What are the common reasons for nail biting?
Nail biting, or onychophagia, is considered a body-focused repetitive behaviour. It is most common in adolescents and prevalence decreases with age. Onychophagia can be a non-destructive, temporary automatic habit where individuals bite their nails when they are bored, stressed, waiting in a line, or even reading a book or watching TV.
Nail biting can persist and develop into a pathological, severe oral habit. Often the nail biting is intentional, and the affected individuals will often cease other activities to bite their nails. Such individuals can often have underlying medical/psychological disorders. They bite to an extent of injuring themselves.
Are there any underlying medical or psychological factors that might be contributing to nail biting?
It is often associated with anxiety and depression, but individuals can also suffer from attention deficit hyperactive disorder, oppositional defiant disorder (36%), separation anxiety disorder, enuresis, tic disorder and OCD.
How common is nail biting, and what age groups are most affected by it?
It is estimated to affect up to 20–30% of the general population. It affects up to 45% of children ages 10 years to puberty. The rate of nail-biting decreases with age usually, but in some people, it persists into or only begins in adulthood.
Which health risks can be associated with nail biting and how much can it affect your health?
Complications of nail biting affects the nail, including the nail plate and periungual region, the oral cavity and gastrointestinal. In chronic nail biters, partial or complete loss of the nail plate can occur, exposing the nail bed. As a result, the nail bed hardens leading to irreversible nail plate shortening and scarring.
Chronic trauma to the nail matrix may lead to overstimulation of melanocytes, leading to longitudinal melanonychia (brownish black discolouration of the nail). Nail biting can also predispose patients to secondary infections; bacterial (acute paronychia), viral (periungual warts, herpetic whitlow) and fungal.
Oral and dental complications include gum injury, leading to swelling and abscess, increased incisor damage from cracking and erosion, poor alignment of teeth and inflammation of the tooth root.
Nail biting can also cause damage of the temporomandibular joint leading to pain, especially worse during chewing. Nail biting patients can have very high bad bacteria in their mouths. This can lead to local and systemic infections if there is oral trauma or when enteric bacteria are ingested.
Individuals that intentionally bite their nails, also those who might have other habits like pulling of the hair and biting their lips must get medical help for both psychotherapy (stimulus control, habit reversal, other forms of counselling, aversion therapy) and medical therapy were possible.
How can parents get their children off nail biting as it might be difficult at later stage? (The answers here apply also for the question above and for question 10)
Try learning what the triggers are. Reduce boredom for the ones biting from, boredom or reduce stress for the ones biting from stress. Keep the nails short and well-trimmed with no splintered cuticles. Making nail biting physically difficult-bandages and or gloves for smaller kids or for those who won’t be embarrassed by it.
Professional manicures may also help as individuals especially girls, might be motivated to keep them for longer and therefore breaking the habit of nail biting. Application of an unpleasant-tasting polish to the nails might interfere with the enjoyable aspect of biting.
Are there any warning signs or symptoms that one should be aware of that might indicate a more serious problem related to nail biting?
Intentionally biting to a point of causing injuries to teeth or nails, other habits like hair pulling, signs of depression or anxiety or any suspicion of mental disorder.
Are there any treatments or medications that can help with nail biting?
Patients that have underlying psychiatric illnesses will benefit from medical treatment by a psychologist. All patients with benefit from treatment by a psychologist for behavioural changes, counselling for stress and learning new coping mechanisms.
How long does it typically take to break a nail-biting habit?
No treatment is necessary for mild onychophagia as a child can often outgrow the habit eventually mostly by their teenage years. For the others it depends on the severity of the condition and underlying psychiatric condition, it might take months to years.
Any additional information you would like to add.
Persons with nail biting habits needs a lot of support from their families. They should never be shamed for their behaviour. It’s best to try and understand why they are biting and encourage them to stop. Seek professional help for severe cases.
Medically Reviewed by Dr. Mathobela