What is the treatment for lip biting?

Treatment for Lip Biting

For habitual lip biting causing trauma or malocclusion, the primary treatment is behavioral modification combined with mechanical barriers using a lip bumper appliance, which effectively eliminates the habit within 5-6 months while preventing further dental and soft tissue damage. 1, 2

Immediate Wound Care (If Acute Trauma Present)

• Irrigate the wound thoroughly with saline or water to remove debris and reduce bacterial contamination 3
• Apply white soft paraffin ointment every 2 hours to protect the injured lip tissue and maintain moisture 4, 5
• Perform warm saline mouthwashes daily (1 teaspoon salt, 1 teaspoon baking soda in 4 cups water) to reduce bacterial load and promote healing 3, 4
• Avoid alcohol-containing mouthwashes as they cause additional pain and delay healing 3, 5

Antimicrobial Prophylaxis (For Traumatic Bites)

Prophylactic antimicrobials should be given as early as possible to all patients with human bite wounds regardless of wound appearance, as human oral flora contains mixed aerobic and anaerobic bacteria including streptococci (80%), staphylococci, and beta-lactamase producing anaerobes 3

• Administer antibiotics covering oral flora (streptococci, anaerobes, Eikenella corrodens) 3
• Ensure tetanus prophylaxis is current; if outdated or unknown, administer 0.5 mL tetanus toxoid intramuscularly 3

Treatment for Habitual Lip Biting

Mechanical Intervention (Primary Approach)

A lip bumper appliance is the most effective treatment, creating a physical barrier that makes lip biting difficult while simultaneously correcting associated dental problems 1, 2, 6

• The appliance eliminates the habit in 5-6 months while improving overjet, incisor inclination, and arch length 1, 2
• This approach is superior to behavioral therapy alone because it creates an oral environment that physically prevents the habit 2

Complementary Behavioral Therapy

• Lip exercises to activate flaccid upper lip musculature and increase awareness of the habit 2
• Habituation techniques combined with morphological correction 2
• For children, raising awareness through education about the habit's consequences 2

Management of Secondary Complications

If Infection Develops

• Obtain bacterial cultures and administer appropriate antibiotics for at least 14 days 5, 7
• Use 0.2% chlorhexidine digluconate mouthwash twice daily as antiseptic oral rinse 4, 5

For Pain Management

• Apply benzydamine hydrochloride anti-inflammatory oral rinse every 2-4 hours, particularly before eating 5, 7
• For severe pain, use viscous lidocaine 2% topically 5, 7

For Inflammation

• Apply topical corticosteroids four times daily (clobetasol propionate 0.05% or betamethasone) if significant inflammatory component present 4, 5

Critical Pitfalls to Avoid

• Never close infected wounds from bite injuries; allow healing by secondary intention 3
• Do not use petroleum-based products chronically as they promote mucosal dehydration and increase secondary infection risk 3, 7
• Avoid debridement that is too aggressive, as it may enlarge the wound and impair closure 3
• For children with lip biting habits, do not delay treatment, as spontaneous correction of malocclusion can occur once the habit is eliminated 8

Expected Outcomes

• Habit elimination typically occurs within 5-6 months with lip bumper therapy 1, 2
• Associated dental malocclusions (overjet, open bite) often correct spontaneously after habit cessation in young children 8
• Acute traumatic wounds typically improve within 2 weeks with appropriate supportive care 7