By Gilda Morales, ANP, DC
Today’s column deals with a common condition, nail biting, which can cause problems not only in the fingers but in the digestive system. These problems are caused not only from the physical damage of biting, but from the potential of the fingers becoming a vehicle for infections. Biting nails can lead to broken skin on the cuticles, making them susceptible to microbial and viral infections such as paronychia. Saliva may then redden and infect the skin, and in rare cases, fingernails may become severely deformed after years of nail biting due to the destruction of the nail bed.
Nail biting may also cause oral problems, such as injury to the gums and malocclusion of the front teeth. It some cases, there may also be a transfer of pinworms or bacteria buried under the surface of the nail. If the bitten-off nails are swallowed, stomach problems can occasionally develop. Nail biting can also be related to other repetitive behaviors such as skin picking or skin biting, or even trichotillomania (the urge to pull out hair), and all of them tend to coexist with nail biting. It is also associated with bruxism (tooth clenching and grinding), and other habits such as pen chewing and cheek biting.
In children nail biting most typically co-occurs with attention deficit hyperactivity disorder (75% of nail biting cases in a study), and other psychiatric disorders, including oppositional defiant disorder and separation anxiety disorder. It is also more common among children and adolescents with obsessive–compulsive disorder.
The most common treatment, 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.
Another treatment for chronic nail biters, is using a dental deterrent device that disables the front teeth from making any damage to the nails and the surrounding cuticles. After about two months the device leads to a full suppression of the nail biting urge.