Nail biting
Encyclopedia
Onychophagia, or nail biting, is a common oral compulsive
habit in children and adults.
in the DSM-IV-R; the ICD-10 classifies it as "other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence."
. When cuticles are improperly removed, they are susceptible to microbial and viral
infection
s such as paronychia
. Saliva
may then redden and infect the skin.
Nail biting is also related to dental problems, such as gingiva
l injury and malocclusion of the anterior teeth.
It can also transfer pinworm
s 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.
to the nails. The bitter flavor discourages the nail-biting habit. Mouthpieces that prevent nail-biting are also available.
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.
Children can wear footed pajamas as a reminder not to bite their toenails.
s 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 disorder
s than those without them. It is also more common among children and adolescents with obsessive–compulsive disorder.
Body-focused repetitive behavior
Body-Focused Repetitive Behavior is an umbrella name for impulse control behaviors involving compulsively damaging one's physical appearance or causing physical injury.The main BFRB disorders are:*Trichotillomania, compulsive hair pulling...
habit in children and adults.
Classification
Nail biting is considered an impulse control disorderImpulse control disorder
Impulse control disorder is a set of psychiatric disorders including intermittent explosive disorder, kleptomania, pathological gambling, pyromania , and three body-focused repetitive or compulsive behaviors of trichotillomania , onychophagia and dermatillomania...
in the DSM-IV-R; the ICD-10 classifies it as "other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence."
Health consequences of nail biting
Biting nails can lead to broken skin on the cuticleCuticle
A cuticle , or cuticula, is a term used for any of a variety of tough but flexible, non-mineral outer coverings of an organism, or parts of an organism, that provide protection. Various types of "cuticles" are non-homologous; differing in their origin, structure, function, and chemical composition...
. When cuticles are improperly removed, they are susceptible to microbial and viral
Virus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
s such as paronychia
Paronychia
The nail disease paronychia , commonly misidentified as a synonym for whitlow or felon, is an often-tender bacterial or fungal hand infection or foot infection where the nail and skin meet at the side or the base of a finger or toenail...
. Saliva
Saliva
Saliva , referred to in various contexts as spit, spittle, drivel, drool, or slobber, is the watery substance produced in the mouths of humans and most other animals. Saliva is a component of oral fluid. In mammals, saliva is produced in and secreted from the three pairs of major salivary glands,...
may then redden and infect the skin.
Nail biting is also related to dental problems, such as gingiva
Gingiva
The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...
l injury and malocclusion of the anterior teeth.
It can also transfer pinworm
Pinworm
The pinworm , also known as threadworm or seatworm, is a nematode and a common human intestinal parasite, especially in children...
s or bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
buried under the surface of the nail from the anus
Anus
The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...
region to the mouth
Mouth
The mouth is the first portion of the alimentary canal that receives food andsaliva. The oral mucosa is the mucous membrane epithelium lining the inside of 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 polishNail polish
Nail polish, or nail varnish, is a lacquer applied to human fingernails or toenails to decorate and/or protect the nail plate.-History:...
to the nails. The bitter flavor discourages the nail-biting habit. Mouthpieces that prevent nail-biting are also available.
Behavioral therapy is beneficial when simpler measures are not effective. Habit Reversal Training
Habit reversal training
Habit reversal training is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders"....
(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
Stimulus control
Stimulus control is the phenomenon of a stimulus increasing the probability of a behavior because of a history of that behavior being differentially reinforced in the presence of the stimulus...
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.
Children can wear footed pajamas as a reminder not to bite their toenails.
Epidemiology
Nail biting affects about 30 percent of children between 7 to 10 years of age and 45 percent of teenagers. The ten fingernails are usually equally bitten and 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 behaviorBody-focused repetitive behavior
Body-Focused Repetitive Behavior is an umbrella name for impulse control behaviors involving compulsively damaging one's physical appearance or causing physical injury.The main BFRB disorders are:*Trichotillomania, compulsive hair pulling...
s include dermatillomania
Dermatillomania
Dermatillomania is an impulse control disorder characterized by the repeated urge to pick at one's own skin, often to the extent that damage is caused...
(skin picking), dermatophagia
Dermatophagia
Dermatophagia is a form of obsessive-compulsive disorder wherein a sufferer compulsively bites their own skin. Sufferers typically bite the skin around the nails, leading to bleeding and discoloration over time....
(skin biting), and trichotillomania
Trichotillomania
Trichotillomania, which is classified as an impulse control disorder by DSM-IV, is the compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment. It is often chronic and difficult to treat....
(the urge to pull out hair). Nail biting appeared in a study to be more common in men with eating disorder
Eating disorder
Eating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common specific...
s than those without them. It is also more common among children and adolescents with obsessive–compulsive disorder.