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In psychiatry, psychology, medicine, and dentistry, nail biting (NB) is a frequent yet unsolvable condition. While it may appear that NB is a simple behaviour that can be easily stopped, most children having NB have previously tried and failed. Others, such as siblings and parents, are frustrated as a result of the failed endeavour. The purpose of this review is to give an overview of NB prevalence, consequences, counselling services, and management. Overall, the examined existing literature reveal that psychiatric disorders and other stereotypic behaviours are present in more than 80% of clinical samples of children with NB, and maximum of the parents had psychiatric illnesses, primarily sadness. However, treating NB is not as straightforward as it may look. The management of NB is significantly more complicated than focusing just on its abolition. It's impossible to predict nail-biting without considering its co-morbidities, triggers, and consequences. Children with NB, their family members, siblings, and instructors, according to the reviewed study, should be educated what to do and what not to do about the illness. Sentencing does not work. Furthermore, evidence-based behavioral and pharmacologic therapy procedures must be made available through clinical randomized controlled trials. Nail-biting and lip biting habits develop as a consequence of stress management among children. Such habits help cope with emotional and physical stresses. As a result, this study is critical in raising awareness about such oral habits and the necessary interventions to effectively stop them. This provides a holistic approach to endodontic care and helps prevent future debilitating problems to the oral cavity and the associated structures.

Background: Anterior open bite (AOB) is the vertical separation between upper and lower teeth when all other teeth are in maximum intercuspation. It is considered abnormal when it affects patient’s function, speech, mastication, future dental health risks and aesthetics. Aim: The current study was conducted to determine the prevalence of anterior open bite and its etiological factors in a group of Egyptian children aged 8 years and above. Methods: The sample comprised 115 participants aged between 8 and 10 years, attending the Outpatients’ Clinic of Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University. AOB was assessed on study cast models using digital caliper. Increased overjet, abnormal oral habits, and parents’ educational level were checked. A close ended questionnaire was answered by patients’ guardians. Data were statistically analyzed with SPSS software package (version 21 SPSS Inc., Chicago, USA). Results: About 24(20.9%) of the 115 participants had AOB, 82 (71.2%) had normal overbite, 9 (7.8%) had increased overbite. Overjet relationship was increased in 51(44.4%). The most common etiological factor was mouth breathing 13(11.3%). Abnormal oral habits revealed higher percentages of tongue thrust 5 (7.2%), thumb sucking 4(5.8%) and lip biting 6(8.7%) in girls. Boys revealed higher percentages regarding mouth breathing 7(15.2%) and nail biting 1(2.2%). There was significant low positive correlation between parents’ educational level and the amount of AOB (r < 0.5, P-value < 0.05). Conclusions: Prevalence of AOB is relatively low, with no sex predilection. Abnormal oral habit may be a causative factor of AOB.

Onychophagia, commonly referred to as nailbiting is a chronic condition that is repetitive and compulsive in nature, and generally seen in both children and young adults. Multiple factors play a role in the development of nailbiting, ranging from genetic components, to underlying psychiatric conditions. Complications of chronic, compulsive nail-biting range from obvious distortion of the nail bed unit, to ungual and oral infection. Dental hygiene is, typically, less well-maintained in patients with nail-biting disorders: teeth may become chipped or notched, and gums many become inflamed. Treatment of nailbiting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care. Treatment ranges from psychotherapy modalities, to medication trials of selective serotonin reuptake inhibitors and N-acetylcysteine. Proper nail hygiene remains a mainstay in the prevention of the complications of chronic nail-biting. Additional supportive measures include the support of self-motivational novels and television episodes that help children learn coping mechanisms.

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Body-focused repetitive behaviors (BFRBs) include skin picking, trichotillomania, nail biting and cavitadaxia/lip-cheek biting, among other behaviors. For the first time, we compared three different self-help techniques aimed at reducing BFRBs. We explored the acceptance and preliminary efficacy of the approaches and whether the techniques exerted differential effects depending on BFRB-type. A total of 113 participants with at least one BFRB were randomly allocated to either habit reversal training (HRT; active elements: awareness and competing response training), decoupling (DC) or decoupling in sensu (DC-is). Reassessment was conducted 4 weeks later. The Generic Body-Focused Repetitive Behavior Scale (GBS) served as the primary outcome. The completion rate was best for DC-is (68.6%) as compared to HRT (57.1%) and DC (53.5%). A total of 34.8% of completers in the DC group showed an improvement of at least 35% on the GBS compared to 10.0% in the HRT and 23.3% in the DC-is group. In accordance with previous work, moderator analyses showed that improvement under DC is best for non-skin-pickers. A dose-effect relationship emerged, particularly for HRT. Subjective appraisal ratings were more favorable for DC-is and HRT than for DC. With respect to completion rate, subjective appraisal and symptom improvement, DC-is yielded consistently satisfactory results, whereas HRT showed good subjective but rather poor objective improvement. Those who performed DC, especially non-skin-pickers, showed good improvement but overall completion and subjective efficacy were low. Future studies should investigate whether the three techniques exert add-on effects when combined and whether demonstration via new media (e.g., video) will augment comprehensibility and thus efficacy of the techniques.

During the first two months of the Coronavirus Disease 2019 (Covid-19) pandemic, Romania was in lockdown, and all dental practices were closed, so orthodontic patients had to postpone their check-ups for at least eight weeks. This led not only to a delayed end of treatment but also to accidents and complications. The present study tried to evaluate the orthodontic situation both from the patient’s and orthodontist’s point of view, so the patients were given a few questions to answer, and the orthodontist analyzed each treatment before and after the two-month lockdown and decided if it was mildly or severely affected by the absence of check-ups. The study group consisted of 105 patients evaluated by three orthodontists in the same private practice. Patients that have gotten worse after the lockdown or who had problems were included in the study. Also, all the patients were given a 7-question form in order to find out their opinion. After two months without check-ups, our orthodontists found that 9.52% got worse because of the lack of intermaxillary elastics, broken brackets, broken removable orthodontic appliances, and others. Most of the patients believe that their treatment was delayed by the Covid-19 pandemic, but none of the patients felt unsafe when visiting the clinic. The Covid-19 pandemic had severe effects on orthodontic treatments. Orthodontists noticed a delay for about one-third of their patients. However, from the patient’s point of view, half believe that their treatment was negatively affected by the Covid-19 pandemic in different degrees.

Background: Oral parafunctional habits are related to any abnormal hyperactivity of the oromandibular system. They are prevalent in all societies in varying intensity and have potential physical and psychological implications. The aim of this study was twofold: (1) to determine the prevalence of various types of oral parafunctional habits in the Saudi adult population, and (2) to examine their association with and the level of anxiety and personality factors. Methods: This cross-sectional study was conducted with an electronic data collection form distributed to the public through social media. The questionnaire comprised of the following: (a) demographic information, (b) the Hamilton Anxiety Rating Scale (HAM-A), (c) the Ten-Item of Big-Five Personality Traits, (d) a list of oral parafunctional habits. Data were analysed using a Pearson’s Chi square and binary logistic regression. Results: The participants reported several parafunctional habits including daily gum chewing (86%), lip/object biting (59%), clenching (45%), nail biting (36%) and grinding (32%). Males were 3 [2.3–3.7] times and younger age groups were 1.5 [1.1–2.0] times more likely to be associated with nail biting compared to their counter groups (adj.P

Chronic nail biting (onychophagia) is a common habit which negatively impacts on the quality of life of those affected, has a negative social impact, and is accompanied with disabling inflammatory processes like gingivitis and paronychia. Habit reversal is a behaviour treatment procedure used to help patients get rid of the habit. The presented case report describes how a six-month period of habit reversal prescribed by the dermatologist was used to treat a 42-year male suffering from life-long onychophagia. During the treatment period, the patient experienced both an improved growth of nails and an improvement in quality of life, but never got fully cured from the habit. Finally, suggestions for an improved treatment success by prescribing habit reversal in specialized onychophagia clinics run by a multidisciplinary team (consisting of e.g., dermatologists, psychiatrists, and psychologists) who ensure regular follow-ups and patient compliance is provided.

Objective: The purpose of this study is to identify the prevalence of parafunctional oral habits among schoolchildren aged 6 to 12 years in Alexandria, Egypt. Materials and methods: A total of 255 Egyptian children, consisting of 158 males and 94 females were randomly examined. The examination included 1-Tongue thrusting: masseteric palpation 2-Thumb sucking: finger examination and intra-oral examination. 3-Mouth breathing: a. medical history. b. Mirror test (fog test) c. Jwemen’s Butterfly test. d. Water Holding Test (Masslers test). 4-Nail biting: fingers, nails examination and intraoral examination. Questionnaires were handed out to the parents to obtain information about the child’s gender, age, medical and dental history and any noticeable oral habits and collected a week later. Data was collected, sorted and registered. The subjects were assigned to different groups according to the habit. Percentile distribution of the subjects was calculated for different habit and their relation to each other, Categorical variables were analyzed using the chi-square test and Student t-test. Significance of the obtained results was judged at the 5% level (P ≤ 0.05). Results: the majority of subjects shows with 41.07% of the subjects had nail biting followed by tongue thrust with 29.4% then mouth breathing with 15.9% and the least prevalent oral habit was thumb sucking with 14.73%. 32.1% of the subjects had no habits at all and 67.9% had at least one habit. conclusion: Nail biting was the most dominant oral habit and the least common was thumb sucking, no patients were found practicing more than 3 habits.

Root resorption is the loss of apical root tissue which is implicated by decrease in root-crown ratio. It usually effects from external surface to pulp chamber if not identified in the early stage. Several natural conditions place roots at risk of resorption without any pathology. Knowing the pressure or etiology of the resorption will help the orthodontist in the treatment aspect. To date literature regarding root resorption due to various malocclusions is deplete in Indian population. To measure and assess the root crown ratios of maxillary incisors with vertical malocclusions, deleterious habits, and validate by two different radiographic techniques.90 Patients enrolled for the orthodontic treatment were allocated to three groups - open bite, deep bite & control groups and were subdivided based on nail biting habit. Panoramic radiographs, Periapical radiographs (by paralleling technique) for maxillary incisors (360 teeth) were taken and traced. Length of the root & crown were assessed and root crown ratios were calculated and the results substituted to statistics using SPSS. Comparison of Root-crown ratios in vertical malocclusions, revealed statistically significant (P < 0.001) differences in Open bite group for all maxillary incisors in both panoramic and periapical radiographs. No statistical significant differences were found in the deep bite group. Significant association was found between nail biting habit and Root-crown ratio. Gender predilection was found to be absent.Decreased Root- crown ratios were observed in open bite patients. Nail biting patients show significant root resorption. Both panoramic radiographs and periapical radiographs with paralleling technique can be used for assessing root resorption.

Extraneous activities of either the mouth, tongue or the jaw comprise the oral parafunctional habits of the stomatognathic system. This denominated habit is expressed through bruxism, digit sucking, nail biting to name a few, have led to hypothesizing the possible relationship of evolution of occluso-facial abnormalities such as malocclusion thereby hindering the conventional developmental process. Hence, the present study aimed to determine the prevalence and the possible relationship of parafunctional oral habits with the types of malocclusions among 12–16 years old females in Jeddah, Saudi Arabia. This cross-sectional study was conducted through questionnaire and clinical examinations, where the sagittal abnormalities within a randomly selected 672 participants who met the eligibility criteria were tabulated and analyzed. A positive history of the presence of parafunctional habit was recorded among all the participants with nasal and mouth breathing [46.6%], nail biting [39.6%] being predominant. 36.4% presented with significantly higher prevalence of bi-maxillary protrusion in mouth breathers while 17.1% with moderate overbite in participants with nail biting habit. Therefore, within the limitations of the present study, the findings do support the literature on the prevalence and the possible association of these habits with the malocclusion development thereby emphasizing on the importance of early recognition, management and prevention of them.

Trichotillomania (TTM), excoriation disorder, onychophagia, and onychotillomania are categorized as body focused repetitive behavior (BFRB) disorders, causing damage to the skin, hair, and/or nails with clinically significant psychosocial consequences. Currently, there are no standardized treatments for these compulsive, self-induced disorders. Studies on treatment of these disorders using psychotropic drugs (i.e., selective serotonin reuptake inhibitors, tricyclic antidepressants, anticonvulsants) have shown variable efficacy. Recently, there is a growing interest inRelevant articles were searched in the PubMed/MEDLINE database.Twenty-four clinical trials, retrospective cohort studies, and case reports assessing the efficacy of NAC in TTM, excoriation disorder, and onychophagia were included. No studies for onychotillomania were found in our search.Although NAC has proven successful for treatment of BFRB disorders, data is derived from few clinical trials and case reports assessing small numbers of patients. Larger studies with longer durations are needed to fully establish the efficacy of NAC in these disorders.

Body-focused repetitive behaviors (BFRBs) are recurrent behaviors targeting one or more body regions that may associate with negative outcomes. Little is known on their prevalence and correlates in...

Objective The aim of this study was to determine the prevalence of oral habits in eleven to twelve year old children in Trinidad and Tobago and to determine if there is any association with ethnicity and gender. Design Cross-sectional survey. Methods An epidemiological survey of 975 high school students (566 females (58.1%) and 409 males (41.9%)) was conducted. A questionnaire was developed to record information on the presence of oral habits. A clinical examination was also conducted at the school site. Statistical analysis was undertaken using Chi-square test and binary logistic regression. Results There was a high prevalence of oral habits. The overall prevalence of habits was 93%. 81.3% of children had a tongue thrust, 46.3% nail biting habit, and 34.9% digit sucking habit. Afro-Trinidadian subjects and female subjects were more likely to have habits with tongue sucking in particular exhibiting a female (OR 0.419 95%CI 0.285, 0.616) and Afro-Trinidadian ethnic (OR 0.559 95%Ci 0.433, 0.721) predilection. Conclusion The prevalence of oral habits in eleven and twelve year old children in Trinidad and Tobago is high, with higher prevalence in females and Afro-Trinidadians with tongue thrusting being most prevalent oral habit overall.

Background: The nail disorders comprise approximately 10% of all dermatological conditions. The nail unit may reflect dermatological disorder by its own and may show specific changes that are markers for a wide range of systemic disorders. Aims: To study the clinical spectrums of nail disorders including congenital, developmental, infectious, neoplastic, degenerative, dermatologic and systemic diseases affecting the nail unit. Materials and Methods: 200 consecutive cases with nail disorders attending to the Dermatology. Complete dermatologic and systemic examinations were carried out. Hematological investigations, including hemoglobin, total leukocyte count, differential leukocyte count and urine examination were carried out in all patients. Results: In this study, the involvement of nail was more common among males when compared to females. Onychomycosis was the commonest finding (27%) followed by psoriatic nail change (14.5%), Onycholysis (5.5%), Pitting (4.5%), Onychogryphosis (4.5%), Trachyonychia (4.5%), Chronic Paronychia (4.5%), Clubbing (4%), Subungual Warts (3.5%), Clubbing with resorption of terminal fingers (2.5%) and Ingrowing toe nail (2%). The other uncommon nail changes included Onychomadesis (1.5%), Pincer nail (1.5%), Onycholysis & pitting (1.5%), Nail discoloration (1.5%), Anonychia (1.5%), Half-and-Half nail (1.5%) Koilonychia (1.5%), Longitudinal Melanonychia (1.5%), Nail biting (1.5%), Worn down nail (1%), Transverse grooves (1%), Racket nail with clubbing (1%), Idiopathic total leuconychia (1%) and Beaus lines (1%). Also observed as single cases (0.5%) were Dorsal pterygium, Macrolunula, Longitudinal grooves, Dariers disease, Pachyonychia congenita, Acute Paronychia and Acrodermatitis continua of Hallopeau. Conclusion: Study has revealed onychomycosis, onycholysis, chronic paronychia, ingrowing toenail etc, as the common nail disorders. These conditions were associated with subclinical trauma. Nail biopsy in these patients may clarify this issue further.

Objective This study explored the boundaries of the proposed diagnostic criteria for nonsuicidal self-injury disorder (NSSID) as outlined in the Conditions for Further Study section of the Diagnostic and Statistical Manual, Fifth Edition. We sought to falsify the exclusion of certain NSSI behaviors from a diagnosis of NSSID (Criterion D), arguing that these exclusions are inconsistent with the broader phenomenology of the disorder outlined in the other criteria. METHOD: We describe three case studies involving NSSI (Case 1: scab-picking; Case 2: nail-biting; Case 3: tattooing) that cannot be diagnosed as NSSID because the behaviors are explicitly listed in Criterion D. Results Despite exclusion as a relevant NSSI behavior per Criterion D, each examined behavior is consistent with the intentionality, functionality, and distress/impairment of NSSID that represent core features of the disorder. Conclusion The case studies presented here suggest that Criterion D should be revised or removed from the NSSID criteria.

Objective This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB.Methods 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children’s personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245).Results For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule-breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes (‘adaptiveness,’ ‘high reward dependence,’ ‘low self-directedness,’ and ‘maldaptiveness’). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated highest tendency for problematic behavior irrespective of the frequency of NB.Conclusion Children with NB reported significantly more problematic behaviors compared to children without NB. Children with specific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accompanying personality profiles should be considered when assessing behavioral problems in children with NB.

In September 2019, the New York Times (NYT) published the article "Fighting the Shame of Skin Picking," which discussed the cosmetic, social and emotional impacts of body-focused repetitive behaviors (BFRBs). BFRBs, including excoriation disorder, trichotillomania, onychotillomania, and onychophagia, are recurring actions that damage one's physical appearance. The aim of this study is to characterize the demographic information provided and themes raised in the 166 comments posted in response to the article. The most commonly reported condition was skin picking (38.2%), followed by trichotillomania and/or trichophagia (30.3%), onychotillomania (24.7%), and onychophagia (23.6%). All conditions had a female predominance. Treatment of body-focused repetitive behaviors was the most common topic of discussion, followed by shame and impact on appearance. Since commenters described significant impairments to quality of life, larger randomized controlled trials on skin picking, trichotillomania, onychophagia, and onychotillomania are necessary to provide evidence-based management to patients.

Purpose Compelling evidence indicates that an addictive process might contribute to overeating/obesity. We hypothesize that this process consists of two components: (a) a sensory addiction to the taste, texture, and temperature of food, and (b) a motor addiction to the actions of eating (e.g., biting, chewing, crunching, sucking, swallowing). Previously, we reported a mobile health application (mHealth app) obesity intervention addressing the sensory addiction component, based on staged food withdrawal. We propose that the motor addiction component can be treated using cognitive behavioral therapy (CBT)-based strategies for body-focused repetitive behaviors (BRFB), e.g., nail biting, skin picking, and hair pulling. Methods The present study tested the effectiveness of CBT-based, BFRB therapies added to the staged withdrawal app. Thirty-five participants, ages 8–20, 51.4% females, mean zBMI 2.17, participated in a 4-month study using the app, followed by a 5-month extension without the app. Using staged withdrawal, participants withdrew from specific, self-identified, “problem” foods until cravings resolved; then from non-specific snacking; and lastly from excessive mealtime amounts. BFRB therapies utilized concurrently included: distractions, competing behaviors, triggers avoidance, relaxation methods, aversion techniques, and distress tolerance. Results Latent growth curve analysis determined that mean body weight and zBMI decreased significantly more than in a previous study that used only staged withdrawal (p Conclusions This study provides further preliminary evidence for the acceptability of an addiction model treatment of obesity in youth, and that the addition of CBT-based, BFRB therapies increased the effectiveness of staged food withdrawal. Level of evidence Level IV, Evidence obtained from multiple time series analysis with the intervention.

Psychological correlates of adult nail biting have received little empirical attention so far, despite its high prevalence and negative associations with physical and mental health. One possible correlate of nail biting is arousal modulation, which has also been linked to smoking (i.e., another oral behavior). Here, we link nail biting to an adaptive (i.e., Task-oriented) and two maladaptive stress-coping strategies (i.e., Emotion-oriented, Avoidance-oriented) as well as smoking while controlling for personality traits and socio-demographic characteristics. In all, 838 German-speaking adults ( Mage = 32.02, SD = 13.48; 431 women) completed measures of stress coping (CISS-SF), the Big Five personality traits (Mini-IPIP), and indicated nail biting and smoking behavior. In three theory-guided, hierarchical linear regressions we predicted each stress coping strategy by nail biting and smoking while controlling for personality and socio-demographic characteristics. Oral behaviors had differential effects on maladaptive stress coping strategies: The interaction between nail biting and smoking predicted Emotion-oriented coping, while smoking predicted Avoidance-oriented coping. Both behaviors were unrelated to adaptive, Task-oriented coping. In sum, our results show that nail biting and smoking are important predictors of maladaptive but not adaptive coping strategies, even when controlling for confounders.

Onychophagia (nail biting) and onychotillomania (nail picking) are chronic nail conditions categorized as body-focused repetitive behavior (BFRB) disorders. Due to a limited awareness of their clinical presentations, embarrassment on the part of patients, and/or comorbid psychiatric conditions, these conditions are frequently underrecognized and misdiagnosed. This article reviews the prevalence, etiology, diagnostic criteria, historical and physical exam findings, and treatment options for these conditions. The PubMed/MEDLINE database was searched for relevant articles. Onychophagia and onychotillomania are complex disorders necessitating a detailed patient history and physical examination and a multidisciplinary treatment approach for successful diagnosis and management. Due to the dearth of clinical trials for treatment of nail biting and nail picking, large clinical trials are necessary to establish standardized therapies.

The aim of the study was to compare the prevalence of parafunctions and signs and symptoms of TMD in a population group of children with and without ADHD.The study included all 5th grade children of all public primary schools in Sopot (untreated, unguided children). The reporting rate was 91%. At the first stage of the psychological-psychiatric study both parents and children filled in the CBCLand YSR questionnaires. At the next stage, in the group of children selected during the screening, aqualified child psychiatrist conducted asemi-structured diagnostic interview K-SADS-PLand diagnosed ADHD. Parafunctions, signs and symptoms of TMD were assessed by conducting a direct interview with a child and a clinical examination by a dentist.There were significant differences (p0.05) between children with ADHD and without ADHD associated with parafunctions such as chewing gum (76.47% vs. 46.07%), nail biting (70.59% vs. 40.45%) and bruxism (52.54% vs. 26.22%), the number of signs and symptoms of TMD (1 sign or symptom 0.0% vs. 32.21%; 4-7 signs or symptoms 17.65% vs. 3.75%).In children with ADHD, symptoms of temporomandibular joint disorders and parafunctions were significantly more frequent. These studies suggest that children with ADHD constitute agroup of increased risk for TMD in the future. Interdisciplinary treatment of an ADHD patient by a psychiatrist and a dentist is necessary.

Introdução: Bruxismo é definido como a actividade muscular repetitiva da mandibula caracterizada por duas manifestações distintas: Bruxismo do sono e Bruxismo de Vigília. A onicofagia, tal como o bruxismo, é um hábito relacionado com o stress. A onicofagia é uma condição crónica, repetitiva e compulsiva por natureza e constitui um problema de saúde pública, tanto em termos da sua frequência como do seu impacto na saúde em geral. Objectivos: Investigar uma possível relação entre a Onicofagia e o Bruxismo e compreender os factores descritos na literatura que podem estar associados à Onicofagia. Metodologia: Foi efectuada uma pesquisa na base de dados Pubmed usando as seguintes combinações: (((onychophagia) OR (nail biting)) AND ((bruxism) OR (dental health) OR (quality of life) OR (comorbidity))). Os critérios de exclusão foram artigos de revisão e artigos que não abordavam o tema em questão. A pesquisa identificou um total de 154 artigos e, após uma análise rigorosa, foram selecionados 19 artigos. Resultados: Vários estudos confirmam o impacto negativo da onicofagia nos sintomas de DTM. Foi também encontrada uma influência nos sintomas de ansiedade, stress e problemas psicológicos. A prevalência da onicofagia está dependente da faixa etária. Conclusão: A onicofagia e o bruxismo são condições crónicas, repetitivas e compulsivas por natureza e são relacionados com o stress. Nosso estudo não prova uma ligação directa entre a onicofagia e o bruxismo, mas a onicofagia é um hábito oral deletério prevalente nos bruxomános. Introduction: Bruxism is defined as repetitive muscular activity of the jaw characterized by two distinct manifestations: sleep and wakefulness bruxism. Onicophagia, like bruxism, is a stress-related habit. Onicophagia is a chronic, repetitive and compulsive condition by nature and constitutes a public health problem, both in terms of its frequency and its impact on general health. Objectives: To investigate a possible relationship between Onicofagia and Bruxism and to understand the factors described in the literature that may be associated with Onicofagia. Methodology: A Pubmed database search was performed using the following combinations: (((onychophagia) OR (nail biting)) AND ((bruxism) OR (dental health) OR (quality of life) OR (comorbidity))). Exclusion criteria were review articles and articles that did not address the topic at hand. The search identified a total of 154 articles, and after rigorous analysis, 19 articles were selected. Results: Several studies confirm the negative impact of onicofagia on TMD symptoms. An influence on symptoms of anxiety, stress and psychological problems was also found. The prevalence of onicofagia is age-dependent. Conclusion: Omnicophagia and bruxism are chronic, repetitive and compulsive conditions by nature and are stress-related. Our study does not prove a direct link between onychophagia and bruxism, but onychophagia is a prevalent deleterious oral habit in bruxomans.

Although onychophagia is a medical condition and is associated with poorer health, there are no guidelines for assessment or treatment. The purpose of this study was to investigate the clinical aspects of nail biting from doctors’ points of view, to estimate the prevalence of onychophagia among physicians, and to review the literature on and treatment methods for onychophagia. Twenty-four percent of doctors reported nail-biting periods during their lifetimes, and 2% of them remained active nail biters. A total of 64.4% of doctors see nail biting in their practices, and 60.6% never or only on request ask patients about nail biting and examine their nails. Family doctors and pediatricians ask their patients about nail biting most often. Attitudes and opinions on the treatment of nail biting are undefined and vary. Doctors reported usually treating nail-biting patients by referring them to another specialist or offering special nail polish. There is a need to improve physicians’ knowledge of nail-biting treatment methods, but a lack of studies evaluating the clinical aspects of onychophagia and its relation to mental health and emotion dysregulation. Further research is needed. Clinical attitudes toward nail biting could be more precise in training and medical practice.

Onychophagia and onychotillomania are common forms of nail-biting and nail-picking disorders, but there is insufficient literature documenting their comparison and coexistence. In fact, overlapping features can be involved in different nail self-injuries, and significant variations also exist. We conducted a retrospective study aimed at identifying differences between onychophagia and onychotillomania, and providing more detailed findings of both conditions.

CASE Onychophagia, or nail-biting, is a common habit seen in both children and adults. Harmful effects include oral exposure to a variety of pathogens and concomitant damage to dentition and fingers. This report focuses on the most severe reported case of recurrent osteomyelitis of the bilateral hands with destructive changes secondary to onychophagia. CONCLUSION Successful treatment relies on a multidisciplinary approach which in this case included surgical management and counseling on cessation, with referrals to other providers to address underlying psychiatric and/or psychologic conditions that may predispose to this compulsion.

Background: Nail biting can increase the risk of infection and abnormal-looking nails. The purpose of the present investigation was to formulate and evaluate anti-nail-biting lacquers consisting of bitter herbal extracts. Methods: The hydroalcoholic extracts obtained from Andrographis paniculata and Tinospora crispa were determined for phytochemical constituents, total phenolic contents, antioxidant activities, anti-inflammatory activities, and cytotoxicities. Anti-nail-biting lacquers were prepared by using herbal extracts (bittering agent), shellac (film forming polymer), ethanol (volatile solvent), and other indispensable additives with continuous stirring. Thus, attempts to enhance the film property and bitterness is accomplished by using polyvinylpyrrolidone K30 as a copolymer and varying concentrations of herbal extracts. Good accepted formulations were established for drying time, pH, viscosity, smoothness of film, film strength, water resistant, and solubility in simulated saliva and then evaluated their bitterness in human volunteers.Results: Phytochemical constituents including tannins, glycosides, reducing sugars, alkaloids, terpenoids, and flavonoids were found present in both extracts while saponins was only detected in A. paniculata extract. Although T. crispa extract exhibited a significantly higher (p < 0.05) total phenolic content and antioxidant activity than A. paniculata extract, it showed lower protein denaturation inhibition property than A. paniculata extract. Because of the potentials of both extracts without cytotoxicity, anti-nail-biting lacquers containing either A. paniculata extract or T. crispa extract were developed and evaluated. Drying time of formulations were 6-11 min with visually seen glossiness of formulation. Formulations of the nail lacquer showed good pH, viscosity, smoothness of film, film strength, water resistant, and solubility in simulated saliva. The formulations displaying no significant cytotoxicity effect on CRL-2076 cells were assessed on healthy human volunteers to compare bitterness and film characteristics. Conclusion: The optimized formulation containing A. paniculata extract could successfully achieve good film forming property and bitterness release which is considered promising for stopping nail biting.

ObjectiveTo evaluate the prevalence of nail biting in child and adolescent outpatients at a single institution and the chronological relationship between nail biting and tics in patients with Tourette syndrome (TS) with or without attention-deficit hyperactivity disorder (ADHD).DesignRetrospective observational study.SettingTeaching hospital in Taiwan.ParticipantsAll participants were aged 4–18 years, including 535 patients with TS, 230 patients with provisional tic disorder and 1460 patients without neurological or psychiatric disorders (controls).Outcome measuresPresence of nail biting, starting age for nail biting and starting age for motor and/or vocal tics.ResultsNail biting was more commonly observed in patients with TS (56.6%) than in patients with provisional tic disorder (27.4%) or controls (15.0%), regardless of sex (all pConclusionNail biting was more prevalent and occurred earlier than tics in patients with TS, regardless of ADHD status, in the study population.