The OPTISMILE Podcast 58 – Parafunctional Habits – Cheek & Lip Biting
Timestamps:
00:46 Why do people do this and how does it matter for your dental health?
Answer: Stress, anxiety or concentration triggers unconscious cheek/lip chewing, causing tissue damage and bite alterations.
02:43 Surely it creates a lot of damage if you’re chronically biting the soft tissues within your mouth?
Answer: Chronic chewing leads to frictional keratosis, callus formation, inflammation and may affect how your teeth meet.
03:55 And these habits, Dr Yudelman, can they actually affect your bite or lead to jaw alignment issues over time?
Answer: Yes; such habits can shift tooth position and alter jaw rest position, placing strain on the TMJ.
05:33 Are these habits mostly daytime or do people do them while they’re sleeping?
Answer: Both: daytime due to stress/concentration, nighttime often linked to bruxism and grinding.
06:42 Can cheek or lip biting actually cause or worsen headaches, facial pain or TMJ problems?
Answer: Microtrauma overworks facial and jaw muscles, leading to tension headaches and TMJ strain.
07:35 This is more common in people with stress or anxiety, much like nail biting. Is that correct?
Answer: Yes; cheek and lip biting is a stress-related coping mechanism, similar to nail biting.
08:15 Are there any warning signs that someone is biting their cheeks or lips subconsciously?
Answer: Look for linea alba (white lines), calluses, chronic ulcers or thickened cheek/lip tissue.
09:24 How do you treat or help someone with a long-term habit like this?
Answer: Assess and correct bite (e.g., Invisalign), employ stress management, mindfulness and night guards.
10:51 Can cheek or lip biting lead to more serious oral issues like infections or lesions?
Answer: Severe cases may yield recurrent ulcers, fibromas and complicate diagnosis of lesions like oral cancer.
12:07 For those who’ve realised they’re biting their cheeks or lips, do you have any final advice?
Answer: Seek dental evaluation, address alignment issues, identify stress triggers and practise awareness to break the habit.
For more in-depth information on each of these topics—including causes, symptoms and professional treatment strategies—please see our references below.
Understanding Bruxism and TMJ Disorders
https://optismile.co.za/blog/understanding-bruxism-tmj/
What is TMJ and How is it Treated?
https://optismile.co.za/blog/what-is-tmj-and-how-is-it-treated/
Relief and Recovery: Managing Bruxism and TMJ Disorder
https://optismile.co.za/blog/relief-and-recovery-managing-bruxism-and-tmj-disorder/
How to Deal with Teeth Grinding
https://optismile.co.za/blog/deal-teeth-grinding/
Your Guide to Common Dental Emergencies
https://optismile.co.za/blog/common-dental-emergencies/
Full Transcript
Eon Engelbrecht – E-Radio-SA (00:04 – 00:39)
Hello and welcome again to Save Your Money, Save Your Teeth, the podcast series where we focus on parafunctional habits – the unconscious or stress-related things we do with our mouths that wreak havoc on our teeth, jaws and overall health. Last week we spoke about nail biting; this week we’re talking about cheek and lip biting, the sneaky habit that’s stressing out your smile and your jaw. Joining us again is Dr Clifford Yudelman – OptiSmile. Dr Yudelman, welcome back.
Dr Clifford Yudelman – OptiSmile (00:39 – 00:46)
Thank you; thanks for having me back. Last week was the nail-biting episode.
Eon Engelbrecht – E-Radio-SA (00:46 – 01:17)
Yes. We had a cliff-hanger in between. So today is cheek and lip biting; next week will be ice chewing, in case you think you got away with the lips and the nails. We know who you are – you’re chewing ice, which is maybe even worse. I think so too. But, you know, I sometimes accidentally bite my cheek and it hurts and it bleeds sometimes. Why do people do this, and how does it matter for your dental health?
Dr Clifford Yudelman – OptiSmile (01:17 – 02:11)
Yes, so the cheeks and the lips are soft tissues; they’re not meant to be repeatedly chomped on. It’s different to a chewing accident, when you accidentally bite your tongue or your cheek. This is more people who sort of suck their cheeks in and constantly chew on them. You see signs of that – a white, scar-like tissue and inflammation – and it can actually affect the way the teeth close together. Especially people who bite their lip: they often bite one side or the other and get a little callus on the lip, and it’s often a much more unconscious habit. People are not aware of lip biting.
Many times I’m talking to someone during an initial consultation, and I’ll notice they bite their lip every so often. I’ll say to them, “Do you bite your lip?”
Eon Engelbrecht – E-Radio-SA (02:11 – 02:20)
And while they’re answering, they look up, start thinking – and they’re literally biting their lip. They say, “No, I don’t think so,” and then bite it again.
Dr Clifford Yudelman – OptiSmile (02:21 – 02:43)
It’s like, well, you are. People are very unaware of lip biting. Anybody who’s got a sore jaw on one side or the other should look in the mirror and see if there’s a little dry skin. They might say, “Oh, I’ve got this bit of dry skin and I just chew on that a bit,” but that dry skin is actually a callus from your tooth – a vicious circle.
Eon Engelbrecht – E-Radio-SA (02:43 – 02:56)
So that’s a sign that something’s out of balance if you’re doing that. Surely it creates a lot of damage if you chronically bite the soft tissues within your mouth?
Dr Clifford Yudelman – OptiSmile (02:56 – 03:19)
Yes, we do see ulcers or callus patches on the inside of the cheek or the lip in people who bite the insides a lot. You get thickened white or greyish lines – it’s called frictional keratosis – and in severe cases you can get scarring. Some people develop a fibroma, which is a lump of dense scar tissue.
Eon Engelbrecht – E-Radio-SA (03:20 – 03:41)
If you occasionally bite your cheek or lip by mistake, that’s a different story. You can end up with a small bump inside the lip, like a little ball filled with mucus – a mucocele. And if you’ve got one of those, you can get in the habit of rolling it around and chewing on it like a small ball.
Dr Clifford Yudelman – OptiSmile (03:41 – 03:54)
I know sometimes I catch myself trying to find one of those and bite it. It’s just a bad habit, I guess. But each time you do that, whatever you’re chewing on only gets worse.
Eon Engelbrecht – E-Radio-SA (03:55 – 04:02)
And these habits, Dr Yudelman, can they actually affect your bite or lead to jaw-alignment issues over time?
Dr Clifford Yudelman – OptiSmile (04:02 – 04:29)
Yes, I think in two ways. One, it’s caused by the bite: if your teeth are misaligned or you’ve had orthodontic changes that shift your bite, cheek or lip tissue can get caught. Or two, it can start causing bite changes. We see people who bite their lip and that starts pushing a particular tooth out of alignment.
Eon Engelbrecht – E-Radio-SA (04:29 – 04:44)
Often it’s one of those side-front teeth. I just recently completed Invisalign on a lovely lady and then she subsequently got engaged; her sister came to see me and she’s a yachtie. They both had the same tooth that was crooked.
Dr Clifford Yudelman – OptiSmile (04:45 – 04:51)
And while she was there, I saw her biting her lip in exactly the same way her sister did.
Eon Engelbrecht – E-Radio-SA (04:51 – 05:33)
So although it’s not necessarily genetic – and the mother apparently also has that same crooked tooth – perhaps these ladies saw their mother biting, much like a nail-biting habit. You see someone doing it, you pick up the habit, and that makes your tooth grow crooked. Also, the subconscious shift in your jaw’s resting position can stress your TMJ and lead to bigger jaw issues. Are these habits mostly daytime or do people do them while they’re asleep?
Dr Clifford Yudelman – OptiSmile (05:33 – 05:39)
Both. Daytime biters often do it out of stress or when concentrating.
Eon Engelbrecht – E-Radio-SA (05:40 – 05:49)
They may catch themselves biting the inside of their cheek during a tense phone call – like that story about biting your tongue.
Dr Clifford Yudelman – OptiSmile (05:50 – 06:04)
Maybe a young two-year-old is acting up and instead of raising your voice you end up biting your tongue or cheek or lip. Some people nibble their lip while reading emails.
Eon Engelbrecht – E-Radio-SA (06:05 – 06:13)
Or if you watch people on a Zoom call, with eight or ten participants, you’ll often see someone biting their lip.
Dr Clifford Yudelman – OptiSmile (06:14 – 06:42)
Night-time cheek biting is often linked to teeth grinding or bruxism. Episode 42 was all about that. If you’ve got white lines on the inside and aren’t aware of biting your cheeks in the day, it may be a sign you’re biting and sucking your cheeks at night, clenching and grinding. The same applies to the tongue – you can see little scallops on the sides, which could all indicate bruxism.
Eon Engelbrecht – E-Radio-SA (06:42 – 06:51)
All right. And can cheek or lip biting actually cause or worsen headaches, facial pain or TMJ problems?
Dr Clifford Yudelman – OptiSmile (06:51 – 07:34)
Indeed it can. The constant micro-trauma overworks the muscles of the face and jaw. If you’re biting down hard on your cheek or lip you engage your masseter – the main jaw muscle – and your temporalis, which runs over the temples. Over time that tension spreads into your temples, behind your eyes, even down your neck and shoulders. Some people adopt a protective posture, shifting how they chew to avoid painful areas in their mouth, causing imbalance and TMJ strain, which often leads to headaches or facial pain.
Eon Engelbrecht – E-Radio-SA (07:35 – 07:44)
I would imagine this is more common in people with stress or anxiety, much like nail biting. Is that correct?
Dr Clifford Yudelman – OptiSmile (07:44 – 08:15)
Yes. Just like nail biting, cheek and lip biting often stems from stress, anxiety or deep concentration. It can be a mindless coping mechanism – “I’m worried, so I bite.” Some folks are so used to it they think it’s normal, but it’s essentially your body’s stress-relief method. Once you identify it as a sign of underlying tension you can address the root cause.
Eon Engelbrecht – E-Radio-SA (08:15 – 08:21)
Are there any warning signs that someone is biting their cheeks or lips subconsciously?
Dr Clifford Yudelman – OptiSmile (08:21 – 09:24)
Yes. There’s something called linea alba, which means “white line”: visible lines or calluses on the inside of your cheek. If you’re constantly gnawing on the inside of your cheek, one or both cheeks can look very white and rough. I’ve seen that many times over the last 42 years, plus chronic sore spots or small ulcers in the same place. People catch themselves mid-bite, especially biting their lip when stressed. If your dentist mentions thickened cheek tissue and asks if you’re biting it, that’s a good clue. If you notice these signs, pay attention. If you’re listening to this podcast and it’s caught your interest, you’re probably already aware and looking for more information.
Eon Engelbrecht – E-Radio-SA (09:24 – 09:30)
How do you treat or help someone with a long-term habit like this?
Dr Clifford Yudelman – OptiSmile (09:31 – 10:50)
We always examine the bite to check for misalignment. Sometimes a posterior cross-bite – where the upper teeth should bite outside the lower teeth but cross over – can lead to these issues, or worsen them. We can often correct that with Invisalign if it’s a problem. We discuss stress management and mindfulness. I mentioned a few podcasts ago that I listened to a book called Oxygen Advantage, and there’s another popular one called Breath by James Nestor. They’re about nasal breathing and relaxation. I want to say meditation, but really 20 minutes of deep breathing can help patients who bite at night. We may prescribe a special splint – a bite guard – to keep the cheeks away from grinding surfaces. Breaking the cycle requires consciousness: noticing triggers and using alternative stress outlets rather than chewing on your tissues.
Eon Engelbrecht – E-Radio-SA (10:51 – 11:01)
Just one more question, Dr Yudelman: can cheek or lip biting lead to more serious oral issues like infections or lesions?
Dr Clifford Yudelman – OptiSmile (11:01 – 12:06)
Yes, in severe cases people can get recurring ulcers or infections. I haven’t seen that often, but definitely fibromas in areas that get constantly bitten – they’re non-cancerous but require removal, often by laser these days. People need to be aware that a sore or white patch on the side of the tongue should be examined by a dentist, as it’s a common site for oral cancer. I’m not saying cheek or tongue biting causes cancer, but it can mask a white patch that needs biopsy, delaying diagnosis.
Eon Engelbrecht – E-Radio-SA (12:07 – 12:15)
And for those who’ve just realised they’re constantly biting their cheeks or lips, do you have any final advice for us, Dr Yudelman?
Dr Clifford Yudelman – OptiSmile (12:15 – 12:47)
Don’t ignore it. See your dentist – come to OptiSmile – check your bite, rule out hidden alignment issues, reflect on stress or anxiety triggers, and be mindful: “Oops, I’m biting again.” That awareness helps you stop. With a bit of effort you can break the habit, prevent scar tissue and save yourself from bigger dental headaches – and even other headaches down the line.
Eon Engelbrecht – E-Radio-SA (12:47 – 13:40)
Okay, fantastic. That concludes cheek and lip biting for today, Dr Yudelman. Thank you so much once again, and we look forward to speaking to you next week about ice chewing.
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Disclaimer: The content provided in this podcast, “Save Your Money Save Your Teeth” on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.