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Kevin E. Hardy, DDS, MBA Hudec Dental, Cleveland, Ohio This is a common habit among both children and adults. Nail and/or finger biting is unsightly, damages the nails, causes infection, and if nothing else, is annoying to others. Long-term engagement in this habit can also damage the teeth and jaw joint. Young children will develop a gap between the front teeth, requiring future orthodontic correction. This habit can also stretch the muscles in the jaw, resulting in pain and an imbalanced joint, which could require treatment for TMJ (Temporomandibular Joint Syndrome). Finger and nail biting can extend to picking at the gums. The most severe consequence would be gingivitis, a severe infectious situation. Conscious finger-biters hide their habit well, but it is usually an unconscious habit. Either way, it is difficult to break the cycle. The causes are not definitive, but stress, nervousness, hunger (dieters often develop the habit), boredom, or inactivity are the usual suspects. More rarely it is part of an emotional illness. It is practiced more among boys than girls, and the famous are just as susceptible, including Tom Cruise and Bruce Springsteen. TREATMENT and RECOMMENDATIONS Every dentist or physician has a few favorite treatments ranging from the simple to the involved: • Keep a Journal For children: Keep a journal of the days, times, and circumstances the child is observed biting fingers or nails. Begin to break the cycle by intervening but also marking habit-free days with stars on a calendar. Decide in advance a number of habit-free days that will merit a reward. Gradually extend the time between rewards. For adults: A journal helps determine the circumstances that trigger finger-biting episodes. Understanding the underlying conditions for the habit is the first step to controlling the habit. • Simple physical reminders placed on a finger such as a bandage, bow, rubber band, or piece of colored tape. • Practice calming, stress relieving activities aimed at minimizing anxiety: Breathe deeply, drink chamomile tea, take a walk, and meditate (just a few minutes is sufficient, even at a work station). • Regular, professional manicures are a safe method to break the finger-biting habit, particularly for women. One tends to pause before destroying a $40+ investment. • Surface application of a bitter substance such as soaking fingers in a slurry solution of alum powder and water, or rub aloe vera gel on fingers. Lemon juice or pepper are often suggested but are usually too weak or too hot. Check the nail care aisle in local stores for others. • Improve sitting posture. Sitting up straight tends to keep hands away from the face. This simple technique is surprisingly effective. Slumping in a chair leads to the elbows being supported by a table or stomach/chest. Remove the support and the hands move away from the face. See your dentist at the first sign of oral pathology arising from this habit. Early intervention prevents more serious problems, but the very act of recognizing the need for assistance is a motivation factor in breaking the cycle.
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