Breaking the Teeth — Grinding Habit

Thursday, September 22, 2005

ROCHESTER, Minn. — Are you a teeth grinder?

Bruxism, the medical term for grinding, gnashing or clenching your teeth, is an occasional problem of little consequence for most people. But for others, it's a real problem causing discomfort or tooth damage.

Bruxism can occur during the day or during sleep. The tendency to clench or grind your teeth during the day is increasingly being viewed as a habit, nothing more. It's commonly believed that bruxism may be related to — but not necessarily caused by — stress and anxiety.

On the other hand, early morning jaw pain may be related to bruxism that occurs during the night. Evidence suggests there may be a relationship between bruxism and temporomandibular joint (TMJ) disorders.

Bruxism may also be an uncommon side effect of some antidepressant medications, particularly selective serotonin reuptake inhibitors. Some are citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).

The September issue of Mayo Clinic Health Letter offers tips to stop the grind:

Splint or mouth guard: These dental prostheses can be worn on the upper or lower teeth, usually on an ongoing basis. Your dentist can make a custom-fitted splint for your teeth. Another option is to purchase a mouth guard from a sporting goods store. These are less expensive but may not be as comfortable as one made for you.

Behavior modification: Practice putting your mouth in a neutral position behind your upper front teeth — where it's placed when you say the letter "n." Then separate your teeth slightly. Repeatedly relaxing your jaw in this way can help break the teeth grinding habit. Use stickers or other visual cues in your car, home or workplace as a reminder to relax your jaw.

Medication: If you wake with pain from clenching or grinding, certain drugs can be effective in managing sleep-related bruxism. They include the benzodiazepine drug clonazepam (Klonopin, others) and tricyclic antidepressants such as nortriptyline (Aventyl, Pamelor, others). If you take an SSRI, your doctor may suggest decreasing the dosage or possibly taking the antianxiety drug buspirone (BuSpar, others) in addition to your SSRI.

Cognitive behavior therapy: In some cases, bruxism may be strongly related to psychological stress, so cognitive behavior therapy could help.

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