Medical Edge Newspaper Column

Treatments Available To Control Teeth-Grinding

Sept. 4, 2006
DEAR MAYO CLINIC:
Can anxiety cause teeth-grinding and mouth irritation? -- Fort Wayne, Ind.

ANSWER:
Stress and anxiety are associated with bruxism, the medical term for teeth-grinding. When stress or anxiety levels climb, some people clench their jaws and grind their teeth, even without realizing it.

That's a little different from saying stress causes teeth-grinding. We do not know the exact causes of teeth-grinding, which can occur during the day or during sleep. In addition to psychological factors, it is thought that malocclusion of the teeth (when the top and bottom teeth don't fit together properly), ongoing jaw pain and temporomandibular joint disorders, some neurological conditions and some medications can cause bruxism.

We do know that teeth-grinding causes problems. It can make teeth sore; cause dull, achy jaw pain; and damage teeth beyond what you'd expect from normal age-related wear.

Bruxism can be difficult to cure, but several treatments are available.

A mouth guard at night can minimize the tooth damage. Your dentist can build one customized for your mouth. Tooth guards available at retail stores could help too, but might not be as comfortable.

Cognitive behavior therapy taught by a psychologist could help you better manage the stress and minimize the grinding.

Behavior modification techniques can also help break the daytime grinding habit. You can use notes or other visual cues at home, work or in the car to remind yourself to relax the jaw, and keep upper and lower teeth separate.

Medications can be used to treat sleep-related bruxism that causes pain. They include the benzodiazepine drug clonazepam (Klonopin) and others, and tricyclic antidepressants such as nortriptyline (Aventyl, Pamelor) and others.

Talk to your dentist if you are bothered by teeth-grinding. Symptoms can range from a minor concern to a major problem if you are experiencing significant pain or if your teeth are cracking or chipping.

-- Sreenivas Koka, D.D.S., Ph.D., Prosthodontics, Mayo Clinic, Rochester, Minn.