Nail biting
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Nail biting (onychophagia) is a common oral habit in children and young adults, affecting around 30% of children between 7 to 10 years and 45% of teenagers.[1]
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 unproperly removed are susceptible to microbial and viral infections producing whitlows. Nail biting is also related to dental problems.[1] Finally it may also result in the transportation of bacteria that are buried under the surface of the nail. Enterobacteriaceae, a specific bacterial family, is more prevalent in the oral cavities of children with nail-biting habits.[2]
Treatment
Behavioral treatments
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. There are also mouthpieces that prevent biting.[3]
Some patients have found professional behavioral therapy to be beneficial on its own or as a complement to medication when simpler measure are not effective. The first part of nail biting therapy consists of Habit Reversal Training (HRT), a four part process that seeks to "unlearn" the habit of nail biting and possibly replace it with a more constructive habit. In addition to HRT, stimulus control therapy is used to both identify and then eliminate the stimulus that frequently triggers biting urges.[4]
Medication
Nail biting has been shown to respond well to certain types of medication. The medications used to treat the problem include anti-depressants. These medications are also used to treat Trichotillomania and OCD and include clomipramine, fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, escitalopram, nefazodone and venlafaxine. Also, small amounts of the anti-psychotics used to treat schizophrenia such as risperidone, olazapine, quetiapine, ziprasidone, and aripiprazole can be used to augment anti-depressants.[4]
References
- ^ a b Leung AK, Robson WL (1990). "Nailbiting". Clin Pediatr (Phila). 29 (12): 690–2. PMID 2276242.
- ^ Baydaş B, Uslu H, Yavuz I, Ceylan I, Dağsuyu 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.
{{cite journal}}:|access-date=requires|url=(help)CS1 maint: multiple names: authors list (link) - ^ "Dutchman Offers 'Cure' for Nail Biting". The Washington Post. 2007-09-08. Retrieved 2008-03-22.
- ^ a b Penzel, Fred. "Skin picking and nail biting: related habits". Western Suffolk Psychological Services. Retrieved 2008-03-22.