WITHDRAWN: The Effects of Mask Usage During the COVID-19 Pandemic on Temporomandibular Joint

Abstract

Objectives: To evaluate possible temporomandibular joint disorder (TMD) symptoms that may occur due to mask use in dentists during the COVID-19 pandemic period and reveal the potentially effective factors.Materials and Methods: An online questionnaire, consisting of three parts, was sent to dentists and clinical dental students. The first part included questions for sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD if any for before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing pattern while wearing a mask were evaluated.Results: TMD symptoms and stress level were found significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared to daily life in dentists whose professional mask selection was N95 respirator. The change in TMJ pain and muscle pain at rest between the T0 and T1 was higher in those whose professional mask choice was N95 respirators than those who chose to wear one surgical mask. Conclusion: The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may cause an increase in TMD.Clinical Relevance: During the use of N95 respirator masks, an increase in mouth breathing and mask-related parafunctional movements can be observed. It should be considered that this situation may cause an increase in the TMD symptoms.

Is Prolonged Mask Wearing Associated With Orofacial Pain?

“…Indeed, dental students and dentists who wear N95 respirators during work reported an increase in TMD symptoms and parafunctional movements such as repetitive mouth opening and closing, bruxism, lateral excursions or protrusive movements compared to daily life when without mask. 4 Although the association between mask wearing and daytime bruxism is pathophysiologically unclear, underlying reasons can be related to stress with prolonged hours of work with the use of masks, anxiety from discomfort and even claustrophobic reactions from the tight seal of N95 respirators. On the other hand, some dentists reportedly have a significant drop in oxygen saturation 1 hour after wearing N95 respirators, which later increased after another hour but was still lower than the baseline.…”