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Medical Edge Newspaper Column from Mayo Clinic

TREATMENTS AVAILABLE TO CONTROL TEETH-GRINDING

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.

Additional Resources:
Dental Specialties
Appointment Information
News Release: Breaking the Habit
More Information on Bruxism

READERS: Nobody says the physical changes of growing older come easy. That doesn’t mean you can’t still do it your way — with a little help from assistive devices.

Mayo Clinic Women’s HealthSource shares tips and tools to make daily chores safer and more convenient.

— Kitchen cart: A cart on wheels is a good way to transport many items at once, such as moving items from a cabinet to a counter or plates and silverware to the table.

— Utensils: Look for peelers, knives and other utensils with larger, rubberized handles. Specially designed kitchen knives with large handles can make food preparation safer. Cutting boards with spikes in the center to hold a fruit or vegetable in place may also help.

— Grab bars: Install these in your shower or tub to help you get in and out.

— Bath bench: A special seat inserted in your tub allows you to sit down while bathing. If you have a walk-in shower, consider a fold-down seat that attaches to the wall.

— Foam tubing: Put foam tubing, available at hardware stores, around your toothbrush and hairbrush handles to make them easier to grasp.

— Bedrail: A sturdy bedrail, available at medical supply stores, can make it easier to get in and out of bed by giving you something to hang on to. A high, firm bed is easier to get out of than a lower, softer one.

— Zipper ring: Loop a key ring through your zipper to make it easier to grip and give you more leverage.

— Buttonhook: This gadget eliminates fumbling with buttons. Slip the hook through your buttonhole, catch the button and pull it back through.

— Long-handled shoehorn: A shoehorn that’s at least 18 inches in length can greatly ease the task of getting your shoes on without bending over.

These tools and tips are a small sample of what’s available. An occupational therapist can do a customized assessment of your needs and make recommendations. Ask a doctor or local hospital for a referral.
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Additional Resources:
Growing Older

Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.