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Chronic cheek chewing - Oral Mucosal Lesion
Other Resources UpToDate PubMed

Chronic cheek chewing - Oral Mucosal Lesion

Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed


Chronic cheek chewing is a common factitial condition that is seen in patients who nibble on the lining of the mouth as a nervous, often unconscious, habit. In most cases, the patient uses the canine teeth to crush the superficial layers of the surface oral epithelium. Interestingly, no ulcerations are seen because biting through the entire thickness of the epithelium would be painful.

This condition usually is first seen in the second decade of life and seems to be less frequently encountered after the fourth decade.

Chronic cheek chewing is asymptomatic.

Related topic: Oral frictional hyperkeratosis


K13.79 – Other lesions of oral mucosa

59901004 – Cheek chewing

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Differential Diagnosis & Pitfalls

  • Oral candidiasis – The plaques of candidiasis usually wipe off more easily than the keratotic tags of cheek chewing.
  • Leukoplakia – This condition usually does not have a ragged surface and is more sharply demarcated than cheek chewing.
  • Leukoedema – This condition is characterized by a smooth white surface of the buccal mucosa, and the lesion tends to disappear when the mucosa is stretched or everted.
  • Oral lichen planus – While lichen planus often affects the buccal mucosa, the surface of this process is not as ragged, and even the more papular forms often have areas of reticular striae.
  • White sponge nevus – The lesions of white sponge nevus tend to be more diffuse and affect areas of the mucosa that cannot be reached by the teeth.
  • Oral squamous cell carcinoma

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Last Updated:06/10/2018
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Chronic cheek chewing - Oral Mucosal Lesion
A medical illustration showing key findings of Chronic cheek chewing : Buccal mucosa, Oral white plaque
Clinical image of Chronic cheek chewing - imageId=2556547. Click to open in gallery.  caption: 'A ragged plaque on the buccal mucosa.'
A ragged plaque on the buccal mucosa.
Copyright © 2024 VisualDx®. All rights reserved.