Finger sucking & nail biting as oral habits
An oral habit is any repetitive or stereotypic behaviour which utilizes the mouth. It is a reflection of growth and maturing of structures in the mouth. There are numerous habits that fall under this category such as NAIL BITING, FINGER/DIGIT SUCKING, DIGIT SUCKING, TONGUE THRUSTING, LIP SUCKING, ARM SUCKING, BRUXISM. But of all these, the COMMONEST is digit sucking which is the placement of the thumb or one or more fingers in varying depths in the mouth. It is a normal and a necessary stage in the physical development of a child.
It is an adaptation mechanism which occur within a certain age group (less than 4years), it becomes detrimental to the mouth structures beyond the age when the permanent teeth begins to erupt. They occur in 90% of normal developing infants within 2hrs of birth. 100% of children within the 1st year of life indulge in oral habits. It becomes a mild to moderate health risk after 4yrs of age.
About 3 out of every 10 kids from ages 7 to 10 years suck their fingers or bite their nails and also 45% of teenagers have these oral habits. People often gnaw their nails or suck their fingers to actually cool off stress and when boredom come knocking, they consciously or unconsciously start some of these oral habits.
Finger sucking & nail biting
They are the commonest oral habits that affect people of all ages, commoner among children in high socioeconomic group whether they are done simultaneously consciously or subconsciously. When I was a little boy, each time I tried to bite my nails or suck my fingers, my mum would scream ‘stop that, it is bad, are you hungry? So, over time I asked myself what is the big deal about finger sucking? When we were in pry school, our teacher used to say it is bad because the fingers and long nails when dirty, harbour infectious organisms. In fact, they waged war against keeping long nails but no one ever told us the effect of nail biting and finger sucking on the teeth probably because they didn’t know about that.
Many in the time past have proposed theories on why people suck their fingers or bite their nails like food, but mostly it is believed that it often stems from loneliness, stress or just as a form of newly acquired habit.
The habit of nail biting is often a way to ease anxiety as it keeps at least one part of the body busy while the mind lacks interest. Anger, frustration, hunger, boredom and loneliness can also be seen as added emotional triggers. Nail biting is also believed to be one of the symptoms of obsessive compulsive disorder (OCD) – a psychological condition.
One may argue that there is no big deal about that. Generally, the duration, the frequency and the intensity of indulgence in this habit determine the dental effects in the long run.
However, studies have shown that fingers sucking and nail biting have fairly severe deleterious effects on the dentition and overall oral health of those who engage in the habit.
EFFECTS OF NAIL BITING & FINGER BITING ON THE TEETH
- Prolong oral habits affect the child’s personality with every tendency to emotional liability.
- Oral habits often lead to other habits such as head rolling, temper tantrum, hair pulling, bedwetting etc.
- Increased accidental poison
- Psychosocial problem
- Interference with selected aspects of speech production
- The finger(s) can become deformed
- Chronic finger infection-Herpetic Whitlow
- Mouth breathing
- Teeth malalignment …upper teeth can become flared ,lower teeth pushed backwards, upper and lower teeth not in proper contact
- Nail biting can also lead to bruxism-unintentional grinding or clenching of teeth that can cause wearing down of the teeth enamel, facial pain, headaches, tooth sensitivity etc.
- The spread of bacteria from other body parts to the mouth and from mouth to the nail bed or blood stream.
MEASURES THAT CAN BE TAKEN TO STOP FINGER SUCKING & NAIL BITING
N.B. Treatment consideration are usually delayed until after 4yrs. Treatment should not be done until its potential risks outweighs its potential benefits. This is rarely occur before age 4yrs.
CONSULT YOUR DENTIST IF;
There is presence of a dental problem related to finger sucking
There is digit deformity from high intensive sucking
There is infection or bone damage to the fingers
The habit is affecting the child concentration i.e. psychosocial problem
There is associated habit e.g. bedwetting, hair pulling
There is excessive reaction from the parent
The patient specifically ask for assistance
Both the parent and the child will be properly counselled to know the reason why the habit must be stopped. This is usually done by explaining the adverse effect to them in details. It may be necessary to take photographs of the child to explain. Children should be encouraged not forced to stop the habit. The greater the involvement of the parent and child the more successful the outcome.
- Reward can be –extra cuddle, playing new game together, special activities or trips, giving gifts e.g. toys, special meal etc. NB: Special meal must be sugar free.Keeping records of habit free-day and give a reward
- Reminder – Adhesive bandage, Cotton glove, Fingernail polish-It has bitter taste , Arm wraps, Flavored substance applied to the thumb
- Appliance – If all other methods have failed, especially in those who are more reluctant to let go of the habit, an introduction of appliance to be placed in the mouth may be necessary.This serves as the most effective deterrent. The consent of the child must be sought
- In conclusion
Abnormal oral habits typically interfere with normal facial development.The longer a habit is practiced, the harder it is to break. Duration, frequency and intensity play important roles in the permanency of the damage seen. When considering treatment, we must make sure the child wants to break the habit. Placing fixed appliances should be the last resort for habit cessation