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Onychophagia or nail biting is a common oral compulsive habit in children and young adults, affecting around 30% of children between 7 to 10 years and 45% of teenagers.
Negative effects
Bitten fingertips can become very sensitive to pain, usually at the place the skin meets the edge of the nail. Hangnails are broken skin on the cuticle. When they are improperly removed, they are susceptible to microbial and viral infections producing whitlows. When the nails are infected with saliva the scratching of them makes the skin get red and infect the skin.Finally it may also result in the transportation of bacteria that are buried under the surface of the nail, or pinworms from anus region to mouth. Nail biting is also related to dental problems, such as gingival injury.
Regarding social effects the aesthetic aspect of the nail may affect employability, self-esteem, and interaction with other people
Treatment
Behavioral treatments are based in discouraging the habit and replace it with a more constructive habit. The most common treatment, as it is cheap and widely available, is a special clear nail polish that has to be applied to the nails. It releases a bitter flavor on contact with the mouth which discourages the habit; and has demonstrated its effectiveness. There are also mouthpieces that prevent biting.
Behavioral therapy is beneficial when simpler measures are not effective. Habit Reversal Training (HRT), seeks to "unlearn" the habit of nail biting and possibly replace it with a more constructive habit and has shown its effectiveness versus placebo both in children and adults. In addition to HRT, stimulus control therapy is used to both identify and then eliminate the stimulus that frequently triggers biting urges.[10]
Finally nail cosmetics can help to ameliorate nail biting social effects.[5]
Related disorders
Some related disorders are dermatillomania (skin picking), dermatophagia (skin biting) or trichotillomania (urge to pull out hair).
References
- ^ a b Leung AK, Robson WL (1990). "Nailbiting". Clin Pediatr (Phila) 29 (12): 690–2. PMID 2276242.
- ^ Sung JF, Lin RS, Huang KC, Wang SY, Lu YJ (November 2001). "Pinworm control and risk factors of pinworm infection among primary-school children in Taiwan". Am. J. Trop. Med. Hyg. 65 (5): 558–62. PMID 11716114.
- ^ Baydas B, Uslu H, Yavuz I, Ceylan I, Dagsuyu IM (2007). "Effect of a chronic nail-biting habit on the oral carriage of Enterobacteriaceae". Oral Microbiol. Immunol. 22 (1): 1–4. doi:10.1111/j.1399-302X.2007.00291.x. PMID 17241163.
- ^ Krejci CB (June 2000). "Self-inflicted gingival injury due to habitual fingernail biting". J. Periodontol. 71 (6): 1029–31. doi:10.1902/jop.2000.71.6.1029. PMID 10914808.
- ^ a b Iorizzo M, Piraccini BM, Tosti A (March 2007). "Nail cosmetics in nail disorders". J Cosmet Dermatol 6 (1): 53–8. doi:10.1111/j.1473-2165.2007.00290.x. PMID 17348997.
- ^ Allen KW (March 1996). "Chronic nailbiting: a controlled comparison of competing response and mild aversion treatments". Behav Res Ther 34 (3): 269–72. doi:10.1016/0005-7967(95)00078-X. PMID 8881096.
- ^ "Dutchman Offers 'Cure' for Nail Biting". The Washington Post (2007-09-08). Retrieved on 2008-03-22.
- ^ Twohig MP, Woods DW, Marcks BA, Teng EJ (January 2003). "Evaluating the efficacy of habit reversal: comparison with a placebo control". J Clin Psychiatry 64 (1): 40–8. PMID 12590622.
- ^ Woods DW, Murray LK, Fuqua RW, Seif TA, Boyer LJ, Siah A (December 1999). "Comparing the effectiveness of similar and dissimilar competing responses in evaluating the habit reversal treatment for oral-digital habits in children". J Behav Ther Exp Psychiatry 30 (4): 289–300. doi:10.1016/S0005-7916(99)00031-2. PMID 10759325.
- ^ Penzel, Fred. "Skin picking and nail biting: related habits.". Western Suffolk Psychological Services. Retrieved on 2008-03-22.