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My 7" Jack Dempsey has been rubbing his head on various things in the tank; plants, the drift wood, a clay pot, and especially the gravel. He's been doing it for a few weeks now, and it hasnt gotten more frequent nor any better. There are no visible signs of anything on his body aside from the a few nicks here and there from him and the Oscar getting in little scuffs.

The only thing I've noticed are tiny little white worms free floating around the tank after I mess move around the gravel. I scaled back feeding a little bit, did a 50% water change with a thorough gravel cleaning and they seem to be clearing up. The Dempsey continues to glace against everything. The Oscar is perfectly fine however.

I tested the water this afternoon, and everything is fine. The Nitrates were maybe a little higher than I'd like (around 40).

Im considering just using a basic cure-all medication, but before I do that I'd like to see if anyone has any suggestions.

The scratching usually indicates some kind of skin irritation -- most common cause is a parasite such as ich.  Examine him closely for any signs.  Look for small white spots, especially on his fins or tail, or any sign of fin deterioration  -- just because you don't see spots it doesn't mean that it isn't ich.  Sometimes water conditions can cause this behavior, but my experience leads me to suspect ich first.  Best bet would be either the salt treatment (see Disease FAQ's) or an OTC parasite remedy.  I prefer the ones that use malachite green, such as Nox-Ich, Ich-out, Quick-Cure, or Maracide.  Whatever you use, read the instructions carefully, and follow them religiously.  Good luck with your JD, and let us know how it turns out.

Nitrates of 40ppm wont' make him rub on the deco.. I would check the pH and see if it has crashed to a lower number.. You say the others, ammonia,nitrite are fine.. ARE they 0ppm?? IF not and any one of those two register a number, then that can cause skin irratation and make them rub.. SO before you treat for something that you dont' know if they have.. AS ICH can not be treated on the fish, it has to fall off first...

Check the pH and see if it is where it should be..

A good tank cleaning wil be a good start to see if he still rubs after 24 hr or not.. clean the filter BOX as this could be a problem too.. IF not cleaned out within 7 days... If you use a canister, does it need to be cleaned??  Every 30 days for American cichlids as they produce a lot of waste.. It may  just need to be rinsed out good with tank water to flush it out..