Adverse Impacts of Temporomandibular Disorders Symptoms and Tooth Loss on Psychological States and Oral Health-Related Quality of Life During the COVID-19 Pandemic Lockdown

Abstract

BackgroundEmotion and quality of life may have been impacted by the coronavirus disease 2019 (COVID-19) crisis, especially in the lockdown. The impact of temporomandibular disorders (TMD) symptoms and tooth loss on mental status and Oral Health-Related Quality of Life (OHRQoL) are not fully understood in a stressful situation.ObjectivesWe aimed to investigate whether TMD and tooth loss were the impaired risks of psychological states and OHRQoL in COVID-19 lockdown, and attempt to explore other potential risk factors.MethodsThis cross-sectional study surveyed residents via an online self-reported questionnaire, when Yangzhou was in lockdown. Demographic data, clinical information, the level of anxiety, depression and OHRQoL were collected and analyzed.ResultsPainful TMD symptoms and tooth loss are the risks of more severe anxiety and depression. TMD symptoms and tooth loss worsened OHRQoL. Lower education degree (OR: 6.31, P = 0.019), TMD-related pain symptoms (OR: 10.62, P = 0.005), tooth loss (OR: 3.12, P = 0.035), sleep disorders (OR: 2.92, P = 0.049) and relatively close contacts (OR: 3.95, P = 0.020) were verified as risk factors for increased level of anxiety. With respect to depression, low socio-economic status (OR: 6.22, P = 0.021), TMD-related pain (OR: 7.35, P = 0.012), tooth loss (OR: 4.48, P = 0.009), sleep disorders (OR: 5.13, P = 0.007) and relatively close contacts (OR: 12.94, P = 0.001) were identified as independent factors for developing depression. Additionally, drinking (B: −2.584, P = 0.013) and never going to the dental clinic (B: −3.675, P = 0.024) were relevant to better OHRQoL, while TMD without pain (B: 2.797, P = 0.008), TMD-related pain (B: 12.079, P < 0.001), tooth loss (B: 2.546, P = 0.006), sleep disorders (B: 2.598, P = 0.003) were independent factors for impaired OHRQoL.ConclusionPainful TMD symptoms, tooth loss and sleep disorders were the impaired risks of psychological states. TMD symptoms and tooth loss damaged OHRQoL when the city was in lockdown. Therefore, individualized psychological counseling is supposed to maintain control of mental health and OHRQoL under the stressful event.

The influence of the COVID-19 pandemic, sex, and age on temporomandibular disorders subtypes in East Asian patients: a retrospective observational study

“…As most patients experienced chronic TMDs, the higher frequencies of the aforementioned conditions might be the consequence of intensified TMD pain and/or dysfunction or heightened concerns over TMD problems during the pandemic. Findings were consistent with the elevated levels of psychological distress, oral parafunction, and TMD symptoms reported during the COVID-19 pandemic [ 18 , 19 , 23 ]. Psychological distress was posited to trigger a cascade of events culminating in increased sympathetic activity and release of adreno-corticoid hormones leading to muscle vasoconstriction and amplified stress responses [ 15 ].…”

“…Psychological distress was posited to trigger a cascade of events culminating in increased sympathetic activity and release of adreno-corticoid hormones leading to muscle vasoconstriction and amplified stress responses [ 15 ]. This coupled with increased awake and/or sleep bruxism during the pandemic could result in sustained masticatory muscle contractions and exacerbation of TMD-related myalgia and headache [ 15 , 18 , 19 ].…”

“…Research concerning TMDs and the COVID-19 pandemic as an “impact event” (phenomena with major societal consequences) is still limited [ 16 – 23 ]. The few cross-sectional studies suggested that the pandemic was associated with greater distress, worse sleep, lower QoL, as well as increased prevalence and intensity of TMD symptoms [ 16 – 19 ]. Psychological distress and prevalence of TMD pain/TMJ sounds escalated further a year after the pandemic [ 20 ].…”

Comparison of painful temporomandibular disorders, psychological characteristics, sleep quality, and oral health-related quality of life of patients seeking care before and during the Covid-19 pandemic

“…The few cross-sectional studies conducted during and one year after the Covid-19 pandemic indicated greater frequencies of symptoms and higher levels of psychological distress among individuals with TMDs [ 24 – 27 ]. Furthermore, both sleep quality and OHRQoL were also found to be diminished and related to TMDs [ 28 , 29 ]. Nevertheless, the two available prospective studies involving TMD patients yielded varied findings with one demonstrating greater psychological distress and another specifying no worsening of pain intensity and OHRQoL during the Covid-19 pandemic [ 30 , 31 ].…”

Análise quantitativa do interesse por implantes dentários em diferentes países ao longo do tempo e durante a pandemia da COVID-19

“…Os sintomas de DTM e a perda de dentes prejudicaram a qualidade de vida relacionada a saúde oral durante o confinamento (WENG et al, 2022).…”