Caleb Foster
Nail biting, also known as onychophagy or onychophagia, is a compulsive habit that is very common, especially among children and young adults. It is often a coping mechanism in response to feelings of nervousness, boredom, loneliness or hunger. In children, nail biting is associated with attention deficit hyperactivity disorder, oppositional defiant disorder and separation anxiety disorder. Nail biting can also lead to feelings of guilt and shame, a reduced quality of life and increased stigmatisation.
| Characteristics | Values |
|---|---|
| Name | Onychophagy or onychophagia |
| Type | Oral compulsive habit |
| Prevalence | Very common, especially among children (25-35%) |
| Causes | Genetic components, underlying psychiatric conditions, medication side effects, coping mechanism for nervousness, boredom, loneliness or hunger |
| Complications | Distortion of nail bed unit, ungual and oral infection, poor dental hygiene, chipped or notched teeth, gum inflammation, guilt and shame, reduced quality of life, stigmatisation |
| Treatment | Multidisciplinary team providing social, psychiatric, dermatologic and dental care, manicures, nail cosmetic products, gum chewing |
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What You'll Learn
Nail biting as a coping mechanism
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit. It is sometimes described as a parafunctional activity, meaning the common use of the mouth for an activity other than speaking, eating, or drinking. Nail biting is very common, especially amongst children, of which 25-35% bite their nails. However, nail biting can also begin during adolescence or adulthood.
Nail biting is often a coping mechanism in response to feeling nervous, bored, lonely or hungry. It can be a source of guilt and shame, leading to a reduced quality of life and increased stigmatisation. Other body-focused repetitive behaviours include onychotillomania (nail picking), excoriation disorder (skin picking), dermatophagia (skin biting), and trichotillomania (the urge to pull out hair). These behaviours tend to coexist with nail biting.
Nail biting can also be associated with other oral parafunctional activities, such as bruxism (tooth clenching and grinding), pen chewing and cheek biting. In children, nail biting most typically co-occurs with attention deficit hyperactivity disorder (ADHD) and other psychiatric disorders, including oppositional defiant disorder and separation anxiety disorder.
Treatment of nail biting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care. Proper nail hygiene is essential, including keeping nails trimmed and filed. Allowing adolescents to have professionally manicured nails may help to discourage nail biting due to the positive cosmetic appeal. Nail cosmetic products can also be used as a treatment and to mask severe nail dystrophy while the nail is healing. Gum chewing may be an effective alternative option to curb the compulsion to bite nails in socially stressful situations.
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Nail biting as a side effect of medication
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit that is very common, especially among children, of whom 25-35% bite their nails. However, it can also begin during adolescence or adulthood, and a sudden nail-biting habit can be a side effect of medication.
Nail biting is sometimes described as a parafunctional activity, which is the common use of the mouth for an activity other than speaking, eating, or drinking. It is often associated with other parafunctional activities such as bruxism (tooth clenching and grinding), pen chewing, and cheek biting. In addition, nail biting is frequently associated with other body-focused repetitive behaviours, including onychotillomania (nail picking), excoriation disorder (skin picking), dermatophagia (skin biting), and trichotillomania (the urge to pull out hair). These behaviours tend to coexist with nail biting and may be indicative of underlying psychiatric conditions.
In children, nail biting most typically co-occurs with attention deficit hyperactivity disorder (ADHD), with a 75% co-occurrence rate among one psychiatrically referred cohort of nail biters. Other co-occurring psychiatric disorders include oppositional defiant disorder (36%) and separation anxiety disorder (21%). Treatment of nail biting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care.
The consequences of chronic, compulsive nail biting can range from obvious distortion of the nail bed unit to ungual and oral infection. Dental hygiene is typically less well-maintained in patients with nail-biting disorders, and teeth may become chipped or notched, and gums may become inflamed. Additionally, nail biting can lead to feelings of guilt and shame, reduced quality of life, and increased stigmatization within family circles or at a societal level. Proper nail hygiene, including keeping nails trimmed and filed, is essential for preventing these negative outcomes.
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Nail biting as a source of shame
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit that can be a source of shame and guilt for the nail biter. It is sometimes described as a parafunctional activity, meaning the common use of the mouth for an activity other than speaking, eating, or drinking. Nail biting is very common, especially among children, of whom 25-35% bite their nails. More pathological forms of nail biting are considered an impulse control disorder in the DSM-IV-R and are classified under obsessive-compulsive and related disorders in the DSM-5. The ICD-10 classifies the practice as "other specified behavioural and emotional disorders with onset usually occurring in childhood and adolescence".
Nail biting can lead to feelings of shame and guilt, a reduced quality of life, and increased stigmatisation within the family or at a societal level. It is often associated with other body-focused repetitive behaviours, such as onychotillomania (nail picking), excoriation disorder (skin picking), dermatophagia (skin biting), and trichotillomania (the urge to pull out hair). As an oral parafunctional activity, it is also linked to bruxism (tooth clenching and grinding) and other habits such as pen chewing and cheek biting.
In children, nail biting often co-occurs with attention deficit hyperactivity disorder (ADHD) and other psychiatric disorders, including oppositional defiant disorder and separation anxiety disorder. It can also begin during adolescence or adulthood, sometimes as a side effect of medication. Regardless of when the habit forms, it often arises as a coping mechanism in response to feelings of nervousness, boredom, loneliness, or hunger.
The chronic and compulsive nature of nail biting can lead to complications, including distortion of the nail bed unit and ungual and oral infections. Dental hygiene is typically poorer in patients with nail-biting disorders, and teeth may become chipped or notched, with inflamed gums. Treatment of nail biting requires a multidisciplinary approach that addresses social, psychiatric, dermatological, and dental concerns.
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Nail biting as a cause of dental issues
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit. It is sometimes described as a parafunctional activity, meaning the common use of the mouth for an activity other than speaking, eating, or drinking. Nail biting is very common, especially among children, of which 25-35% bite their nails.
Nail biting can be a source of guilt and shame for the nail biter, a reduced quality of life, and increased stigmatisation in the inner family circles or at a more societal level. It is also associated with bruxism (tooth clenching and grinding), and other habits such as pen chewing and cheek biting. Dental hygiene is typically less well-maintained in patients with nail-biting disorders, and teeth may become chipped or notched and gums may become inflamed. Treatment of nail biting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care.
Nail biting can also begin during adolescence or adulthood, though a sudden nail-biting habit can also be a side effect of medication. No matter when the habit forms, it often begins as a coping mechanism in response to feeling nervous, bored, lonely or hungry.
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Nail biting as a cause of nail bed distortion
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit of biting one's fingernails. It is a common habit, especially among children, with 25-35% biting their nails. Nail biting can also begin during adolescence or adulthood, and it is often a coping mechanism in response to feeling nervous, bored, lonely or hungry.
Nail biting can cause nail bed distortion. More pathological forms of nail biting are considered an impulse control disorder in the DSM-IV-R and are classified under obsessive-compulsive and related disorders in the DSM-5. The ICD-10 classifies the practice as "other specified behavioural and emotional disorders with onset usually occurring in childhood and adolescence".
Nail biting can also cause dental issues, with teeth becoming chipped or notched and gums becoming inflamed. It is also associated with bruxism (tooth clenching and grinding), and other habits such as pen chewing and cheek biting.
Treatment of nail biting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care. It is recommended that those who bite their nails keep their nails trimmed and filed, and use nail cosmetic products to treat nail biting and mask severe nail dystrophy while the nail is healing. Gum chewing may also be an effective alternative to curb the compulsion to bite nails.
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Frequently asked questions
Nail biting, also known as onychophagy or onychophagia, is an oral compulsive habit of biting one's fingernails.
Nail biting can be caused by a number of factors, including genetic components, underlying psychiatric conditions, and medication side effects. It often begins as a coping mechanism in response to feelings of nervousness, boredom, loneliness, or hunger.
Nail biting can lead to oral and nail infections, distorted nail beds, and poor dental hygiene. It can also cause feelings of guilt and shame, reduce quality of life, and increase stigmatization.
Nail biting is very common, especially among children, with 25-35% biting their nails. It is generally seen in children and young adults, but it can also begin during adolescence or adulthood.
Treatment for nail biting involves a multidisciplinary approach, including social, psychiatric, dermatologic, and dental care. Allowing girls to have professionally manicured nails may help prevent nail biting due to the positive cosmetic appeal. Gum chewing can also be an effective alternative to curb the compulsion to bite nails.
