Revista de Odontologia da UNESP
Revista de Odontologia da UNESP
Original Article

Lesão severa causada por onicofagia

Severe lesion caused by onychophagia

Regis, R.R.; Souza, R.F.; Paranhos, H.F.O.

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O presente trabalho tem por objetivo descrever uma lesão severa decorrente da onicofagia, bem como apresentar uma breve revisão de literatura sobre esse hábito. Um paciente adulto, ao se apresentar para consulta odontológica de manutenção, descreveu que havia provocado uma lesão ungueal no polegar esquerdo. Sua unha possuía um aspecto irregular, de espessura reduzida, com uma depressão na lúnula e uma petéquia visível sob a lesão. Após relatar exacerbação de seus hábitos parafuncionais, tornou-se evidente a associação do hábito de roer unhas com a lesão. Foi planejada uma etapa de aconselhamento, na qual se buscou orientar o paciente, recomendando-se que evitasse roer as unhas e remover o epitélio circundante. Depois de um período de aproximadamente dois meses, a lesão havia regredido como conseqüência do crescimento ungueal.


Hábito de roer unhas, estresse psicológico, automutilação


The aim of this study was to describe a severe lesion associated with onychophagia and to present a brief literature review comprising this habit. An adult male patient undergoing a maintenance dental appointment had reported the development of a nail lesion on the left toe. The nail presented an uneven surface, with reduced thickness, a depression over the lunula and a red spot. After reporting exacerbation of parafunctional habits, the association of those habits and the lesion was evident. A counseling procedure was carried out, in order to avoid nail biting and picking by the patient. Following a two months period, the lesion had disappeared as a consequence of nail growth.


Nail biting, psychological stress, self mutilation


1. Miltenberger RG, Fuqua RW, Woods DW. Applying behavior analysis to clinical problems: review and analysis of habit reversal. J Appl Behav Anal. 1998;31:447-69.

2. Leung AK, Robson WL. Nailbiting. Clin Pediatr. 1990;29:690-2.

3. Schneider PE, Peterson J. Oral habits: considerations in management. Pediatr Clin North Am. 1982;29:523-46.

4. Ballinger BR. The prevalence of nail biting in normal and abnormal populations. Br J Psychiatry. 1970;117(539):445-6.

5. Weinlander MM, Lee SH. Suicidal age and childhood onychophagia among neurotic veterans. J Clin Psychol. 1978;34:31-2.

6. Walker BA, Ziskind E. Relationship of nail biting to sociopathy. J Nerv Ment Dis. 1977;164(1):64-5.

7. Hodges ED, Allen K, Durham T. Nail-biting and foreign body embedment: a review and case report. Pediatr Dent. 1994;16:236-8.

8. Mutz B, Sturmer D. Is stress higher in nail biters?: An examination of survey data. Soc Work Res. 2005;25:1-15. Available from: 9 Wells JH, Haines J, Williams CL. Severe morbid onychophagia: the classification as self-mutilation and a proposed model of maintenance. Aust N Z J Psychiatry. 1998; 32:534-45.

10. Leonard HL, Lenane MC, Swedo SE, Rettew DC, Rapoport JL. A double-blind comparison of clomipramine and desipramine treatment of severe onychophagia (nail biting). Arch Gen Psychiatry. 1991;48:821-7.

11. Silber KP, Haynes CE. Treating nailbinting: a comparative analysis of mild aversion and competing response therapies. Behav Res Ther. 1992;30(1):15-22.

12. Waldman BA, Frieden IJ. Osteomyelitis caused by nailbiting. Pediatr Dermatol. 1990;7:189-90.

13. Farsi NM. Symptoms and signs of temporomandibular disorders and oral parafunctions among Saudi children. J Oral Rehabil. 2003;30:1200-8.

14. Odenrick L, Brattström V. Nailbiting: frequency and association with root resorption during ortodontic treatment. Br J Orthod; 1985;12:78-81.

15. Greene PR. An unusual self-inflicted gingival injury. Br Dent J. 1994;177:23-4.

16. Miyake R, Ohkubo R, Takehara J, Morita M. Oral parafunctions and association with symptoms of temporomandibular disorders in Japanese university students. J Oral Rehabil. 2004;31:518-23.

17. Winocur E, Littner D, Adams I, Gavish A. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescents: a gender comparison. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:482-7.

18. Santos ECA. Avaliação clínica de sinais e sintomas da disfunção temporomandibular em crianças. Rev Dental Press Ortodon Ortop Facial. 2006;11:29-34.

19. Sari S, Sonmez H. Investigation of the relationship between oral parafunctions and temporomandibular joint dysfunction in Turkish children with mixed and permanent dentition. J Oral Rehabil. 2002;29:108-12.

20. Koo J, Gambla C. Psychopharmacology for dermatologic patients. Dermatol Clin. 1996;14:509-23.

21. Inglese M, Haley HR, Elewski BE. Onychotillomania: 2 case reports. Cutis. 2004;73:171-4.

22. Koo JY, Smith LL. Obsessive-compulsive disorders in the pediatric dermatology practice. Pediatr Dermatol. 1991;8:107-13.

23. Stein DJ, Hollander E. Dermatology and conditions related to obsessive-compulsive disorder. J Am Acad Dermatol. 1992;26:237-42.

24. Moldavsky M, Lev D, Lerman-Sagie T. Behavioral phenotypes of genetic syndromes: a reference guide for psychiatrics. J Am Acad Child Adolesc Psychiatry. 2001;40:749-61.

25. Serdlow NR. Obsessive-compulsive disorder and tic syndromes. Med Clin North Am. 2001;85:735-55.

26. Tosti A, Piraccini BM. Treatment of common nail disorders. Dermatol Clin. 2000; 18:339-48.

27. Deardoff PA, Finch AJ Jr, Royall LR. Manifest anxiety and nail-biting. J Clin Psychol. 1974;30:378.
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