Autistics and Cheek Biting


Content Warning: Parts of this are a bit gross.


There are quite a few autistics who can visibly be seen to stress-out and find themselves doing Morsicatio Buccarum ('More-sick-art-si-oh Bew-carr-rum') as a response to anxiety. It is more widely known as Cheek Biting. I am not referring to people who accidentally bite their cheeks (or tongues or lips) while chewing food. That may be a matter for an ENT doctor.


It is usually a sensory matter, a body-focused repetitive behaviour (BFRB), one that chewies and sugarless gum might help counter. But in some it can reach the level of an obsessive-compulsive disorder (OCD), very hard to even begin to resist, and a joint parent-child hunt for sources of anxiety to eliminate needs to be got under way, perhaps with professional assistance. Cheek Biting also has very real health consequences. So it is also right to term it a self-injurious behaviour (SIB).

(From age 4 till 40 this was me, along with the nail-biting, cuticle picking, nose-picking, scab eating ... I know, TMI. So many forms of 'grooming in public' that I became notorious for it, and for not noticing what I was doing till it was reflected to me by others, serving only to add to my anxiety.)


Those who additionally have oral thrush (candida albicans) due to too much simple and complex sugars in their diets will also know how whole ribbons of inside-cheek flesh can be incised from the wall of one's mouth rather easily. And will know the ulcers that can form too. Weeks of pain, pain that is hard to treat.


Cheek Biting fulfils an innate need in a child or adult, like it or not. Sensory feedback can be mainly positive from it, and a sense of accomplishment also - as one might get from trimming back a hedge with clippers. There is nothing to be gained from ending the practice while the basic underlying anxiety remains, as other harmful behaviour will likely result elsewhere on the body.

So... I feel it is improper to address the behaviour first, before addressing where this need might arise... a detective issue, a labour of love. I reject behaviour modification (e.g. ABA is monstrous), mindfulness and CBT (they seek to adjust an end behaviour without adjusting the starting cause, put all the weight on the individual to change), occlusal splints (again, they miss the point). After a decade, you may find the keratin layer grows radically faster to accommodate Cheek Biting. That may diminish upon cessation of the practice.

SOME REFERENCES: (only part relevant)

~ ʎllɐǝɹƃ uɥoɾ