Do Nail Biters Have A Disorder

Medical status

Nail biting

Fingers of a boom-biter.
Specialty	Pediatrics, psychiatry
Risk factors	damaged cuticles, damaged nails, hangnails, etc.

Nail biting, also known as onychophagy or onychophagia (or fifty-fifty erroneously onyhophagia), is an oral compulsive habit of biting one'southward fingernails. It is sometimes described as a parafunctional activeness, the common utilise of the rima oris for an activity other than speaking, eating, or drinking.

Blast biting is very common, specially amongst children. 25-xxx pct of children seize with teeth nails. More than pathological forms of nails biting are considered an impulse control disorder in the DSM-4-R and are classified under obsessive-compulsive and related disorders in the DSM-5. The ICD-x classifies the practice every bit "other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence".^[1] However, not all nail biting is pathological, and the difference betwixt harmful obsession and normal behavior is not always articulate.^[2] The primeval reference to boom bitter every bit a symptom of anxiety was in late sixteenth century in French republic.^[3]

Signs and symptoms [edit]

Nail biting usually leads to harmful effects to the fingers, like infections. These consequences are directly derived from the concrete impairment of biting or from the hands becoming an infection vector. Moreover, it tin can also have a social impact, for example social withdrawal and avoiding handshakes.^[2]

The ten fingernails are usually equally bitten to approximately the same degree.^[4] Oftentimes, the next skin is bitten off, also, which is called perionychophagia, a special case of dermatophagia. Biting nails can lead to broken skin on the cuticle. When cuticles are improperly removed, they are susceptible to microbial and viral infections such every bit paronychia. Saliva may then redden and infect the skin.^[2] ^[iv] In rare cases, fingernails may become severely deformed after years of nail biting due to the destruction of the boom bed.^[2] ^[five]

Smash bitter may have an clan with oral problems, such as gingival injury, and malocclusion of the anterior teeth.^[2] ^[six] Information technology can also transfer pinworms or bacteria buried under the surface of the blast from the anus region to the mouth.^[two] If the bitten-off nails are swallowed, stomach problems can occasionally develop.^[six]

Nail-biting tin be a source of guilt and shame feelings in the nail biter, a reduced quality of life, and increased stigmatization in the inner family circles or at a more societal level.^[2] ^[vii]

[edit]

Other body-focused repetitive behaviors include excoriation disorder (pare picking), dermatophagia (skin biting), and trichotillomania (the urge to pull out pilus), and all of them tend to coexist with nail bitter.^[two] ^[viii] As an oral parafunctional action, it is also associated with bruxism (tooth clenching and grinding), and other habits such as pen chewing and cheek biting.^[9]

In children nail biting most typically co-occurs with attention deficit hyperactivity disorder (75% of smash bitter cases in a study),^[2] and other psychiatric disorders including oppositional defiant disorder (36%) and separation anxiety disorder (21%).^[2] It is also more than mutual amid children and adolescents with obsessive–compulsive disorder.^[two] ^[ten] Nail biting appeared in a report to be more mutual in men with eating disorders than in those without them.^[11]

Treatment [edit]

The virtually mutual treatment, which is cheap and widely available, is to apply a articulate, bitter-tasting blast polish to the nails. Normally denatonium benzoate is used, the most bitter chemical compound known. The bitter flavour discourages the nail-biting addiction.^[12]

Behavioral therapy is beneficial when simpler measures are non effective. Addiction Reversal Training (HRT), which seeks to unlearn the habit of nail biting and possibly replace it with a more effective habit, has shown its effectiveness versus placebo in children and adults.^[13] A study in children showed that results with HRT were superior to either no treatment at all or the manipulation of objects as an alternative behavior, which is another possible approach to treatment.^[14] In addition to HRT, stimulus command therapy is used to both identify and then eliminate the stimulus that frequently triggers biting urges.^[15] Other behavioral techniques that have been investigated with preliminary positive results are self-assist techniques, such as decoupling^[xvi] and the use of wristbands equally non-removable reminders.^[17] More recently, applied science companies have begun producing wear devices and smart watch applications that runway the position of users' easily just no inquiry has been published so far.^{[ commendation needed ]}

Another treatment for chronic boom biters is the usage of a dental deterrent device that prevents the front end teeth from damaging the nails and the surrounding cuticles. After well-nigh ii months, the device leads to a full oppression of the blast biting urge.^[eighteen]

Testify on the efficacy of drugs is very express, and they are not routinely used.^[19] A small double-blind randomized clinical trial in children and adolescents indicated that N-acetylcysteine, a glutathione and glutamate modulator, could, in the short term but, be more constructive than placebo in decreasing the boom-bitter behavior.^[xix]

Nail cosmetics can assistance to ameliorate nail biting social effects.^[twenty]

Independently of the method used, parental education is useful in the case of young nail biters to maximize the efficacy of the treatment programs, as some behaviors by the parents or other family members may be helping to perpetuate the problem.^[two] For case, punishments accept been shown to be non better than placebo, and in some cases may even increase the nail biting frequency.^[2]

Epidemiology [edit]

While it is rare earlier the age of 3,^[2] almost 30 per centum of children between 7 and 10 years of age and 45 percent of teenagers engage in nail biting.^[2] ^[iv] Finally, prevalence decreases in adults.^[2] Figures may vary between studies, and could be related to geographic and cultural differences.^[2] The proportion of subjects that have ever had the addiction (lifetime prevalence) may exist much college than the proportion of current boom-biters (fourth dimension-point prevalence).^[21] Although there does not seem to be a gender correlation, results of epidemiological studies on this consequence are non fully consistent.^[2] It may be underrecognized since individuals tend to deny or exist ignorant of its negative consequences, complicating its diagnosis.^[viii] Having a parent with a mental disorder is also a risk gene.^[ii]

References [edit]

^ "Impulse control disorder". SteadyHealth. xxx December 2010. Retrieved 28 April 2012.
^ ^a ^b ^c ^d ^eastward ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o ^p ^q ^r ^s Ghanizadeh, A (Jun 2011). "Nail biting; etiology, consequences and direction". Iranian Journal of Medical Sciences. 36 (2): 73–9. PMC3556753. PMID 23358880.
^ Aboujaoude, Elias; Koran, Lorrin Thousand., eds. (2009). Impulse Control Disorders. doi:ten.1017/cbo9780511711930. ISBN9780511711930.
^ ^a ^b ^c Leung AK, Robson WL (1990). "Nailbiting". Clin Pediatr (Phila). 29 (12): 690–2. doi:10.1177/000992289002901201. PMID 2276242. S2CID 208874278.
^ Jabr FI (September 2005). "Astringent nail deformity. Smash biting may cause multiple agin conditions". Postgrad Med. 118 (three): 37–eight, 42. doi:x.3810/pgm.2005.09.1712. PMID 16201307. S2CID 71984361.
^ ^a ^b Tanaka OM, Vitral RW, Tanaka GY, Guerrero AP, Camargo ES (August 2008). "Nailbiting, or onychophagia: a special habit". Am J Orthod Dentofacial Orthop. 134 (2): 305–8. doi:10.1016/j.ajodo.2006.06.023. PMID 18675214.
^ Pacan, P; Reich, A; Grzesiak, 1000; Szepietowski, JC (Feb 17, 2014). "Onychophagia is Associated with Impairment of Quality of Life". Acta Dermato-venereologica. 94 (half-dozen): 703–half-dozen. doi:10.2340/00015555-1817. PMID 24535041.
^ ^a ^b Bohne A, Keuthen N, Wilhelm S (2005). "Pathologic hairpulling, pare picking, and nail biting". Ann Clin Psychiatry. 17 (4): 227–32. doi:10.1080/10401230500295354. PMID 16402755.
^ Cawson RA, Odell EW, Porter Due south (2002). Cawson'due south essentials of oral pathology and oral medicine (7th ed.). Edinburgh: Churchill Livingstone. p. 66. ISBN0443071063.
^ Grant JE, Mancebo MC, Eisen JL, Rasmussen SA (January 2010). "Impulse-command disorders in children and adolescents with obsessive–compulsive disorder". Psychiatry Res. 175 (one–2): 109–13. doi:10.1016/j.psychres.2009.04.006. PMC2815218. PMID 20004481.
^ Mangweth-Matzek B, Rupp CI, Hausmann A, Gusmerotti S, Kemmler G, Biebl Due west (2010). "Eating disorders in men: current features and babyhood factors". Eat Weight Disord. 15 (ane–ii): e15–22. doi:10.1007/BF03325276. PMID 20571316. S2CID 46664252.
^ Allen KW (March 1996). "Chronic nailbiting: a controlled comparison of competing response and mild aversion treatments". Behav Res Ther. 34 (iii): 269–72. doi:10.1016/0005-7967(95)00078-X. PMID 8881096.
^ Bate, KS; Malouff, JM; Thorsteinsson, ET; Bhullar, N (July 2011). "The efficacy of addiction reversal therapy for tics, habit disorders, and stuttering: a meta-analytic review". Clinical Psychology Review. 31 (5): 865–71. doi:10.1016/j.cpr.2011.03.013. PMID 21549664.
^ Ghanizadeh, A; Bazrafshan, A; Firoozabadi, A; Dehbozorgi, Chiliad (Jun 2013). "Habit Reversal versus Object Manipulation Training for Treating Smash Bitter: A Randomized Controlled Clinical Trial". Iranian Journal of Psychiatry. 8 (two): 61–7. PMC3796295. PMID 24130603.
^ Penzel, Fred. "Skin picking and nail bitter: related habits". Western Suffolk Psychological Services. Retrieved 2008-03-22 .
^ Sarris, Jerome; Camfield, David; Berk, Michael (2012). "Complementary medicine, cocky-assist, and lifestyle interventions for Obsessive Compulsive Disorder (OCD) and the OCD spectrum: A systematic review". Journal of Affective Disorders. 138 (3): 213–221. doi:ten.1016/j.jad.2011.04.051. PMID 21620478.
^ Koritzky, G; Yechiam, E (Nov 2011). "On the value of nonremovable reminders for behavior modification: an awarding to boom-biting (onychophagia)". Behavior Modification. 35 (6): 511–thirty. doi:x.1177/0145445511414869. PMID 21873368. S2CID 16277609.
^ Davinroy, Donald L. (Oct 2, 2008), Nail biting deterrent device and method , retrieved 2016-09-29
^ ^a ^b Ghanizadeh, A; Derakhshan, Northward; Berk, M (2013). "N-acetylcysteine versus placebo for treating nail biting, a double bullheaded randomized placebo controlled clinical trial". Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry. 12 (3): 223–8. doi:10.2174/1871523011312030003. PMID 23651231.
^ Iorizzo Thousand, Piraccini BM, Tosti A (March 2007). "Smash cosmetics in blast disorders". J Cosmet Dermatol. vi (1): 53–eight. doi:10.1111/j.1473-2165.2007.00290.ten. PMID 17348997. S2CID 40739671.
^ Pacan, P; Grzesiak, Grand; Reich, A; Kantorska-Janiec, M; Szepietowski, JC (Jan 2014). "Onychophagia and onychotillomania: prevalence, clinical picture and comorbidities". Acta Dermato-venereologica. 94 (1): 67–71. doi:10.2340/00015555-1616. PMID 23756561.