NAIL BITING

                                                                                               NAIL BITING

                      

                      Nail biting is the most common of the so-called "nervous habits," which include thumb-sucking, nose picking, hair twisting or tugging, and teeth grinding. It's also the one most likely to continue into adulthood.

Growing up can make kids anxious, and many of these tensions and pressures are invisible to parents. If your child bites moderately (doesn't injure himself) and unconsciously (while watching television, for example), or if he tends to bite in response to specific situations (such as performances or tests), it's just his way of coping with minor stress and you have nothing to worry about.

Classification

                    Nail biting is considered an impulse control disorder in the DSM-IV -R,and is classified under obsessive-compulsive and related disorders in the DSM-5. The ICD-10 classifies it as "other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence."

Signs And Symptoms

                        Biting nails can lead to broken skin on the cuticle.When cuticles are improperly removed, they are susceptible to microbial and viral infections  such as paronychia. Saliva may then redden and infect the skin.

Nail biting is also related to dental problems, such as gingival injury and malocclusion of the anterior teeth.

It can also transfer binworms  or bacteria  buried under the surface of the nail from the anus  region to the mouth. When the bitten-off nails are swallowed, stomach problems can develop.

Fingernails may become severely deformed after years of nail biting.

Related disorders

            Related body-focused repetitive behaviors include dermatillomania  (skin picking), dermatophagia (skin biting), and trichotillomania  (the urge to pull out ha Nail biting appeared in a study to be more common in men with eating disorder  than those without them. It is also more common among children and adolescents with obsessive-compulsive disorder. Nail biting is an oral parafunctional activity, and may be associated with bruxism (tooth clenching and grinding), and other habits such as pen chewing and morsicatio buccarum.(cheek biting).

Treatment 

                  The most common treatment, which is cheap and widely available, is to apply a clear, bitter-tasting nail polish to the nails. Normally denatonium benzoate is used, the most bitter chemical compound known. The bitter flavor discourages the nail-biting habit.

                 Behavioral therapy  is beneficial when simpler measures are not effective.Habit Reversal Training (HRT), which seeks to unlearn the habit of nail biting and possibly replace it with a more constructive habit, has shown its effectiveness versus placebo in children and adults. In addition to HRT, stimulus control therapy is used to both identify and then eliminate the stimulus that frequently triggers biting urges.   Finally nail cosmetics can help to ameliorate nail biting social effects.

Epidemiology 

             About 30 percent of children between 7 and 10 years of age and 45 percent of teenagers engage in nail biting. The ten fingernails are usually equally bitten to approximately the same degree. It may be under recognized since individuals tend to deny or be ignorant of its negative consequences, complicating its diagnosis.