The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders

Abstract

This study aimed to understand the impact of COVID-19 distress on psychological status, features of central sensitization and facial pain severity in people with temporomandibular disorders (TMDs). In this prospective cohort study, 45 adults (19 chronic, 26 acute/subacute TMD) were recruited prior to the COVID-19 outbreak. Baseline assessment took place before the outbreak while a follow-up was performed immediately after the lockdown period. Multiple variables were investigated including age, gender, perceived life quality, sleep quality, anxiety and depression, coping strategies, central sensitization, pain intensity, pain-related disability and oral behaviour. COVID Stress Scales (CSS) were applied at follow-up to measure the extent of COVID-related distress. CSS were significantly higher in those with chronic TMDs compared to those with acute/subacute TMDs (p<0.05). In people with chronic TMD, the variation in anxiety and depression from baseline to follow-up was significantly correlated with scores on the CSS (r = 0.72; p = 0.002). Variations of the central sensitization inventory (r = 0.57; p = 0.020) and graded chronic pain scale (r = 0.59; p = 0.017) were significantly correlated with scores on the CSS. These initial findings indicate that people with chronic TMD were more susceptible to COVID-19 distress with deterioration of psychological status, worsening features of central sensitization and increased chronic facial pain severity. These findings reinforce the role of stress as a possible amplifier of central sensitization, anxiety, depression, chronic pain and pain-related disability in people with TMDs. Trial Registration: ClinicalTrials.gov ID: NCT03990662.

Alterações psicológicas durante a pandemia por COVID-19 e sua relação com bruxismo e DTM

“…Dos artigos incluídos nesta revisão, 7 abordavam aspectos psicossociais e sua relação com a pandemia por COVID-19 (Di Blasi et al, 2021;De Boni et al, 2020;Gutiérrez-Hernández et al, 2021;Limcaoco et al, 2020;Liao et al, 2021;Liu et al, 2021;Wang et al, 2021), 5 apresentavam os aspectos psicossociais e sua relação com DTM (Alahmary, 2019;Guimarães;Almeida, 2018;Canales et al, 2019;Yap;Natu, 2020;Zavanelli, 2017) e 7 dissertavam sobre a associação entre as alterações psicológicas causadas pela pandemia por COVID-19 e sua relação com bruxismo e DTM (Asquini et al, 2021;Emodi-Perlman et al, 2020;Gaş;Özsoy;Aydin, 2021;Medeiros et al, 2020;Restrepo et al, 2021;Saccomanno et al, 2020;Silva et al 2021).…”

TMD in Females with Menstrual Disorders

“…Studies by List et al demonstrated that 15% of adults and 7% of adolescents were affected by the condition [ 5 ], contrary to Valesan et al who reported TMD prevalence at 31% in the population of adults/the elderly and 11% in children/teenagers [ 6 ]. These disorders affect the whole adult population but the highest number of diagnosed cases is reported in the 20–40 years age range [ 1 , 5 , 7 , 8 , 9 , 10 ]. At the same time, women are reported to be more often affected by masticatory dysfunctions than men.…”

“…At the same time, women are reported to be more often affected by masticatory dysfunctions than men. Women are two-to-four times more likely to experience pain due to masticatory activities than men [ 1 , 2 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Besides a high incidence of TMJ and/or muscle dysfunctions in women, they also suffer from a wider range of symptoms and their increased intensity [ 14 , 20 ].…”

“…The clinical symptoms of TMD are manifested by disturbed movement of the mandible (improper range and pattern), the presence of acoustic manifestations (clicks, crepitations) in the TMJ during mandibular movement, pain in the TMJ, either spontaneous or provoked by consumption of food, and lastly pain in the masticatory muscles, the head, and the neck. All of the above-mentioned manifestations may compromise the performance of basic daily activities and lower the patient’s quality of life [ 5 , 7 , 8 , 11 , 19 , 24 ]. The most frequent TMD complaints from patients presenting at dental offices are painful sensations and the presence of acoustic manifestations.…”

“…A number of biological and psychosocial risk factors for TMD development have been identified. These include: occlusal dysfunctions, chronic stress, parafunctions, individual tendency to excessive articular flaccidity, trauma, age, gender, and genetic or anatomic determination [ 5 , 6 , 7 , 8 , 10 , 15 , 18 , 19 , 20 , 28 ]. Occlusal abnormalities are listed first among the local factors predisposing to the development of TMD, although their role in the pathomechanism of TMD is ambiguous and sometimes controversial.…”