35M severe cheek-biting problem with underlying chronic conditions
2025.01.30 06:52 srmcmahon 35M severe cheek-biting problem with underlying chronic conditions
Asking for family member. Normal weight, has MS and Tourettes (also psoriasis), anxiety, ADHD, CPTSD, and severe aversion to taste or smell of blood (which complicates things). He's on DMT for the autoimmune stuff, gaba, medications for bladder urgency (MS related), buspar, and guanfacine for the Tourette's. Also ritalin for fatigue (nuvigil and provigil caused sleep problems).
Since his MS diagnosis (3.5 years ago), tics (which had decreased during adulthood) got worse, including jaw/mouth tics. People on the MS sub confirm many of them have problems as well with accidental cheek/tongue biting when eating.
When it happens he bites so hard he bleeds quite a bit and it persists (seeping) for an hour or more. Then swelling can result in repeated incidents over the course of several days. He says it doesn't matter if he tries to be careful and happens both with foods requiring chewing and things like yogurt or ice cream. He also avoids eating during the day as that tends to trigger fatigue, so he waits until evening to eat. Once in awhile this will also happen when he is not eating, just talking.
It's extremely stressful for him when it happens, probably more so since it is at the end of the day when he's fatigued anyway. Anything I find online pertains to compulsive cheek/lip/tongue biting in itself, or doing so while sleeping, and I have seen mouthguards to avoid the problem but those clearly are not intended to be used while eating. Asked his dentist about blood-stop products to at least minimize the bleeding but those do not seem to be a solution.
Any ideas for prevention? It's a significant QOL problem. SLP had basic suggestions a few years ago (get rid of distractions, eat slowly, etc) which don't seem to have helped.
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