What is Nail Biting?
Nail biting (onychophagia) is a compulsive, sometimes stress-related habit. It involves biting the nail and surrounding soft tissue.
Nail biting is commonly seen among children and young adults. While the exact causes are still somewhat unclear, it is believed to be sometimes associated with psychological disorders, such as anxiety. (1)
It might seem like a harmless habit which can be stopped easily. However, many find themselves unsuccessful in weaning from this addiction. It can result in dental issues as well as chronically broken nails or damaged fingers. (2)
Nail biting is part of a group of body-focused repetitive behaviors (BFRBs), along with hair pulling and skin biting. (3)
Nail biting is generally started between the ages of three to five. Those affected are often unsuccessful in quitting the habit until reaching adulthood. Some experts suggest that smoking or gum chewing is a replacement for the biting as the person gets older. (4)
Some people may use nail biting as a type of stress-relief, others may use it in times of boredom or frustration.
Nail biting has not been considered a condition in which a child may inherit from a genetic aspect. However, it could be passed on to the child as a form of imitation of a parent. (5)
Nevertheless, some children may acquire the habit due to psychological stress. Studies show that children are likely to become nail biters if the parents suffer from psychiatric disorders. (6)
Nail biting does not present many symptoms other than the biting itself. The nails and surrounding soft tissue are likely to look damaged. The affected area may be prone to infection if the biting is severe.
Nail biting may be looked upon as a bad habit. Those affected might often be laughed at or even discredited due to the trait. This could result in restrictions on the individual’s social behaviors. (7)
Those affected often tend to refrain from participating in social activities involving the hands.
Children are especially victimized due to others’ perception that nail biting is a choice, which the child simply does not desire to stop.
These “attacks” are likely to worsen the habit and may cause further distress and anxiety in the child. They may even have severe consequences on social behavior as the individual enters adulthood.
Teeth and Gums
Nail biting can have severe consequences for the teeth and gums.
Inside the mouth, there is a “family” of bacteria called Enterobacteriaceae. Under normal circumstances, the amount is limited to a controllable number. Nail biting is likely to increase this amount and may also transfer it to the gums. In turn, this could result in gum infections as well as teeth misalignment. (8)
This might be an expected symptom. Nevertheless, chronic nail biting is likely to damage the nail beds, which in turn can affect the way the nail grows. The result is usually a shortened or disappearing nail. (9)
When the soft tissue surrounding the nail becomes damaged, it is also vulnerable to infections, which can lead to further trauma.
Nail biting is generally not evaluated in a stage form, but some experts have stressed the importance of classifying it as mild or severe. (10)
Severe cases are usually associated with other psychological disorders which contribute to more intense nail biting. These are typically harder to break away from; thus, it is essential to treat the underlying condition. (11)
Mild nail biting is generally seen as a nervous habit, like fidgeting. It is usually something most patients will outgrow as they enter adulthood; therefore, treatment is often not needed.
In these cases, some people may prefer to apply bitter-tasting nail polish. The aim is for the nail biter to refrain from biting due to the bad taste. However, this method is generally ineffective in the long term.
Severe nail biting is usually associated with an underlying issue. Such disorders could include: anxiety, obsessive-compulsive disorder (OCD), autism and schizophrenia. Severe biting will generally result in more significant damage to the nails and teeth.
Treatment of nail biting can involve behavioral training as well as psychological therapy. When treating or managing this habit, it is essential to acknowledge the reasons behind it, pattern and outcomes. (12)
When treating a child or young adult, experts stress the importance of involving close family members, such as parents and siblings. Parents or caregivers should understand that punishment, ridiculing or threatening the child won’t help. In turn, it may even worsen the issue.
Severe cases of nail biting usually require help from a dentist or other specialists to assess the possible damage to teeth and gums.
Psychotherapy works to teach the patient a set of skills which can help control the behavior involving nail biting.
This involves different methods, one of which is cognitive behavioral technique (CBT). The patient may talk to a therapist who will help them understand the reasons behind the behavior. The therapist may then suggest ways to cope with those feelings without having to resort to nail biting. (13)
Another approach to treating nail biting involves different techniques to reverse the habit.
This generally includes confronting the patient with the habit in different ways, such as videotaping. It is thought that it may help the individual to realize why and when nail biting occurs. It can also be a great way to record progress. Specifically, for younger children, it is likely to motivate them to continue improving. (14)
This method teaches the patient to meet the urge of nail biting with a “competing response.” This could, for example, involve an activity to avoid or hinder the fingers from entering the mouth. (15)
An aversive stimulus works to wean the patient from the habit by associating it with something unpleasant. This could be bitter nail polish or other substances applied to the nails. Although this method is useful, it is not as successful as the one mentioned above. (16)
This method consists of five steps. The patient is taught some self-control skills which he/she should apply when the urge to bite presents itself.
The first step is teaching the patient that nail biting is something which must be changed, and that it is possible. Secondly, the individual is motivated to find the cause of nail biting and the associated feelings. (17)
The third step requires self-monitoring which is believed to increase awareness and better the understanding of change. The fourth and fifth steps involve coping skills, such as self-talk and reward, and applying these when needed.
What is nail biting? Nail biting defines a person who vigorously bites the fingernails and surrounding soft tissue.
What are the signs of nail biting? The initial indication is when a person is repeatedly seen biting the nails. More apparent symptoms usually don’t present except in severe cases. Severe cases of nail biting will generally be regarded as little to no nails with damaged cuticles. The surrounding soft tissue is probably damaged and prone to infections. The front teeth and gums may also suffer significant trauma.
How do you develop a nail biting habit? Nail biting may have various causes. Some experts suggest it is a learned habit taught unknowingly from parent to child. Others suggest it is a symptom of another condition, usually a psychological disorder such as anxiety or OCD. A child may also inhibit this addiction if either one of the parents suffers from a psychological disorder such as depression. Mild cases are a bit different, as these may just arise due to boredom or stress. (18)
How are you diagnosed for nail biting? Nail biting generally does not require a medical diagnosis as the person or loved ones can easily spot the issue. However, underlying causes may need evaluation, as will any possible complications, such as teeth or gum problems. This is typically achieved through a series of questions and a psychological assessment. (19)
What is the best treatment for nail biting? Mild cases of nail biting require little or no treatment. Those affected may apply bitter-tasting nail polish. Otherwise, it is recommended to keep the nails trimmed. Severe cases are usually caused by an underlying issue, which requires treatment to stop the habit. Different therapies may be applied. These can involve CBT (cognitive behavioral treatment) or habit reversal techniques. (20, 21)
What are the long term complications of nail biting? Complications may include infections in the surrounding tissue of the nails and permanent damage. If the affected person has a habit of swallowing the nails, it is possible to develop a stomach infection. It may also cause permanent damage to teeth and gums. (22)
Is nail biting considered a disability? No, nail biting is not a disability.
Is there any cure for nail biting? Many outgrow this habit. Otherwise, treatment is generally successful at curing nail biting.
Is nail biting life threatening? Nail biting is not a fatal habit.
Nail biting is a habit in which an individual bites the fingernails and cuticles.
It is a somewhat underestimated habit. Unless affected, it may be hard to understand that it can be a sign of a much broader issue, such as anxiety or even autism. These usually require treatment to stop the nail biting.
Fortunately, nail biting can usually be stopped with therapy. Although it is essential to keep in mind that change does not occur overnight; it takes time and patience.