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Chronic cheek chewing - Oral Mucosal Lesion
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Chronic cheek chewing - Oral Mucosal Lesion

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

Synopsis

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

Codes

ICD10CM:
K13.79 – Other lesions of oral mucosa

SNOMEDCT:
59901004 – Cheek chewing

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • 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.
  • 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.
  • Squamous cell carcinoma

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 06/11/2018
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Chronic cheek chewing - Oral Mucosal Lesion
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Chronic cheek chewing : Buccal mucosa, Oral white plaque
Clinical image of Chronic cheek chewing
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