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Nail biting

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Fingers of an extreme nail-biter.

Nail biting is the habit of biting one's fingernails or toenails during periods of nervousness, stress, hunger, or boredom [1]. It can also be a sign of mental or emotional disorder. The clinical name for nail biting is chronic onychophagia.

It occurs in:[2]

  • 28% to 33% of children ages 7-10 years old,
  • 44% of adolescents,
  • 19% to 29% of young adults and
  • 5% of older adults
  • It is more common in young males


Negative effects

Biting the nails can result in the transportation of germs that are buried under the surface of the nail into the mouth. In fact, nail salons use tools that potentially affect a human in a similar way. "If [nail tools, such as files] are used on different people, these tools may spread nail fungi, staph bacteria or viruses," warns Rick Lopes, a spokesperson for the California Board of Barbering and Cosmetology.[citation needed] Many pathogens have the ability to "live" under a nail.

Nail biting may result in the chewing of surrounding skin and cuticle. Broken skin is susceptible to microbial and viral infections. These pathogens can be spread between digits via the mouth. A normal, healthy person has a very low risk of suffering from infections.

A long-time habit of nailbiting may have detrimental effects on the substantia adamantinea of the front teeth, promoting caries in these areas.

Extreme nailbiting can be considered to be a form of masochistic self-mutilation. Bitten fingertips can become very sensitive to pain, usually at the place the skin meets the edge of the nail. If the nail surrounds have been damaged, salty foods, (such as potato chips and pickles), can get between the skin and nail and cause pain and hypersensitivity.

Nail biting is, according to Freudian theory, a symptom of oral fixation.

Treatment

Behavioural therapy

Some patients have found behavioral therapy to be beneficial on its own or as a complement to medication. 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.[3]

The symptoms have been found to respond best to a combination of medication and therapy.

Medication

Nail biting has been shown to respond well to certain types of medication. The medications used to treat the problem include the newest, most potent 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. It is important to note that the use of anti-psychotics to treat nail biting does not necessarily indicate that the patient is suffering from psychosis. [4]

Other treatment

Various forms of aversion therapy exists to help people stop biting their nails. These include methods such as coating the nails with a bad-tasting substance (sometimes in the form of a special nail polish, tabasco sauce, or gel deodorant) or wearing a rubber band on their wrist and having friends and family members snap it (or tell the nailbiter to snap it) when they see nailbiting. Replacing the habit of biting nails by the habit of chewing gum works for some people. Some methods (including aforementioned aversion methods) can work by making the biter aware of their actions and finding other things to do. Keeping a record of when one bites may also be helpful in finding the root of the problem.

Some nail biters who undergo orthodontic treatment find that wearing a retainer or a bite plate makes it impossible for them to sever their nails with their teeth. This can have the unintentional side-effect of helping the individual to overcome their nail-biting habit.

Some nail-biters, however, find the effectiveness of all of these remedies to be poor. For them, it may take sheer determination to break the habit. Tactics they may find helpful include making a mental note to stop, promising oneself not to bite, and making it a New Year's resolution, or other such commitment to stop.

Like other nervous habits, nail biting is sometimes a symptom of an emotional problem. In these cases, resolving the underlying problem can help to lessen or eliminate the nail-biting habit.

Another method is to get regular manicures, as having neat, polished nails will keep some people (particularly women) from biting them.

References

See also

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