Nail biting (NB) is a common, but unresolved, problem in psychiatry, psychology, medicine and dentistry. While it seems that NB is a simple behavior that can be stopped easily, many of the children with NB have already tried to stop it, but they have not been successful. The frustrations due to failed attempt involve others such as parents and siblings. The present review aims at providing an overview of prevalence, comorbidities, education and counseling, and management for NB. Overall, the reviewed literatures suggest that comorbidities of psychiatric disorders and other stereotypic behaviors in clinical sample of children with NB is more than 80%, and more than half of the parents suffer from psychiatric disorders mainly depression. Treatment of NB, however, is not as easy as it seems. The management of NB is much more complicated than just focusing on stopping it. Nail biting cannot be managed without considering its co-morbidities, antecedents and consequences. It might be concluded form the reviewed literature that children with NB, parents, siblings, and teachers should be educated about what to do and what not to do about NB. Punishment is not effective. Moreover, clinical randomized controlled trials are required to make available evidence-based behavioral and pharmacologic treatment protocols.

Background and Purpose: Chewing nails is one of the most common behavioral problems in childhood that can be caused by anxiety and stress. The purpose of the present study was to investigate the effect of art therapy (storytelling, photography and painting) based on cognitive behavioral therapy in treating a 7-year-old girl who had this disorder.Method: This study was an experimental single case study by using multiple-baselines. The intervention program was conducted in 10 sessions with a follow-up of six weeks. The instruments used in this study were clinical interview, observation, parenting styles questionnaire (Baumrind, 1991) and Goodenough–Harris draw-a-person test (DAP) (Goodenough- Harris, 1963). The research design was a single-case experimental multi-line method. Chart and drawing analysis were used to analyze the data.Results: The results of the study showed that the effect of art therapy (storytelling, photography and painting) based on cognitive-behavioral approach on nail-biting is clinically meaningful. (P>0.05).Conclusion: The results showed that art therapy (storytelling, photography and painting) based on cognitive-behavioral approach is effective in reducing nail-biting disorders. Also the person after receiving the treatment, in addition to reducing the factors related to nail chewing, also improved in other areas such as interpersonal and social behaviors. Therefore, it is suggested to researchers that an integrated model based on the findings of this research be developed for the treatment of nail biting.

Onchyophagia or nail biting is the performance of repetitive actions of biting one’ s nails often to the level of mutilation of the nail beds. It is a compulsive act most often seen in adolescents but may continue into adulthood, leading to deleterious consequences. Often spurred by anxiety and stress, this oral habit is not so readily addressed by patients and in turn not very much treated by dentists or physicians. This case report describes successful treatment of an adolescent patient with a nail biting habit, with an innovative intraoral fixed habit-breaker appliance.

Background and Purpose: Nail biting is a common behavior in children that may be connected to some environmental factors like parental problems or parenting styles. The purpose of this study was to compare marital satisfaction, parenting style, and attachment style in parents of children with and without nail biting. Method: This research was a descriptive cross-sectional study. The population consisted of all pre-school and primary school students with nail biting behaviors in Shiraz in 2015. To select a sample (284 parents), 10 schools were selected from each area of Shiraz by cluster sampling and then 40 pre-school and primary school students were selected from each school by convenience sampling. Afterwards, their parents were asked to complete ENRICH Marital Satisfaction Scale (Olson, 1989), Baumrind's Parenting Styles Questionnaire (Baumrind, 1972), and Revised Adult Attachment Scale (Collins & Read, 1996). Data were analyzed by T-tests and Multivariate Analysis of Variance (MANOVA) by using SPSS Version 24 Software. Results: Results demonstrated that there was no significant difference between mothers of the nail biting and control groups in terms of marital satisfaction, parenting style, and attachment style at P>0. 05. Also, no such a difference was found between the fathers. Conclusion: Based on the results of this study, it can be suggested that nail biting behavior may be directly or indirectly influenced by some variables that deserve further investigations.

Introduction: Thumb sucking and nail biting are among the disorders that can indicate child has need to confidence and security and have somatic and psychological consequences. Identification of factors related to these disorders is important. The aim of this research is identifying a relation between feeding and oral habits.Methods: This descriptive- analytic study performed on 200 preschool children (100 cases- 100 controls) in Isfahan, Iran. The tools of research were self-developed questionnaire and clinical interview according to DSM IV TR. Data were analyzed by using SPSS software.Results: The findings indicated that factors such as duration of feeding, breast or bottle feeding, use of pacifier are not related to oral habits. But the age at which child is stopped sucking mothers milk is important (P=0.01).Discussion: Appropriate feeding is a response to oral needs of children. If this need does not response completely, some form of oral habits appeared.

AbstractBackground: Onychophagia, commonly known as nail biting, is considered a compulsive behavioral disorder primarily observed in children and adolescents. Nail biting behavior leads to an increased presence of various opportunistic microorganisms in the oral cavity. This study aimed to investigate the association between nail biting and mental health in children aged 10 to 16 years. It further compares the load of Enterobacteriaceae in nail-biters and non-nail biters.Methods: A case control study was conducted on 50 nail biters (cases) and 50 non-nail biters (controls). Data were collected by using convenient sampling technique from school going students aged 10 to 16 years, using pre-designed and self-administered questionnaires, the Massachusetts General Hospital-Nail Biting Questionnaire (MGH-NBQ) and the Strengths and Difficulties Questionnaire (SDQ) as well as saliva samples taken and tested for bacterial growth. All ethical issues were taken into consideration. SPSS v23 was used to analyze the data using descriptive statistics to calculate the mean and standard deviation. The independent t test was used to compare mean SDQ scores between nail biters and non-nail biters. P-values<0.05 were considered statistically significant.Results: Among the 50 cases, 44 (88.0%) of the students had positive Enterobacteriaceae growth, while 13 (26.0%) of thecontrols did not. Nail biters had considerably higher mean scores for emotional symptoms, conduct problems, hyperactivity, and peer problems than non-nail biters (P value<0.001). All of the SDQ domains and nail biting were found to have a statistically significant (P=0.05) association.Conclusion: The study highlights the persistent and burdensome nature of nail biting, which poses risks in terms of disease transmission. Additionally, nail biting has been associated with various behavioural and emotional disorders. Awareness of the harmful consequences of nail biting, along with appropriate preventive and treatment approaches, can assist young individuals in discontinuing this habit.

Oral habits are learned patterns of muscle contraction and have a very complex nature. They are associated with anger, hunger, sleep, tooth eruption, and fear. Some children even display oral habits for release of mental tension. These habits might be nonnutritive sucking (thumb, finger, pacifier and or tongue), lip biting, nail biting and bruxing events. As these habits can result in damage to dentoalveolar system, hence, dentists play a crucial role in giving necessary information to parents. This information includes relevant changes in the dentoalveolar system and the methods to stop oral habits. Also, a dentist is required to treat the ensuing malocclusion.

Introduction: Nail biting is an inappropriate habit and its exact cause is debatable. Researchers believe that nail biting disorder is often associated with psychiatric disorders, including anxiety. State/trait anxiety can be considered an unstable emotional state reflecting the individual's interpretation of a stressful situation in a particular time frame and varies depending on the degree to which the situation is perceived threatening. This study aims to determine the evaluation of the effectiveness of habit reversal techniques on reducing nail biting disorder and state/trait anxiety in students. Methods: The present semi-experimental study with pretest, post-test, and follow-up was conducted on six junior high school male students in the age range of 13-15 years, who asked for help by referring to the school counseling and were selected by convenience sampling method. They received a program of habit reversal techniques individually in 6 sessions for 1 month. Clinical interviewing, frequency recording of nail biting per day, and state/trait anxiety test were used to measure the variables. Results: Data analysis showed that habit reversal techniques reduce nail biting and students' state/trait anxiety. Follow-up one month after the end of treatment indicated the persistence of these results. Conclusion: The habit reversal training is effective on treating nail biting, reducing anxiety, and promoting the person life quality and symptoms from nail biting. Due the low sample size, it is suggested that while repeating the study in a larger sample, its effectiveness on the treatment of other habitual disorders be studied.