Abstract
Background: 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 the
controls 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.