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

Yap, Adrian Ujin; Park, Ji Woon; Lei, Jie; Liu, Chengge; Kim, Seong Hae; Lee, Byeong-Min; Fu, Kai‐Yuan

doi:10.1186/s12903-023-02933-z

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…Moreover, the PT group consisted of older individuals, whilst the CT group had a more prolonged history of TMD contrasted to the other groups. The findings corroborated previous studies, demonstrating the contributory roles of sex and age in the pathophysiology of TMD [ 4 , 29 – 31 ]. The extended TMD duration observed in the CT group could be attributed to the time taken to develop both TMD pain and dysfunction, prompting individuals to seek treatment for their symptoms.…”

Section: Discussionsupporting

confidence: 91%

Sleeping and waking-state oral behaviors in TMD patients: their correlates with jaw functional limitation and psychological distress

Yap,

Kim,

Lee

et al. 2024

Clin Oral Invest

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Objectives This study investigated oral behaviors in various temporomandibular disorder (TMD) subtypes, assessing their frequency, extent, and associations with both jaw functional status and psychological distress. Materials and methods Anonymized data from consecutive "initial-visit" TMD patients at a university-affiliated oral medicine clinic were obtained. Alongside demographic information, patients completed various questionnaires including the Diagnostic Criteria for TMD (DC/TMD) Symptom Questionnaire, Oral Behavior Checklist (OBC), Jaw Functional Limitation Scale-20 (JFLS-20), Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder Scale-7 (GAD-7). Patients underwent a protocolized clinical examination and received diagnoses of pain-related (PT), intra-articular (IT), or combined (CT) TMD using the DC/TMD diagnostic algorithms. Data were evaluated with Chi-square/non-parametric tests and logistic regression analyses (α = 0.05). Results The study comprised 700 patients (mean age 37.4 ± 15.7 years), with 12.6%, 15.1%, and 72.3% diagnosed with PT, IT, and CT, respectively. For all TMD subtypes, oral activities during sleep were more prevalent than those during wakefulness. While variations in total/subscale OBC scores were insignificant, substantial differences were observed in global/subscale JFLS (PT, CT > IT), depression (PT, CT > IT), and anxiety (CT > IT) scores. Near-moderate correlations (rs = 0,36–0.39) were discerned between overall/waking-state non-functional oral behaviors and depression/anxiety. Multivariate analysis indicated that the odds of different TMD subtypes were influenced by sex, age, and jaw functional status. Conclusions For all TMD patients, sleep-related oral activities were more commonly reported than waking-state activities. Factors such as sex, age, and jaw functional limitation are associated with the likelihood of different TMD subtypes. Statement of clinical relevance Oral behaviors, in themselves, do not predict distinct TMD subtypes, in contrast to factors such as sex, age, and jaw functional status.

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Section: Discussionsupporting

confidence: 91%

Sleeping and waking-state oral behaviors in TMD patients: their correlates with jaw functional limitation and psychological distress

Yap,

Kim,

Lee

et al. 2024

Clin Oral Invest

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“…Yap et al suggested that the prevalence of pain-related and intra-articular (non-painful) TMD among East Asian patients was not significantly affected by the COVID-19 pandemic and suggested that sex and age play a more crucial role in the development of painful and non-painful TMD than the pandemic [ 56 ]. It is noteworthy that Yap et al refer to two time periods only (before and during the pandemic).…”

Section: Discussionmentioning

confidence: 99%

The continuous adverse impact of COVID-19 on temporomandibular disorders and bruxism: comparison of pre- during- and post-pandemic time periods

Shalev-Antsel,

Winocur-Arias,

Friedman-Rubin

et al. 2023

BMC Oral Health

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Introduction Some of the conditions affected by the COVID-19 pandemic were Temporomandibular Disorders (TMD) and bruxism. The present study compares the effect of the pandemic on TMD and bruxism (sleep and awake) in three time periods: before the pandemic (pre-COV), during the pandemic (during-COV) and after the pandemic subsided (post-COVR). Material and Methods A total of 587 adult patients (108 in the pre-COV group, 180 in the during-COV group and 252 in the post-COVR group) who arrived for a routine dental treatment between October 2018 and January 2023 were evaluated according to Axis I diagnosis of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Each patient received a DC/TMD Axis I diagnosis as follows: (i) Painful TMD (defined by the presence of at least one of the following - local myalgia, myofascial pain with referral, arthralgia or headache attributed to TMD); (ii) Non painful TMD (defined by the presence of disc displacement with/without reduction, degenerative joint disorders and/or dislocation), (iii) Possible sleep bruxism (SB) and/or (iv) Possible awake bruxism (AB). Statistical methods Logistic regression analyses were conducted to establish the impact of time and gender on the prospects of painful TMD, non-painful TMD, SB and AB. Results The odds of subjects to be diagnosed with painful TMD at the post-COVR era were 3.3 times higher compared to the pre-pandemic time period (pre-COV, 95% C.I. 1.438–7.585). The odds of subjects to be diagnosed with non-painful TMD during-COV were 4 times higher compared to the pre-COV era (95% C.I. 1.332–12.542). The odds of subjects to present possible SB at post-COVR were 2.7 times higher compared to pre-pandemic (pre-COV, 95% C.I. 1.258–5.889, p < 0.05) and the odds to present possible AB after the pandemic subsided (post-COVR) were 3.2 times compared to the pre-pandemic period (95% C.I. 1.496–6.949). The odds of female subjects to be diagnosed with either painful or non-painful TMD were 3.7–4.4 times higher, compared to males. Conclusions Results indicate that with regard to TMD and bruxism the pandemic adverse effects persist also after COVID-19 subsides and the restrictions caused by it are abolished. Apparently, during the pandemic females were affected more seriously by painful and non-painful TMD than males.

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Impact of the COVID-19 pandemic on clinical and psychological aspects of temporomandibular disorders

Kim,

Jeong,

Kim

et al. 2024

BMC Oral Health

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Background The Coronavirus 2019 disease (COVID-19) caused drastic changes in people’s lifestyle that affected TMD characteristics through its physical and psychological influences. The aim of this study was to define the clinical and psychological characteristics of a large group of well-defined TMD patients and seek their differences between before and during the COVID-19 pandemic to establish points of care to be emphasized in the post-pandemic era. Methods TMD patients diagnosed by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) aged ≥ 18 were analyzed. Samples between September, 2017 to July, 2019 (n = 455) and March, 2021 to June, 2022 (n = 338) were collected to represent before and during COVID-19, respectively. The Graded Chronic Pain Scale (GCPS) and Symptom Checklist-90-Revision (SCL-90-R) were used to evaluate disability levels and psychological status. Clinical indices were compared between COVID periods and factors related to higher pain levels were investigated according to pandemic period. Results More patients reported pain on palpation of the masticatory muscles during the pandemic (p = 0.021) while the number decreased for neck muscles (p = 0.001) and TMJ (p < 0.001) areas. Patients reporting nocturnal bruxism (23.3–29.6%) and clenching (45.1–54.7%) significantly increased during the pandemic. TMD patients with pain without disability were more common during the pandemic regardless of pain intensity (p < 0.001). The number of patients expressing interference in daily activities decreased drastically during COVID-19 regardless of disability level (p < 0.001). Factors associated with higher than moderate pain intensity (CPI ≥ 50) were insomnia (odds ratio [OR] = 1.603, p = 0.047) and somatization (OR = 1.082, p < 0.001) before the pandemic. During the pandemic, age (OR = 1.024, p = 0.007), somatization (OR = 1.070, p = 0.006), and paranoid ideation (OR = 1.117, p = 0.003) were significantly associated with higher pain intensity. Conclusions The results of our study underline the importance of evaluating psychological profiles of TMD patients, especially somatization, paranoid ideation and psychoticism, in exceptional situations that may cause a change in individual mental status. This will lead to a better understanding of the individual TMD patient and help in planning personalized treatment strategies that will assist the patient in adjusting to changes occurring in special environments such as the COVID-19 pandemic.

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

Cited by 3 publications

References 35 publications

Sleeping and waking-state oral behaviors in TMD patients: their correlates with jaw functional limitation and psychological distress

Sleeping and waking-state oral behaviors in TMD patients: their correlates with jaw functional limitation and psychological distress

The continuous adverse impact of COVID-19 on temporomandibular disorders and bruxism: comparison of pre- during- and post-pandemic time periods

Impact of the COVID-19 pandemic on clinical and psychological aspects of temporomandibular disorders

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