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How can you help patients who bite their nails?

Onychophagia, as we know it, may provide temporary comfort to patients when they feel stressed, nervous, or bored, but the habit does a lot more damage than they know. As their dentists, we need to help them stop biting their nails. Here are a few instances of nail biting gone bad that we can share with our patients to convince them to stop.

Exposure to bacteria

Pooria Shahin, DDS.

We have to help our patients understand that anytime they use their hands, they risk being exposed to different kinds of bacteria. Even when they wash with soap, some of those germs will remain underneath the fingernails. Biting their nails inevitably passes the germs from their hands to their teeth, tongue, and gums, leading to the spread of bacteria in the mouth.

A study published in the Journal of Oral and Maxillofacial Pathology (May 2013, Vol. 17:2, pp. 163-168) found that individuals with nail-biting habits had a higher carriage of Enterobacteriaceae than those who didn’t bit their nails. The findings tell us that nail biting paves the way for the growth of bacteria, which can affect patients’ teeth. In addition, nail biting also promotes digestive problems when people ingest bits of their fingernails and the bacteria thriving on them.

Nail biting can damage gums

Nail biting typically produces nails with sharper and more-jagged edges. With the removal of the soft, rounded edge that usually forms after nails are properly trimmed, people with onychophagia have a greater chance of accidentally scratching their gums. And with an open wound exposed to countless thriving bacteria, having an infection is no longer a surprise.

The European Journal of Dentistry (April 2009, Vol. 3:2, pp. 150-154) published a case of gingival injury in a 14-year-old girl caused by her fingernail scratching habit. The girl was admitted to a periodontology clinic where she received surgical periodontal treatment as well as oral hygiene instruction and psychological support. With a one-year follow-up, the case study showed the possibility of treating gingival injury in a person with a destructive nail-biting habit. Maintaining periodontal health is highly achievable through regular follow-up teamed with patient compliance and psychological support . . .

Read full article here . . .

 

Probiotics aid oral health: When the goal is to reduce antibiotics

The Centers for Disease Control and Prevention es­timate that up to 50% of antibiotics are unnecessary or inappropriately prescribed.(3) From 1996 to 2013, dental prescribing increased by 62.2%, and its proportionate contribution increased from 6.7% to 11.3% of all antibiotic prescriptions. The rate of prescribing increased most for dental patients aged 60 years or older, in regard to:

  • Unnecessary prescriptions for periapical abscesses and irreversible pulpitis
  • Increased prescribing associated with dental implants and their complications
  • Slow adoption of guidelines calling for less perioperative antibiotic coverage for patients with valvular heart disease and prosthetic joints
  • Emphasis on cosmetic practices reducing the surgical skill set of average dentists
  • Underinsured practices driving antibiotics to be a substitute for surgery
  • The aging population
  • The fact that there are now more dental providers per capita(4)

It is advisable that antibiotic prescribing should be reviewed regularly to make sure that they are compliant with the most recent evidenced-based guidelines.

In addition, with all antibiotics, it is important to take probiotics along with them in order to replenish the good bacteria that may have been killed off during the treatment with antibiotics . . .

Researchers have discovered that probiotics create a film in the mouth that acts as a protective sheath for oral tissues and prevent diseases connected with gums and teeth. The space used by bad bacteria is occupied by probiotics, which thus restricts the multiplication of these bacteria. Consequently, the bad bacteria are replaced by good bacteria, which prevent contributions to oral health problems.

From cavities to bad breath and periodontitis, all of your oral problems have their roots with undesirable bacteria building up in your oral cavity. By introducing good bacteria in the mouth through probiotic supplements, the amount of harmful bacteria is significantly reduced, which improves the health of the mouth environment.(8)

Probiotic products are considered an element of healthy life. Oral administration of probiotics is a safe and effective and may reduce the need for antibiotics. There’s no recommended daily dose of probiotics, but research suggests aiming for 1 billion to 10 billion live bacteria cultures (measured in Colony Forming Units, or CFUs). Since bacteria counts are rarely found on food labels, focus instead on eating a serving of a probiotic-rich food every day . . .

Read full article here . . .

 

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