02/08/2011 03:52 pm ET Updated May 25, 2011

Cheek Biting: Responding to Reader Questions

Wow -- last week's Cheek Biting blog post got a lot of response. So much so that I want to do a "part two" on the topic.

To start, I want to say I always enjoy reading everyone's comments, and from them, I almost always learn something new about the topic I'm writing about. That's a good thing -- I'm never one to think I am the be-all, end-all on any subject, and it's nice to read about other people's experiences.

Just going by comments, it would appear that habitual cheek biting is way more common than I suspected. (Of course, this could be because maybe people who bite their cheeks are drawn to an article about cheek biting, but I digress.) Regardless, it is a subject that hits home for a great many people.

The first thing I want to comment on is existing tissue tags in one's mouth. It makes sense that if there's an existing "tag" available to chew on, it may make something like cheek biting more apt to occur. Now, tags can occur naturally, but I thought it might be useful to some people to list a few products that can make the cheek slough and cause tags to form:

· SLS (Sodium lauryl sulfate), which is found in many toothpastes, is thought to be an irritant. In the words of Samuel Epstein, M.D., professor emeritus of environmental and occupational medicine at the University of Illinois School of Public Health "Sodium lauryl sulfate is a harsh irritant that can facilitate other toxic ingredients' entry into the skin" I also previous blogged about this twice: in a post about toothpaste, and another about canker sores

· Oral Lichen Planus can be a culprit too. I don't want to repeat myself, but I blogged about that too (these links to other posts are to assist anyone who is interested in the subject.)

· Our old friend tobacco is definitely a culprit as well. If you bite your cheek, it may be because you have some tags/lesions there ready to bite. And if you smoke or use smokeless tobacco... well, that could be the cause. At least it's a place to start looking.

· I also got an e-mail from someone suggesting that biting one's cheek was like any other addiction, because endorphins were released. I do agree to a point, because I likened cheek biting to fingernail biting in my last post. I say "to a point" though because I'm not ready to jump on that bandwagon and call it a flat-out addiction. There's just not enough information out there to support that. But it is interesting, and can be an avenue to look into if you bite your cheek and have tried everything else -- maybe some common medications for stopping smoking (etc) can help (for example, Wellbutrin works on addiction centers of the brain).

Now, I am not saying to go out and get some Wellbutrin and everything will be swell. I am saying that it might be worth a conversation with a doctor if you have tried everything else and are still biting your cheek. In fact, thinking along this line can open up an entirely new area in treatment. Almost any alternative "quit smoking" (etc) treatment might have some merit: hypnosis, acupuncture, etc. Again, I am not flat-out endorsing such, but am merely saying it might be something to look into. That's part of the purpose of many of my blogs -- to bring to light several possibilities and avenues of discussion.

I also want to touch on a few other comments to the previous blog post (and other posts I have written as well). Some commentators have criticized me for being somewhat basic in both writing style and depth of topic explored. Others have thanked me for being engaging in writing style, and not cramming too much medical / dental mumbo-jumbo in the posts. I must confess -- the latter is definitely what I am going for in these blogs. I am not writing a complicated white paper here for trained colleagues -- I want the post to touch on the subject, be easy to understand, and, if needed, provide a link or two if a claim is made or whatnot.

Basically, I look at my posts as a solid launching point for discussion. I'm a dentist sharing what he knows with everyday people/readers. And those that want to delve deeper can certainly find no shortage of studies and/or white papers, online and off. But I'm not going to go over anyone's head here -- my goal is to give someone who has no knowledge of a subject a solid starting point, and then they can go where that leads them if they so wish.

Lastly, if you do know something further about a subject that I blog on, and want to share, please do. Like I mentioned earlier, I've learned new things from your comments, and I am pleased when that happens. It's truly an arrogant individual who thinks they have nothing left to learn, be they a doctor, a dentist, or a blog commenter.

Until next time, keep smiling!