This behavior produces a chronic irritation of the lips and / or the mucous membrane that lines the inside of the mouth and can end with the self-infliction of painful lesions unconsciously.
Lip biting is a behavior carried out in some cases without having any awareness of it, while at other times it assumes the characteristics of a nervous tic or a "compulsive habit, like onychophagy or trichotillomania". The disorder can resolve spontaneously, but some remedies can be used to speed up healing and resist the temptation to bite your lips. At other times, however, therapeutic interventions aimed at resolving the underlying reasons are needed.
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As with other BFRBs, the origins of chronically lip biting appear to be multifactorial. According to some experts, this behavior could depend on a tendentially self-injurious attitude and should be interpreted as an "expression of aggression directed against oneself, rather than towards the outside." Other sources argue that cheilophagy sufferers are forced by the need to feel perfectly smooth moss and any perceived irregularity can produce the uncontrollable urge to remove the blemish by biting the area. Still other people are not aware when they start biting. experiencing a kind of trance; eventually, they become aware of the injury they have caused themselves. This process can be initiated or influenced by emotional states (psychological problems, stressful situations or anxiety) and can itself cause an emotional feedback loop which results in recurring behavior.
Who is most at risk?
This phenomenon is quite common and is found more frequently in people who have higher levels of stress and suffer from anxiety or other psychological conditions. The prevalence in females is twice the prevalence of males and is two to three times more prevalent in people over the age of thirty-five.
When it depends on other conditions
- On some occasions, incongruous dental prostheses, pointed teeth or orthodontic appliances cause continuous and repeated irritation due to the alteration of the original bite. When you bite your cheeks or lips, the prosthetic teeth are positioned outside the "zone" neutral ", that is the area in which the dental arch is usually found and the lateral forces between the tongue and the cheek muscles are in equilibrium;
- Professional activities, such as, for example, that of the glassblower, which involves a "chronic aspiration can produce a" similar irritation of the oral mucosa.
- Identical or more severe damage can be caused by self-mutilation in people with psychiatric disorders, learning difficulties or rare syndromes (eg Lesch-Nyhan syndrome and familial dysautonomia).
For some people who suffer from cheilophagy, the fact that the mucous membranes are felt irregular after repeated bites increases the urge to continue the behavior to make the surface smooth.
Psychologically, feelings of guilt and shame can arise. Social activity may decrease in order to prevent others from observing this behavior.
Other possible associated disorders
People with cheilophagy may also show a tendency to bruxism, dysfunctional jaw pain, or other oral manifestations associated with psychological disorders.
and of the physical examination with the confirmation of the characteristic lesions by the general practitioner or by the referring dentist. Usually, a biopsy of the lesions is not necessary, unless you are faced with doubtful cases. The habit of biting the lips or cheeks produces, in fact, characteristic lesions that can be evaluated by simply observing the part.
Characteristic clinical aspects
In the presence of cheilophagy, the histological appearance shows a marked hyperparakeratosis that produces an irregular surface. Typically, there is a superficial colonization by bacteria and there may be vacuolated cells in the upper part of the spiny cell layer.
In this aspect, cheilophagy is similar to the presentation pattern of villous leukoplakia, linea alba (sometimes coexisting) and leukoedema.
To distinguish morsicatio labiorum from oral villous leukoplakia, people with HIV may need a tissue biopsy to be sent to the pathological anatomy laboratory.
Differential diagnosis
Differential diagnosis should include other pathologies of the mucous membrane of the oral cavity, which tend to appear similarly, including:
- Oral lichen planus;
- Candidiasis;
- Leukoplakia;
- Oral leukoedema;
- Chemical burn.
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