Nail biting

Nail biting may cause harmful side effects to the rest of the fingers, such as infections. These consequences are directly derived from the physical damage of biting or from the hands becoming an infection vector. Moreover, it can also have social consequences, such as withdrawal and avoiding handshakes. In rare cases, fingernails may become severely deformed after years of nail biting due to the destruction of the nail bed. Nail biting may have an association with oral problems, such as gingival injury, and malocclusion of the anterior teeth. Nail-biting can 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. Beyond that, however, there is no research to verify long-term consequences that could be attributed to nail biting alone. Related disorders Other body-focused repetitive behaviors include onychotillomania (nail picking), excoriation disorder (skin picking), dermatophagia (skin biting), and trichotillomania (compulsive hair pulling), all of which tend to coexist with nail biting. As an oral parafunctional activity, 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% co-occurrence among one psychiatrically referred cohort of nail biters) Nail biting appeared in a study to be more common in men with eating disorders than in those without them. == Treatment ==

The most common, cheap, and widely available 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. 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. 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. In addition to HRT, stimulus control therapy is used to both identify and then eliminate the stimulus that frequently triggers biting urges. Other behavioral techniques that have been investigated with preliminary positive results are self-help techniques, such as decoupling and the use of wristbands as non-removable reminders. More recently, technology companies have begun producing wearable devices and smart watch applications that track the position of users' hands, but no research has been published so far. Another treatment for chronic nail biters is the usage of a dental deterrent device that prevents the front teeth from damaging the nails and the surrounding cuticles. After about two months, the device leads to a full oppression of the nail biting urge. Evidence on the efficacy of drugs is very limited, and they are not routinely used. Nail cosmetics can help to ameliorate nail biting social effects. 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. For example, punishments have been shown not to be better than placebo, and in some cases may even increase the nail biting frequency. == Epidemiology ==

While it is rare before the age of three, Although there does not seem to be a gender correlation, results of epidemiological studies on this issue are not fully consistent. It may be under-recognized since individuals tend to deny or be ignorant of its negative consequences, complicating its diagnosis. Having a parent with a mental disorder is also a risk factor. ==References==