```*Onychophagia*``` is the clinical name for fingernail biting which is a parafunctional activity of the mouth! It is the common act of using the mouth for other purpose than eating, drinking and talking. Many people who engage in this act started from childhood and it is often carried over to the adolescence stage and still prevalent in adulthood. Nail biting include biting the nail, the cuticle, and tissue around the nail.

WHY DO I BITE MY NAILS?

According to Researchers, nail biting has the following causes:
1. Boredom; It becomes a go-to behavior to keep oneself occupied when one is waiting around, absolutely bored and idle.
2. Concentration: At the starting stage of this habit, nail biting is not a conscious choice rather sometimes caused by absentminded tendency. One might might not be aware of biting his/her nails while trying to work out a problem.
3. Some researchers believe that nail biting is caused by a delay or dysfunction in the oral stage of psychological development.
4. Although it’s not proven, but researchers believe that there may be a genetic component cause of Onychophagia!
5. Finally, nail biting can be associated with mental health conditions but it doesn’t mean you have a psychological disorder once you are a nail biter.
Some of the mental health disorders includes:
A. Major Depressive Disorder (MDD)~A mental health disorder that is characterised by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.
B. obsessive-compulsive disorder (OCD)~Excessive thoughts or obsessions that leads to repetitive behaviours.

*SIDE EFFECTS AND RISKS OF ONYCHOPHAGIA*

One of the major side effects of nail biting is often unrecognized by the unsuspecting nail biting addicts. According to an article in Dermnetnz, nail biting results to dysmorphia. If left untreated, severe onychophagia can lead to dysmorphic dental problems, including:

-Malocclusion (imperfect positioning) of the front teeth.
-Crowding, attrition and rotation of the teeth noted on X-rays.
-Attrition of the incisional edge of the mandibular incisors (lower front teeth).
-Protrusion of the maxillary incisors (upper front teeth).
-Dental resorption( loss of a part or parts of a tooth). Tooth resorption can lead to infections, crooked teeth, tooth loss, and other dental problems that can cause lasting damage to your teeth, gums, and jaw.

These problems can affect the individual’s physical appearance which can only be avoided if the nail-biting habit is broken early.

Again, nail biting causes soreness of the nails and surrounding skin.

Other side effects includes;

1. Abnormal-looking nails, fungal infections of the nail plate and surrounding skin illness due to passing bacteria and viruses from your fingers to your face and mouth.
2. Temporomandibular joint pain and dysfunction.
3. Negative social impact such as social withdrawal and avoiding handshakes.
4. *Attention deficit hyperactivity disorder (ADHD)*: Hyperactivity and impulsiveness as well as difficulty paying attention. (Although this is a major cause and side effect, it does not apply to all nail biters).
5. *Oppositional Defiant Disorder(ODD)*: Defiance and disobedience toward people of authority (Does not apply to all nail biters).

Furthermore, habits like swallowing bitten-off nails increases the risk of stomach and intestinal infections.

TREATMENT OF ONYCHOPHAGIA

1. According to Wikipedia,
“The most common treatment, which is cheap and widely available, is to apply a clear, bitter-tasting nail polish to the nails” One example of such nail polish is _denatonium benzoate_-the most bitter chemical compound known. The reason behind its use is that the bitter flavor discourages the nail-biting habit.
2. One can quit nail biting by making gradual changes. Start by choosing one finger that you will not put in your mouth. Stick with that one finger until it the nail begins to look healthier. Then choose another finger and continue on as long as it takes until you are reach down to a single finger. Then, slowly quit the last finger until you completely break the habit.
3. An article in healthline website suggested that one can try covering the nails by wearing hand gloves(clothe gloves) throughout the day time and remove only when sleeping.
4. Trim your nails often to avoid being tempted to use your mouth because as we know long nails may be hard to resist. So keeping them trimmed is a good idea. Set a particular day and reminder every week for your trim.
5. Cognitive behavioral therapy (CBT): In cognitive behavioral therapy (CBT), a therapist will help you identify unhelpful behavior patterns and replace them with different behaviors.

*TAKEAWAY*:
Nail biting is a common habit that we often overlook as we think it doesn’t have a damage to our health but it is very harmful. It is a repetitive behavior that ranges from mild to severe. Therefore, one who values his/her health should apply all it takes to break this habit. Most importantly, Medical Professionals who are nail biters are often exposed to different microbes that are highly detrimental to their health. One crucial example is a Laboratory scientist who stays in the Lab often filled with different specimens; in the case where such a person fails to break the habit of nail biting, his/her chances of contacting diseases from patients is highly likely. Summarily, quit nail biting today and grow a healthy nails and life!

Written by: Ogbuanya victor Onyedikachi
(Medical Student)

Sourced from: https://www.healthline.com/health/why-do-people-bite-their-nails ; https://dermnetnz.org/topics/onychophagia ; https://health.clevelandclinic.org/nail-biting-when-does-it-go-too-far/amp/ ; https://en.m.wikipedia.org/wiki/Nail_biting ; https://www.npr.org/sections/health-shots/2012/10/01/161766321/nail-biting-mental-disorder-or-just-a-bad-habit ; https://www.sciencedirect.com/science/article/pii/S235264752030143X