On Aug. 30, I had a partial glossectomy for stage 1 SCC. Then on Sept. 20, I had a modified radical neck dissection to remove some lymph nodes (which were clear). Though I still have some residual numbness in my left cheek, jaw, and ear, I had mostly healed up from the surgeries and was doing well. However, around New Year’s Day I noticed I was having some speech issues (slurring; difficulty with certain consonants). Then one night while I was chewing food, I accidentally bit into my tongue really hard, causing intense pain and profuse bleeding. Since then, I’ve bitten myself several times in the same spot. This is something that never happened before I had cancer. Here’s the weird thing: The raised lump and deep bite wounds are not on the left side of my tongue, where my teeth are. No — the injury is almost at the center line of the tongue. This means that I’m biting myself because the tongue is deviating to the left side while I’m eating, and it’s getting in the way of the teeth. You’d think that I would be LESS likely to bite myself on that side, since part of it was removed in the glossectomy and it takes up less space in my mouth.
My question is, why is this happening now? Is it related to the cancer (which, as far as I know, is still in remission)? Is there anything I can do (other than quit eating) to prevent the biting? How do I heal the wound when it keeps getting injured? Should I call my surgeon about this? (My next check-up is scheduled for Feb. 8.)
Most people experience tongue bleeding every once in a while. Your tongue may bleed because you bit it, have braces, dentures, crowns, or broken teeth, have undergone radiation therapy, or eaten sharp foods.
Here at Costa Family & Cosmetic Dentistry, some patients ask us whether their tongue will heal if they bite it and it starts bleeding. The truth is that a little bit of tongue bleeding isn’t a big deal. There are some home remedies that may stop the bleeding quickly and safely. You can try placing ice wrapped in gauze or a clean washcloth on the wound and applying a bit of pressure. Eating yogurt with active cultures may also help. Adding a teaspoon of salt or baking soda to a cup of warm water and rinsing your mouth with this mixture several times a day may be beneficial as well.
If you experience major tongue bleeding or tongue bleeding that persists, there may be an issue. Tongue bleeding may be a symptom of conditions such as thrush or yeast infections, oral herpes, blood vessel and lymph system malformations, and ulcers. In the most serious cases, it may be a sign of cancer.
We encourage you to schedule an appointment at our office if you are facing tongue bleeding that seems serious or does not stop. One of our dentists will thoroughly examine your mouth and let you know whether the bleeding may be a symptom of an underlying condition.
Contact Costa Family & Cosmetic Dentistry
Call our office at 703-439-1214 if you are concerned about your bleeding tongue. We may perform some testing, examine your mouth, and let you know what’s going on.
- How to Stop Biting Your Tongue in Your Sleep
- MS Is Making Me Chew on My Tongue, and It Hurts!
- Is There a Neurological Test for Tongue Biting?
- My Cheeks Got Chewed Up, Too
- Tongue chewing
- Breaking the habit
- Treatment and prognosis
- Information to share with patients about mouth guards
- Clinical suggestions for morsicatio buccarum, morsicatio linguarum, or morsicatio labiorum
- “I’m Biting My Tongue In My Sleep.”
- Custom Night Guard
- More on Nighttime Tongue Biting
- I Bit My Tongue. What Now?
- Remedies for a Bitten Tongue
- Bizarre Question – Anyone else chewing their tongue??
How to Stop Biting Your Tongue in Your Sleep
There are several reasons why you might bite your tongue in your sleep. When a person bites their tongue in the daytime, they’re most likely conscious. However, you’re more likely to bite your tongue unconsciously at night. In most cases, an underlying medical condition leads to tongue biting during sleep.
Bruxism, or teeth grinding and clenching, is a common movement problem that can affect you during sleep. It most often affects the teeth and jaws, causing soreness, pain, and injury. But bruxism can also cause a person to bite their tongue and cheeks. Doctors aren’t sure exactly what causes bruxism, but think it has something to do with dreaming or perhaps being aroused during sleep.
Facial muscle spasms
Facial and jaw muscle spasms can cause tongue biting during the night. This condition is most commonly seen in children, and often causes the chin to tremble uncontrollably during sleep.
People who experience these spasms are unable to control their facial and jaw muscles during sleep, and often bite their tongues. This condition is also called “faciomandibular myoclonus.”
Illicit drug use
MDMA, also known as “molly” and ecstasy, is an illicit drug that causes extreme euphoria. It also appears to cause bruxism, which can cause severe injury to the teeth, cheeks, and tongue.
While experts aren’t exactly sure what causes bruxism in people who have taken MDMA, some think MDMA may intensify the desire to bite or chew. Research on rats suggests MDMA may lead to a reduced ability to keep the jaws open.
Lyme disease is not a very well understood illness. But it appears to cause issues with the central nervous system and bodily reflexes. This may cause you to accidentally bite your tongue or cheeks. Other signs of Lyme disease include:
- abnormal sensitivities to heat and cold
- slurred speech
- frequent diarrhea
- vision changes
- generalized pain and tingling
Nighttime seizures are a common cause of tongue biting. Those with epilepsy lose control of their bodies during a seizure. This may cause them to unconsciously bite down on their tongue. Usually, bites occur on the tip and sides of the tongue. About 50 million people worldwide have epilepsy.
Rhythmic movement disorder
Rhythmic movement disorder strikes while a person is drowsy or asleep. It causes a person to repeat body movements over and over again. Mostly children are affected by this condition. It may cause them to produce humming sounds, body motions like rocking and head banging, or rolling. These movements may be rapid and may cause tongue biting.
Sleep apnea does not cause tongue biting, but tongue biting is common in many people with sleep apnea. This is because people with sleep apnea often have tongues that are especially large or muscles in the mouth that relax abnormally during sleep.
Relaxed muscles and a large tongue can lead to tongue biting. Other signs of sleep apnea include:
- loud snoring
- gasping for air during sleep
- morning headache
- excessive daytime sleepiness
Body-focused repetitive behaviors may include any repetitive self-grooming behavior that involves biting, pulling, picking, or scraping one’s own hair, skin, or nails that results in damage to the body. While most people engage in one or some of these behaviors to a certain degree, an individual may want to seek help and support if the behavior begins to limit their life in some way, feels out of control, causes physical damage, or is causing social impact. These repetitive behaviors are not uncommon, yet there is a very little empirical data in the scientific literature.
These behaviors are characterized by recurrent body-focused behaviors and repeated attempts to stop or decrease the behavior. As with other psychiatric diagnoses, the symptoms must cause clinically significant distress or impairment in an area of daily functioning and cannot be better explained by stereotypic movement disorder or non-suicidal self-injury. The BFRBs listed below are not specifically indexed in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5). Some are classified as “other specified obsessive-compulsive and related disorder,” with specification of “body-focused repetitive behavior.”
Other BFRBs include (but may not be limited to):
- Onychophagia – (nail biting) involves the destruction of fingernails or toenails by means of habitual biting.
- Onychotillomania – (nail picking) involves the destruction of the fingernails or toenails by means of chronic picking and manicuring of the nails.
- Trichophagia – (hair eating) occurs in approximately 15% of patients with trichotillomania. Eating hair may cause serious medical complications in the form of trichobezoars – hairballs that may form in the stomach or bowel. Bezoars can be life-threatening. If you or your child experiences the following symptoms, it is recommended you seek advice from a medical doctor: feeling sick, vomiting, stomach pain, foul breath, or other symptoms of gastrointestinal problems.
- Dermatophagia – (skin eating) often occurs amongst patients with onychophagia. Dermatophagia behaviors include biting the cuticles or fingers, and digesting scabs or skin (usually as a result of skin picking disorder). Oftentimes, lip, cheek, and tongue biting are also considered dermatophagia.
- Lip Biting – (lip bite keratosis) involves the repetitive biting of the skin of one’s own lips.
- Cheek Biting – (cheek keratosis) involves the chronic destruction of oral mucosa via biting with one’s teeth. This behavior may result in ulcerations, sores, and infections within the oral tissue. Furthermore, repetitive biting in a target area typically leads to the development of white patches of keratosis – a callous-like formation. Cheek and lip biting are estimated to occur in approximately 3% of U.S. adults, with more than half of individuals reporting childhood onset. Read more about cheek biting here.
- Tongue Chewing – Chronic chewing on the tongue, most frequently the sides of the tongue, is a common oral problem.
- Trichotemnomania – (hair cutting) is characterized by the compulsive cutting of one’s own hair.
What causes BFRBs?
How are body-focused repetitive behaviors treated?
Read our Expert Consensus Treatment Guidelines
How can I find a therapist?
Search treatment provider referrals
Looking for information to help your child?
Resources for Parents
Ever wondered why you bite your tongue while chewing or talking? Some cultures believe when you bite your tongue it is an indication of someone cursing at you. Which would not make sense for anyone that is a left brainer or anyone who requires the facts. When I began to wonder why I bite my tongue, I was one day talking and happened to which created a bump. As the day went by the bump never subsided. However, when I sat for dinner, I bit my tongue in the same spot AGAIN! Really?! Which brought the question up as what is the reasoning for anyone to bite their own tongue?
As a chiropractor, the most logical reasoning would be that there is a spinal misalignment, causing the jaw to shift from its original positioning. The atlas vertebrae sits directly behind the jaw or more specifically the mandible. When the atlas moves out of alignment, it takes up some of the space between the atlas and mandible (the area right below the ear). This causes the jaw to move out its original place (to create space) as it opens. Now the jaw opens in a slanted and zig- zag pattern confusing the tongue about its spatial placement while it makes specific movements as we talk and chew, thus compromising itself between the teeth. Ouch!
The opposite is true too that the jaw can cause the atlas to move out of alignment. The jaw’s position is compromised by postural abnormalities created by tight and weak muscles in the neck and mouth region, therefore causing the atlas to move out of its way.
As NUCCA chiropractors that specialize in the atlas bone, we will analyze and understand its relationship to the mandible, and address the issue by aligning the spine first, and the jaw second. So do you really need to see your chiropractor for that?Yes, Of course! Your atlas is the outlet for all communication between your brain, spinal cord and the rest of your body. If the mechanics are disturbed by its misalignment, then there is an increased probability of pressure on the brainstem. Next time you catch yourself biting your tongue, come to the Alpha Spine Center to be sure everything is aligned.
MS Is Making Me Chew on My Tongue, and It Hurts!
Stick out your tongue and say “ah.”
It’s almost laughable the number of times medical professionals ask us to make the oral gesture of outing our lingual appendage. In just about any other setting than a medical one (save, perhaps a Maori haka) the practice is considered rather impolite, or juvenile at best.
The diagnostic window of the tongue is pretty remarkable.
Your doctor may be looking for any number of maladies which could be evidenced by coating, discoloration, or swelling of the tongue. A gerontologist may be having a peek at how well a patient’s dentures fit. Our neurologists want to see if we pass the “tongue deviation test,” which tests the hypoglossal nerve and its pathways.
RELATED: 8 Things to Try When MS Affects Your Ability to Taste and Smell
Is There a Neurological Test for Tongue Biting?
Of late, I’m wondering if my neurologist might look for some of the evidence that the gerontologists seek. I’ve been chewing on my tongue and my cheeks like they’re a Sunday roast.
Sure, write off every symptom or malady to multiple sclerosis (MS), you may say. Still, it came on suddenly, around a time of great fatigue (and fever) and has stopped after about five days. Sounds like an “MS thing” to me …
I’m a former chef, and my tongue is an important instrument to me. You can understand my concern with my inability to keep it out of the way of my molars and such. A few times I bit it so hard that it caused pain when simply swallowing.
I tried to pay extra attention while I masticated my foods, but the sheared-copper-penny taste of blood followed eye-watering, immediate pain at nearly every meal for a week.
But my tongue wasn’t the only victim of the attack.
RELATED: Hyperosmia: My MS Makes Smells Smell … a Lot
My Cheeks Got Chewed Up, Too
Almost as if filling the void as I consciously tried to move my tongue away from the crushing teeth, my cheeks seemed to slide into its place.
Between the two, the inside of my mouth looked like a teenaged trumpet player’s whose braces had a go and turned embouchure into hamburger. Luckily, mouth wounds seem to heal pretty quickly, and as soon as I stopped chewing myself, my mouth was right as rain within a few days.
I searched for information to see if others had experienced such a disorder because of MS. I didn’t find anything much in the way of it, so I thought I’d share my experiences.
There are plenty of articles about dysphagia — disorders with swallowing — even I’ve written a piece or two about it. As to chomping on the inside of one’s face, not so much.
I’ll have a chat with my neuro team when I next see them, to see how common it is. Surely if MS can affect the way my tongue helps me taste, the way it moves out of the way of my teeth (or doesn’t) may be the fault of MS as well.
Wishing you and your family the best of health.
My book, Chef Interrupted, is available on Amazon. Follow me on the Life With MS Facebook page and on Twitter, and read more on Life With Multiple Sclerosis.
by Nancy W. Burkhart, BSDH, EDD
Your patient today is Coy who is an 18 year-old college student. Coy has just finished his first year of college, is home for the summer, and is seeing you for his yearly maintenance appointment. Coy could be considered a healthy, young adult who is athletic and denies alcohol or tobacco use.
Figure 1– Steven Chew, DDS, Pleasanton, CA, and Carol Perkins, RDH.
During your oral cancer exam, you notice that Coy has some white, raised, keratotic-appearing tissue on the lateral border of his tongue. The thickened tissue is bilateral. As you bring this up in the conversation with Coy, he tells you that he has been under a lot of stress lately with his exams in college. He is aware that he has been chewing on the sides of the tongue. He says that it has become a habit, and he is not able to stop chewing on his tongue. He has tried to break the habit himself, but cannot seem to disconnect the behavior.
Figure 2 — Steven Chew, DDS, Pleasanton, CA, and Carol Perkins, RDH.
You ask whether he may be performing this habit at night as well, and he says he does not know. He does tell you that he feels a little tongue soreness when he wakes in the mornings (see Figures 1, 2)
Tongue chewing is certainly nothing new in the population and is found by dental practitioners on a regular basis. Varying states of tissue damage may be found clinically with both minor and extensive degrees of keratinization and pigmentation. The tissue responds to friction and becomes thickened in what is termed hyperkeratosis. As with other areas of tissue, wet tissue becomes whiter in color, just as the skin does when kept in water too long.
Other articles by Burkhart
- Is it an oral cancer exam or screening?
- Lumps and bumps belong in bottles!
- The Blue Nevus or Malignant Melanoma?
When found on the lateral borders of the tongue, morsicatio linguarum is a term often used, and morsicatio buccarum is used when the damage is found on the buccal mucosa. Additionally, morsicatio labiorum is used when the patient is chewing, biting, or placing pressure on the inner lip area. The tissue may appear abraded, ulcerative or highly keratinized. As with any other injured tissue, such as a “cheek bite” the patient may continue to traumatize the area while chewing or speaking. As the tissue becomes more enlarged, the patient may traumatize it with normal mastication or speech.
Breaking the habit
Several techniques may be utilized to assist the patient in trying to overcome the habit and allow the tissue to heal. It is important to try and determine whether the patient is performing the habit while sleeping or during the day. Perhaps both times of the day are involved.
Some dentists and hygienists prefer to suggest a mouth guard that the patient wears day and night for a specified amount of time in order for the habit to be broken. Mouth guards are used for multiple reasons, protecting the tissues from constant trauma such as in athletics, eating disorders (protection of the teeth during purging episodes), bruxism, and other reasons.
With the introduction of the guard, the patient may need some time to get accustomed to wearing the appliance, but the mouth guard may assist in relieving the tissue trauma. (See the suggestions for mouth guard use/patient instructions in the sidebar).
Stress continues to be a bi-product of our fast-paced society. Stress is difficult to quantify/qualify, and each person will handle stress in a different way. Some patients will be more successful long-term than others (in addition to reading the sidebar below, the articles listed in the reference section will be useful for the patient in stress reduction).
Below are some suggestions for the dentist/dental hygienist in assisting the patient who may be causing tissue damage in various areas of the mouth.
Treatment and prognosis
We usually are aware of stress factors when symptoms appear clinically with a patient. As the oral signs dissipate, we are able to ascertain that the protocol we have used is causing some reversal of damage. However, with some individuals, the evidence may reappear and we may need to repeat certain steps to work through the problem again. This is true for tongue chewing. As stress levels increase, the patient may revisit the prior problem and may need to take action to correct the behavior again. Unless steps have been taken to adjust to a stressor and learn new coping strategies to deal with stress, the problem may be intermittent. Any chronic type of irritation is not a healthy state and may indicate underlying problems such as extreme stress or anxiety disorders. The determination of the source of the problem may assist the patient in his/her long-term health, in general. Any type of constant irritation should be taken seriously and chronic assault on the tissue may develop into more serious states such as dysplasia and frank carcinoma.
The information provided in this article may be used as information to assist the practitioner and also as printed educational information for the patient.
As always, keep asking good questions and always listen to your patients. RDH
NANCY W. BURKHART, BSDH, EdD, is an adjunct associate professor in the department of periodontics, Baylor College of Dentistry and the Texas A & M Health Science Center, Dallas. Dr. Burkhart is founder and cohost of the International Oral Lichen Planus Support Group (http://bcdwp.web.tamhsc.edu/iolpdallas/) and coauthor of General and Oral Pathology for the Dental Hygienist. She was a 2006 Crest/ADHA award winner. She is a 2012 Mentor of Distinction through Philips Oral Healthcare and PennWell Corp. Her website for seminars on mucosal diseases, oral cancer, and oral pathology topics is www.nancywburkhart.com.
- The appliance should be either in your mouth or in the carrier case.
- Do not place it on a pile of papers because the appliance is clear in color and will accidentally be thrown away with the papers.
- Keep away from any dog because they are known to eat or chew the appliance.
- Do not leave the appliance on your nightstand next to the bed. It may drop on the floor and be kicked under the bed.
- Never wrap it up and place the appliance in a paper napkin because the napkin, out of habit, will be thrown away along with your expensive appliance.
- Some people take the appliance out in their sleep and try to find it in the bedding later. Make a mental note that this should not occur. The appliance may accidentally be discarded or washed with the bed sheets in a harsh or bleach detergent.
The new mouth guard
- Do not place a new mouth guard in your mouth initially and try to fall asleep. Your mental processes will determine a foreign object is present, and it will affect your sleep patterns. You will end up chewing it and playing with it and ultimately taking the appliance out of the mouth.
- A new habit takes approximately 21 days to become part of your normal daily pattern. Be gentle and accepting with yourself in forming new habits.
- Our normal daily activities can be a good distraction from having a new appliance in the mouth.
a. Eat breakfast, brush and floss your teeth
b. Place the appliance in the mouth
c. Wear the appliance all day and only take it out when you eat
d. Do not eat with the appliance in your mouth
At lunchtime/throughout the day, cleaning the appliance
- Brush the appliance with toothpaste and rinse with water just as you do with your own teeth several times a day.
- While at work or school, run the appliance under cold water after meals. This will keep your breath feeling fresh and increase the likelihood that you will continue to wear the appliance.
- Brush the inside area that touches the tissue with a mild toothpaste, if possible. Several benefits occur with the cleanliness of any appliance. The appliance will feel fresh, and the amount of bacteria and candida will be decreased.
- Never place the appliance in any “bleach” solution.
- Do not place the appliance in mouthwash.
- Storage and transportation of the appliance should be in a vented container.
- Occasionally clean the mouthguard in warm soapy water and rinse thoroughly.
- Never leave the mouthguard in the sun or in hot water.
Dental appointments and follow-up
- Always bring the appliance with you to your dental visits for a thorough cleaning by the hygienist (usually in an ultrasonic cleaner) and the dentist can check the appliance for the fit.
- Write yourself a reminder in your calendar to bring it to your prophy/maintenance recall visit.
- In the beginning while wearing the appliance, please note that talking and speech may be affected and will take a few days for speech to resume to normal when the tongue compensates for the appliance. If you say the numbers 33, 34, 35, 64, 65, 66, the number 66 will often cause you to make a whistle-like sound.
- When the mouthguard is recommended for tongue chewing, intraoral images may be taken so that tissue comparison may be performed in future visits.
After a set time, and with careful determination by the dental team, you may wish to stop using the appliance and determine whether the tongue chewing habit is broken. You should, however:
- Save the appliance in the carry case at a safe location.
- Never throw it away because it is very expensive to remake.
- The appliance will be good for years and could be worn in the future.
- A new appliance may be needed if any tears or roughness occur at any time.
Source: Modified from information given to patients for Mouthguard Maintenance by Carol Perkins, RDH, Pleasanton, CA. June, 2013.
Clinical suggestions for morsicatio buccarum, morsicatio linguarum, or morsicatio labiorum
- First, show the patient the area of concern. Determine if the patient is aware of the morsicatio buccarum, morsicatio labiorum, or morsicatio linguarum. Give the patient a hand mirror and use the dental lighting to observe the area together.
- Try to determine whether the patient is chewing on the area at night, during the day, or at other specific times. Professionally produced night guards may be beneficial for patients who are performing the habit at night. Often, the patient may also exhibit evidence of bruxism as noted by tooth surface changes. Some shields can be fabricated and worn daily as well.
- If the patient is new, determine how long ago he or she has noticed the habit. If the tissue is being observed in a patient of record, review the history to determine if any notation is listed in prior visits. How long has it been documented? Chronic habits may take a long time to break.
- If it is determined to be a situational stress problem, suggest stress reduction techniques that may help the patient lower stressful situations. Additionally, forming new coping strategies is crucial in changing a chronic, negative habit and modifying the way that we react to stressors. Some helpful techniques may be exercise, prayer, meditation or other techniques such as biofeedback. Biofeedback will teach a person to use his or her breathing and focus to reduce stress. Personally, I like the hand-held, pocket size device called the EM-WAVE that can be carried by the person and is always available. The device and other relaxation products may be found at: www.stens-biofeedback.com/epistore/search.
- Most people with stress-related conditions are not aware they are stressed, and will tell you that they are no more stressed than anyone else. We all handle stress in different ways, and some techniques are better than others for each person. Ultimately, success depends upon the individual. The good news is: stress reduction can be learned and coping skills can be developed.
- In certain situations, the patient may have taken antianxiety medications and since discontinued those medications, leading to poor health habits. Suggesting that they contact their physician or see a counselor may be appropriate, depending on the person and the clinical signs. In today’s society, many people are overwhelmed with everyday stress, and many dental or medical offices report an increase in the number of people who are diagnosed with morsicatio buccarum, morsicatio linguarum, morsicatio labiorum and bruxism.
- Use intraoral photography to document the areas of concern, and use the images for future comparison at maintenance visits.
- If the patient uses tobacco and/or alcohol, there is further concern related to future changes in the tissue and oral cancer. If the patient has not had an oral cancer screening, perform one or suggest a biopsy if there is any indication that the area of concern has the possibility of a malignancy (see Dec. 2007 RDH, “Dental Exams: Are You Performing One?”). If changes occur or the habit continues, careful evaluation, referral, or future biopsy in some cases is always wise.
- Remind the patient that any irritation and inflammation in the body is detrimental to our health. Pathogens are able to enter the body and chronic inflammation places us at risk for other health-related disease states.
- Develop some techniques that will make the patient aware of the habit, including:
- Tying a ribbon, rubber band or string around the wrist, which is always helpful in behavior modification and used as a reminder to the person to check his or her own behavior.
- Placing strategically located stickers in the home and workplace to remind the person to check their progress.
- Finally, have the patient visualize the word “No” circled with an X through it. This step will help the person eliminate the habit through visualization.
Disclaimer: The author has no affiliation with the Stens Corp.
Modified from Delong L. & Burkhart N. “General and Oral Pathology for the Dental Hygienist.” 2nd ed. Lippincott, Williams and Wilkins, Baltimore, 2013.
Past RDH Issues
“I’m Biting My Tongue In My Sleep.”
Tongue biting is a common problem.
Complaints of ‘biting my tongue’ or ‘biting my cheek’ while sleeping are all too familiar to dentists and can be downright irritating and painful.
The damage done to the tongue or cheek can be quite distressing and even visible. People who bite their tongue while sleeping commonly bite it on the sides or on its tip.
Tenderness, bleeding and incessant throbbing are uncomfortable symptoms but good news! It can be relieved.
You’re not alone and there is a solution.
Severe tongue biting problems can lead to tongue scalloping, soreness and ulcers. Tongue biting can also cause pain while speaking and eating. This can begin at any stage in life.
Sentinel Soft Dental Guards for Tongue Biting/Cheek Biting $159 All Inclusive Free Shipping In The USA. “How does it work?” The soft padding prevents the chewing surfaces of the teeth to catch the tongue or cheek area. The product will prevent any trauma to the tongue or cheek area and will allow any previous trauma to heal.
What causes biting my tongue in sleep? Why does my tongue hurt?
“I bite my tongue in my sleep. Why?”
There are a number of causes for tongue biting while asleep. One common cause is when your tongue is bigger than it should be. In this case, it is a frequent occurrence to accidentally bite it while eating or talking
Other causes include; rhythmic disorder, nocturnal seizures and sleep bruxism. All these lead to involuntary tongue biting. Let us look at each one of them briefly.
Nocturnal seizures (nighttime seizures)
Having seizures during the night can induce biting the tongue. If a person has chronic seizures they are likely to experience biting on parts of the tongue, especially the edges. A seizure is a is a state in which a person has lost consciousness, jerking movements are seen and the muscles stiffen. Some seizures however might be calm and therefore harder to be noted. Tongue biting is listed as a common symptom in people suffering from seizures.
People suffering from nocturnal seizures may not have any other symptom during the day making it hard to determine the cause of the tongue injuries. However, the condition can be diagnosed by observing brainwaves. Prescription Medication is the primary Treatment for this condition. Once taken, the biting stops.
The second potential reason for biting your tongue while sleeping is rhythmic movement disorder. Rhythmic movement disorder involves banging of the head, truck movements and rocking and rolling.
Mostly common in children, it does not always result in injuries but when severe it can lead to tongue injuries. It involves repeated movements of the head and neck. The movements are involuntary and usually occur before and during sleep. It could last about 15 minutes. The victim can suffer from various injuries tongue biting included. In serious but rare cases, brain and eye damage can occur.
The movements usually go unnoticed by the sufferer since they do not cause much pain. They only come to know about the problem after noticing the injuries on their tongue or other parts of the body. In many cases the seizures stop as the child grows up so medical treatment may not be necessary. In adults, controlled sleep restrictions or medical drugs may be used to treat the condition.
Teeth grinding or bruxism
Bruxism is another cause of tongue biting during sleep. In most cases, it is accompanied by other sleeping disorders such as sleep apnea which causes breathing pauses. Snoring is also a common problem that can accompany teeth grinding. People with the habit of grinding their teeth while sleeping may accidentally bite their tongue.
Custom Night Guard
Protect Your Teeth
Other causes of tongue biting include Lyme disease, swollen tongue ulcers, tobacco chewing and side effects of some medications.
This is a condition where you experience shallow breath or frequent pauses while breathing. The tongue relaxes and can slip between the teeth, resulting in tongue injury. Doctors can prescribe treatment for sleep apnea which can stop this form of tongue biting.
This disease negatively affects the brain and nervous system. Incorrect or misfired brain signals are sent to the muscles and nerves causing involuntary movements during asleep that can cause you to bite your tongue.
Drug Use such as MDMA (ecstasy)
MDMA or ecstasy a synthetic, psychoactive drug that acts as a stimulant and increases energy and pleasure. Many people have damaged their tongue, gums and cheeks from taking MDMA.
The drug can increase anxiety and the tongue biting can even feel pleasurable while on drugs. However the damage can be troublesome.
Effect of Medication
Prescribed medications like antidepressants may have negative reactions or side effects and causes tongue biting during sleep. A change in medication could prevent this.
- Dentures that are not fitted properly can cause you to bite your tongue while sleeping.
More on Nighttime Tongue Biting
Nighttime tongue biting is a condition that has disturbed many people leaving them frustrated and seeking answers. Everyone has bitten their tongue at one point or another but this is mostly accidental and happens mostly when eating or talking. It can happen occasionally while sleeping but this is normal. Some causes include having a disproportionately large tongue or having a set of misaligned teeth. Nighttime tongue biting becomes a problem when it is a habit.
How common is it?
Millions of people around the world suffer from tongue biting at night. Some people are not aware of it yet since it can be hard to determine the problem especially when it is not as a result of an underlying illness. It may take time before the problem is detected. To determine approximately how many people suffer from nighttime tongue biting, we could look at the number of people suffering from bruxism, epilepsy and sleep apnea. 1 in 3 people suffer from excessive teeth grinding. Millions of people suffer from epilepsy with over 2 million in the United States. Sleep apnea afflicts more than 20 million in the United States with millions more found all over the world. If all these people suffer from excessive tongue biting frequently then there are likely millions of people experiencing nighttime tongue biting.
- Morsication lingarum
In frequent cases of tongue biting, the lateral sides of the tongue are affected and you develop a condition known as Morsication lingarum which only affects the tongue’s lateral sides.
- Bleeding may occur when the biting is frequent and cuts into the tongue
- Tongue ulcers can form as a result of tongue biting. They usually heal within 10 days
- Your tongue may be sore after frequent biting thus making you uncomfortable
All these may make it hard for you to eat certain types of foods especially spicy ones. Speaking may become difficult and chewing food may be difficult.
Prevent Damage from Tongue Biting
While biting cannot be controlled there are measures you can take to prevent damage.
One of the most effective prevention methods is to wear a soft, thin custom-made night guard on both the lower and upper teeth.
Over the counter night mouth guards will not fit perfectly can cause further oral damage. You can visit your dentist to take dental impressions, create a mold and then a dental lab for a mouth guards specifically for you. But that is the most expensive route. For a more affordable alternative purchase online.
Treating Tongue Damage
If you have experienced any damage resulting from tongue biting there are steps you can to heal the tongue and prevent further damage.
These methods include:
- Using salt solution
This helps to kill bacteria and aids the tongue in the healing process. The solution should be warm with small amounts of salt. Hot water will increase pain and discomfort in the tongue.
- Ice cubes
They help to reduce swelling and also numb nerves on the tongue to reduce pain and soreness
- Avoid eating spicy foods until the tongue heals.
- PREVENT FURTHER DAMAGE Wear soft dental night guards on both your upper and lower teeth. Choose thin 1mm guards so that they are unobtrusive and easy to sleep with. You will want custom fitted guards for the most comfort.
Preventing tongue biting in sleep.
The best way to prevent tongue biting problems is by treating the cause or knowing how to avoid it. The following are treatments used for different causes.
Treatment for rhythmic disorder.
Cognitive behavior therapy is recommended for people suffering from sleep apnea. Rhythmic movements are usually associated with children and can disappear as the child grows older. This might not require pharmacological treatment.
Treatment for seizure.
If your nighttime tongue biting is caused by seizure than the normal course of treatment by a doctor should be followed. If treated successfully it will prevent tongue biting.
There are several medications for tonic-clonic seizure. Going for vagus nerve stimulation device may also reduce the chances of seizure occurrence.
Treatment for bruxism.
Bruxism requires you to treat the underlying cause. Cognitive behavior therapy is recommended. It helps in dealing with anxiety and stress which are major causes of bruxism. Ensuring that your mind is relaxed before going to bed can greatly reduce the chances of bruxism.
Protecting your tongue during sleep using a night mouth guard.
(pictured) Sentinel Soft Tongue Biting Guards (upper and lower teeth) provides padding on the chewing surfaces of the teeth to protect the tongue from the teeth
Regardless of the causes there are ways you can protect your tongue from more damage by using mouth guards. These are plastic mouth appliances made to fit over the teeth. They are meant to reduce the damage effect of the teeth to the tongue should it be caught between them.
The mouth guards are also referred to as night dental guards. Wearing dental guards is the best way to prevent damage to the tongue. There are several types of Mouth guard:
Standard & boil/bite athletic mouth guard: These guards are completely different than dental night guards.
These are the mouth guards used by persons who play sports. They are made from tough plastic and either cannot be adjusted or conform to your mouth by using hot water and manual manipulation. They are available in most sports stores and are NOT recommended for wearing at night.
Standard dental night guard:
These are one size fits all, mass produced night guards designed for nighttime use. They are largely seen as too bulky, ineffective and uncomfortable though they are affordable.
Boil and bite mouth guards
These are made from a special kind of plastic that allows you to semi custom-fit them. They’re softened by hot water and then adjusted to fit your mouth. They are available in most CVS or Walgreens stores.
Custom-fitted mouth guards.
Sentinel Soft Dental Night Guard. For tongue biting it is recommended to wear a soft dental night guard on both the upper and lower teeth arches. Use promo code “big spender” to receive 20% off your order. Free all inclusive shipping in the USA.
These are made in a dental lab to fit your mouth. The dentist takes an impression of your teeth and then creates a model. The model is then sent to the lab for to make a guard taken from the model. You can also order online and take your own dental impression in the convenience of your own home. Your dental impression is sent to the Sentinel dental lab using our convenient mail-order system.
It is always best to consult a dentist before buying a night guard. They will help determine the best mouth guard for you, especially if your tongue biting is caused by seizure disorder.
I Bit My Tongue. What Now?
First comes the horrible crunching sensation, quickly followed by a burst of pain. “Oh no, I bit my tongue!” Whether it happens while you’re eating, playing sports or otherwise, biting your tongue is upsetting and uncomfortable. Fortunately, tongue injuries are rarely serious and you can often treat them at home.
Remedies for a Bitten Tongue
The cut or puncture wound that results from biting your tongue often heals by itself without medical treatment. However, the rich blood supply to the tongue may cause the wound to bleed or swell. To control the bleeding, firmly press a clean cloth to the affected area for five minutes or longer. Alternatively, wrap the cloth around crushed ice before pressing it to the wound, which might help control the swelling and pain.
To clean a wound on your tongue, rinse your mouth with a solution of one part water to one part hydrogen peroxide. Don’t swallow the solution. Additionally, Government of Alberta recommends rinsing your mouth with warm salt water after meals to help relieve the pain. Make the mixture by dissolving 1 teaspoon of salt in a cup of warm water, then swish the liquid in your mouth and spit it out.
Regardless of whether the wound has been treated or not, be aware of the signs of an infection. If you experience increased redness, develop a fever or notice pus in the wound after the injury, you may have an infection, according to the Government of Alberta. A physician can prescribe antibiotics to help treat a tongue infection.
Bit My Tongue Again!
Sometimes biting your tongue becomes a bad habit. When the wound swells, it can be hard to avoid biting the same place again.
Especially if you have a condition like an enlarged tongue or misaligned jaw, tongue injuries may happen more than once. Start by applying home treatments to the tongue wound and speak to your dentist if you’re concerned you’re repeatedly biting your tongue because your bite is misaligned. In that case, orthodontics may be in order.
When to Seek Further Treatment
Biting your tongue while eating is not often cause for concern, but be especially careful if you’re treating a tongue wound from a sports injury or other accident. When a tongue injury results in heavy bleeding or an infection, it’s time to seek medical treatment. Occasionally, the cut may be so deep or wide that it needs dissolving sutures, or stitches, to hold it together while it heals.
Biting your tongue is one of life’s downsides, but the consequences aren’t usually serious. Treat your injury with home remedies to reduce the bleeding and pain and to help keep the cut clean. If the wound on your tongue won’t stop bleeding or you spot signs of an infection, see a medical professional immediately.
Jon K. asks: Why do I sometimes naturally bite my tongue when concentrating on things?
The short answer as to why some people bite their tongue when concentrating is that the tongue requires a surprising amount of brain power to manage- beyond general motor control, it’s covered in various types of sensors constantly providing feedback to your brain about what’s going on in your mouth and making sure your teeth aren’t mashing the tongue. Even when you’re not using it for speaking, it’s still continually moving slightly as it imperceptibly forms words you are thinking about. All this seemingly involuntary movement provides a steady stream of data for certain parts of your brain to pay attention to, even when those parts of your brain are otherwise trying to concentrate on something else. So the leading theory of why you stick out and bite your tongue is that generally immobilizing your tongue by biting it reduces the amount of stimuli that might otherwise interfere with your attention, particularly when concentrating on certain types of activities that we’ll get into in a minute.
Now for the slightly longer explanation.
Until relatively recently, scientists thought that cognition and motor skills activated and were controlled by distinct portions of the brain, with the former occupying the basal ganglia and cerebellum, and the latter effecting and coming from the prefrontal cortex. This thinking has since changed. For instance, in 2000, developmental psychologist and neuro-anatomist Adele Diamond published Close Interrelation of Motor Development and Cognitive Development of the Cerebellum and Prefrontal Cortex. Relying on neuroimaging and analysis, Diamond revealed how the human brain’s motor and cognitive functions were linked, and that they could both be activated either for certain motor or certain cognitive tasks.
Moreover, others have discovered how those portions of the brain that take in language, form new words to speak and move the hardware to speak it (including the tongue and face), are related, and in some cases, use the same portions of the brain. That is, the part of the brain that takes in spoken words and “language inputs,” Wernicke’s area, is linked together in a “neural loop” with that portion of the brain that comes up with the words to say and actually says them, Broca’s area.
Throwing more evidence on this pile, in August of 2015, researchers noted that concentrating on specific types of non-verbal communication tasks are more likely to induce such tongue biting/protrusions than others. In the paper, Slip of the tongue: Implications for evolution and language development, they studied the tongue protruding tendencies of children via observing a group of four year olds doing various tasks- children being drastically more likely to stick out their tongues when concentrating than adults. As noted in the paper, these tasks “required varying degrees of manual action: precision motor action, gross motor action and no motor actions.”
While each type of tasks resulted in at least some of the children eliciting the expected behavior of sticking out and biting their tongues when particularly concentrating, the researchers were very surprised to note that it was not tasks with particularly fine motor skills that resulted in the largest likelihood of tongue protrusions, but rather when the children were asked to play a game called “knock and tap.” In this somewhat fast paced task, the children knocked the table when the researcher tapped and tapped when the researcher knocked. This is a game that doesn’t require particularly precise motor skills, but was the only motor task given that simulated many of the elements of basic hand gesture communication. The fact that the children were all right handed and when sticking out their tongues during this specific task tended to stick it out to the right indicated control by the left hemisphere of the brain, which is typically more dominant for language in right handed individuals. The researchers concluded from all this and similar evidence from past studies that there is a strong connection between the tongue and hands via the language centers of the brain, likely a remnant of what is thought to be the earliest form of human language- basic gestures.
The bottom line from all this is that when you’re concentrating, and particularly on something that requires taking in language and/or producing some of your own (including using communicative motor skills or thinking deeply using your inner voice to drive the thought), your tongue is getting stimulated the whole time, even though you probably aren’t consciously registering it. When particularly high levels of concentration are required, to keep the tongue from distracting your noggin with additional data or tasks to perform when you’re otherwise not actually wanting to use it, the general theory is that sticking out and biting your tongue reduces the need for your brain to manage or pay attention to it, leaving certain parts of your brain free to concentrate more fully on other things.
As to why as you age the tendency to stick out and bite your tongue when concentrating drastically diminishes, this is anybody’s guess at this point with hypotheses ranging from that you simply learn to force yourself not to do this as it’s not entirely socially acceptable (i.e. people will tease you about it); or perhaps your brain gets more efficient at many tasks, requiring less concentration to do them, thus fewer instances of tongue biting; or maybe your brain simply gets better at tuning the tongue out when necessary.
If you liked this article, you might also enjoy our new popular podcast, The BrainFood Show (iTunes, Spotify, Google Play Music, Feed), as well as:
- How Deaf People Think
- Why Do Other People’s Farts Smell Worse?
- Why Do People Move Their Eyes When Trying to Remember Something?
- Why Do Men Snore More Than Women?
- Why It’s Nearly Impossible to Tickle Yourself
- We don’t bite our tongues when we eat (most of the time) due to complex neural interrelationships, where certain premotor neurons “simultaneously connect” the motor-neurons that control jaw opening and those that handle sticking out your tongue, and conversely, another set of premotor neurons synchronize the motor-neurons that manage jaw closing and those that control retracting your tongue.
Expand for References
Biting of oral mucosa is an oral habit that is prevalent in 750 out of every one million individuals with females affected more compared to males. The largest study of 23,785 patients, attending a Mexican dental school clinic, found cheek-biting lesions to be fifth most common oral mucosal finding with a prevalence of 21.7 cases per 1,000 patients. In the Third National Health and Nutrition Examination Survey (NHANES III), when 10,030 non-institutionalized children aged 2-17 years were evaluated, the point prevalence for cheek and lip biting was found to be 1.89%. Repeated biting leads to a chronically traumatized area, which is sometimes thickened, scarred and paler than the surrounding mucosa or may present as white frayed to macerated surfaces that may or may not be tender and sometimes present as edema, purpura and erosions. Wide spectrum of oral conditions such as genetic mucosal diseases white sponge nevus, chronic allergic contact stomatitis, and smokeless tobacco lesions etc., may mimic the biting lesions. When formulating a differential diagnosis, it is important to remember that mucosal areas that approximate the plane of occlusion presenting with pathologic alteration like irregular surfaces with white tags of desquamated epithelium could be due to traumatic injury. Such a condition is usually innocuous and the lesions are not precancerous. A wide spectrum of habitual biting behavior exists and numerous treatment methods have been described and the most important consideration in managing self injurious behavior is to tailor the treatment to the severity of the condition. Individualized approach is needed for each child in the management of such habits. The most effective treatment is the one that addresses the cause of such behavior. In case I, where habit was not targeted initially leads to persistence of biting, which caused recurrence of the lesion even after complete excision of the fibrous growth. Usually patients who have self injurious behavior are unaware of their habit and will not aid in the diagnosis. An important aspect of such a lesion in children is that this may be the initial presentation of some serious underlying medical/psychological problems. Counseling, biofeedback, relaxation techniques, and hypnosis or psychiatric treatment have been suggested along with the dental management of the effects of habit.
A variety of dental appliances have been reported in literature for controlling biting of oral mucosa. Although, a dental appliance does not resolve the cause of biting of oral mucosa, it is an effective means of controlling this self-mutilation. Use of various types of removable shields specifically designed using silicone soft relining material which protect tongue; lip bumpers soldered on orthodontic bands to prevent lip biting; soft mouth guards, occlusal coverage/splint, oral screen in clear acrylic extending from maxillary vestibule to mandibular vestibule, a removable appliance with two lateral acrylic shields joined by a round stainless steel wire to prevent injury to buccal vestibule have been put forth by different authors. When planning prosthesis, it is important to choose the design that is appropriate for the type and severity of injury, patient’s age, general health and patient’s ability to co-operate with the treatment plan. In the two above mentioned case, intraoral prosthesis in the form of soft splint was planned using polyvinyl sheet in pressure molded device. Keeping in mind the patient’s age and the fact that patient used to bite on the cheek while studying, soft splint was designed so that it could provide total coverage and prevent the trauma. The patient was comfortable with the appliance which was well accepted. In the second case, the parents and the child were aware of the habit, so simple habit breaking appliance was good enough to heal the existing lesion and to prevent further trauma by breaking the vicious cycle of biting on the soft tissue. In the second case, the presentation was of a soft edematous lesion on the lower lip after trauma, but the lesion persisted due to the chronic habit of biting on the lip, thus a shield of soft splint acting as habit breaking appliance was good enough to initiate healing and regression of the lesion.
Bizarre Question – Anyone else chewing their tongue??
Yes it is bizarre, so I thought myself coz I’m doin exactly the same. I’m 32 weeks and have been doing it for the past 2 months. I can’t stop. At first I thought I was thirsty all the time, my mouth felt dry. I know I’m not that thirsty because I have cups of tea or other drinks in the day, but nothing satisfies the feeling more than Ice cold water!! At home I can just stick my head under the cold tap and drink. It HAS to be ice cold or it doesnt cut it, and if i had an ice machine i could prob spend the day eating it. Another thing is, I dont have to swallow it, as long as the water is in my mouth it relieves the need (for a bit). I had to ask the midwife because I was concerned i could have gestational diabetes (in pregnancy), as symptoms include excessive thirst. I dont fall into the risk factor “box” for this, still she checked my urine which was fine. her n my fiance pretty much laughed at me for thinking it (still you never know). During the same time I also developed a need to suck my bath sponge when having a bath, and tasting the soapy bath water and spitting it out had the same effect. I continue to do this, and to my flannel or even just a guggle of the water and trickle it out. Again I know this sounds really bizzare! At first I didnt think anything of it until a friend said she knew someone who craved puddle water (she didnt drink it of course but every time she passed one she wanted some). So I thought the soapy water thing was a craving. It gets better – I also feel the need to collect a pile of bubbles from the soapy dish water and put them in my mouth. I try my best to spit them out. My mother thinks its disgusting but I just cant help myself. This however, is something I have done time to time in the past but now its excessive. When it snows I generally feel the urge to eat some, but the urge was too strong during pregnancy. All these strange things I feel the need to do orally, I have no idea what they mean, or why, but they have to be pregnancy linked. I have read about Pica, which talks of ice, and soap cravings. but i dont want to eat soap, just the bubbly soap water it produces… trying my best to resist all these cravings, but the tongue chewing is’ getting on my nerves. plus I’m weeing enough anyway, with all this extra water I’m just back to the toilet all day long. tongue chewing can also be down to stress which I’m under but Im swaying to the Pica thing. cant find alot online about all this, but maybe noone wants to admit such cravings??!! But there, its out, and I’m off for some ice cold water, I had a bath earlier lol x