Nail Biting
Onychophagia (also onychophagy) or nail biting, is a common
oral compulsive habit (sometimes described as a parafunctional activity) in
children and adults.
Nail biting is considered an impulse control disorder in the DSM-IV-R, and is
classified under obsessive-compulsive and related disorders in the DSM-5. The
ICD-10 classifies it as "other specified behavioral and emotional disorders with
onset usually occurring in childhood and adolescence."
Health consequences
Biting nails can lead to broken skin on the cuticle. When cuticles are
improperly removed, they are susceptible to microbial and viral infections such
as paronychia. Saliva may then redden and infect the skin.
Nail biting is also related to dental problems, such as gingival injury and
malocclusion of the anterior teeth.
It can also transfer pinworms or bacteria buried under the surface of the
nail from the anus region to the mouth. When the bitten-off nails are
swallowed stomach problems can develop.
Medical literature reports cases of fingernails being severely deformed after
years of nail biting.
Treatment
The most common treatment, which is cheap and widely available, is to apply a
clear, bitter-tasting nail polish to the nails. Normally denatonium benzoate is
used, the most bitter chemical compound known. The bitter flavor discourages the
nail-biting habit.
Behavioral therapy is beneficial when simpler measures are not effective.
Habit Reversal Training (HRT), which seeks to unlearn the habit of nail biting
and possibly replace it with a more constructive habit, has shown its
effectiveness versus placebo 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.
Finally nail cosmetics can help to ameliorate nail biting social
effects.
Epidemiology
About 30 percent of children between 7 and 10 years of age and 45 percent of
teenagers engage in nail biting. The ten fingernails are usually equally
bitten to approximately the same degree. It may be underrecognized since
individuals tend to deny or be ignorant of its negative consequences,
complicating its diagnosis.
Related disorders
Related body-focused repetitive behaviors include dermatillomania (skin
picking), dermatophagia (skin biting), and trichotillomania (the urge to pull
out hair). Nail biting appeared in a study to be more common in men with
eating disorders than those without them. It is also more common among
children and adolescents with obsessive–compulsive disorder. Nail biting is
an oral parafunctional activity, and may be associated with bruxism (tooth
clenching and grinding), and other habits such as pen chewing and morsicatio
buccarum (cheek biting).
oral compulsive habit (sometimes described as a parafunctional activity) in
children and adults.
Nail biting is considered an impulse control disorder in the DSM-IV-R, and is
classified under obsessive-compulsive and related disorders in the DSM-5. The
ICD-10 classifies it as "other specified behavioral and emotional disorders with
onset usually occurring in childhood and adolescence."
Health consequences
Biting nails can lead to broken skin on the cuticle. When cuticles are
improperly removed, they are susceptible to microbial and viral infections such
as paronychia. Saliva may then redden and infect the skin.
Nail biting is also related to dental problems, such as gingival injury and
malocclusion of the anterior teeth.
It can also transfer pinworms or bacteria buried under the surface of the
nail from the anus region to the mouth. When the bitten-off nails are
swallowed stomach problems can develop.
Medical literature reports cases of fingernails being severely deformed after
years of nail biting.
Treatment
The most common treatment, which is cheap and widely available, is to apply a
clear, bitter-tasting nail polish to the nails. Normally denatonium benzoate is
used, the most bitter chemical compound known. The bitter flavor discourages the
nail-biting habit.
Behavioral therapy is beneficial when simpler measures are not effective.
Habit Reversal Training (HRT), which seeks to unlearn the habit of nail biting
and possibly replace it with a more constructive habit, has shown its
effectiveness versus placebo 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.
Finally nail cosmetics can help to ameliorate nail biting social
effects.
Epidemiology
About 30 percent of children between 7 and 10 years of age and 45 percent of
teenagers engage in nail biting. The ten fingernails are usually equally
bitten to approximately the same degree. It may be underrecognized since
individuals tend to deny or be ignorant of its negative consequences,
complicating its diagnosis.
Related disorders
Related body-focused repetitive behaviors include dermatillomania (skin
picking), dermatophagia (skin biting), and trichotillomania (the urge to pull
out hair). Nail biting appeared in a study to be more common in men with
eating disorders than those without them. It is also more common among
children and adolescents with obsessive–compulsive disorder. Nail biting is
an oral parafunctional activity, and may be associated with bruxism (tooth
clenching and grinding), and other habits such as pen chewing and morsicatio
buccarum (cheek biting).
