cheek Biting: This type is known as Morsicatio buccarum. In this, a person bites his cheek and is not even able to stop it.

There are numerous reasons that can lead to cheek biting. A person doing it may not even realize that he is doing it. A person may be under stress, anxiety and boredom. Research shows a person under stressful situations may bite their cheeks.⁽²⁾ Also, a study found an association between cheek biting and depression.⁽³⁾

A person may also accidentally bite his cheek in the following situations:

• While eating or talking
• Getting distracted during a task
• Those having problems with any dental device
• Problem with wisdom teeth or jaw

Cheek biting can also be due to the result of repetitive behavior that is inherited.⁽⁴⁾ Some people who bite the cheek may try to smoothen the skin by further biting it.

The treatment options for morsicatio buccarum includes the following:

The following home remedies can be tried to lessen cheek biting.

• Chewing Gum: Chewing gum can act as a distraction to help prevent cheek biting. It is better to use sugar-free gum for better dental health.
• Breathing Techniques: A person can try breathing techniques whenever there is an urge to bite the cheek.
• Meditation and Mindfulness: If cheek biting is due to anxiety, meditation can be helpful.
• Eliminating Triggers: A person who identifies triggers can try and avoid them to prevent biting their cheek.

A person with chronic cheek biting or morsicatio buccarum can be referred to a therapist by the doctor. Therapies are beneficial for those in whom cheek biting is due to stress, anxiety, or depression.

The types of therapies that may be given to a person include:

• Cognitive behavior therapy
• Acceptance and commitment to therapy
• Habit reversal therapy
• Comprehensive behavior therapy

During the therapies, the person may be taught breathing and relaxation techniques that can be performed when there is an urge to bite the cheek. The therapist may also ask the person to write down when they feel the urge to bite the cheek. This can be of help in identifying triggers.

Imagery techniques may be taught to the person to calm down when stressed or anxious.

Hypnosis is another therapy that can be helpful in changing and eliminating any habit.

Some doctors prescribe medication along with therapy to stop cheek biting or morsicatio buccarum. These include mostly anti-depressants. If the therapies do not work, a mouth guard or dental device is advised to protect the inner cheek.

A study done in 2021 on a girl with morsicatio buccarum suggested a soft appliance placed on the affected area could be a suitable treatment.⁽⁵⁾ It was observed that the habit returned when the device was removed.

There are a few risks associated with cheek biting. These include:

• Scar formation
• Redness
• Bleeding
• Sores and ulcers in the lining of the mouth that are painful
• Pain with eating and drinking
• Inflammation
• Soft tissue erosion in the cheek

This habit can lead to irregularities in the cheek and its texture that may further attempt to smooth the surface.

There were a few discussions if cheek biting may cause oral cancer. In a study, it was concluded that cheek biting alone cannot cause oral cancer but can worsen the condition.⁽⁶⁾

Occasionally morsicatio buccarum may not be of much concern. But, if a person does it frequently and the habit is damaging the inner cheek, a doctor should be consulted to control the behavior.