ABSTRACT
Background: The aim of this study was to evaluate psychological distress among orthodontic patients and its relationship to orthodontic emergencies related to different appliances during the COVID-19 lockdown. Methods: This was a cross-sectional online questionnaire survey involving orthodontic patients in Shanghai, China. Data collection occurred from May 15 to June 1 2022. The demographic information and orthodontic emergencies were collected, while the peritraumatic distress symptoms were assessed by the COVID-19 Peritraumatic Distress Index (CPDI). Data analysis was performed by SPSS software. Results: A total of 480 patients were examined, including 331 fixed appliance patients, 131 clear aligner patients and 18 removable appliance patients. Patients who encountered emergencies and suffered from temporomandibular joint (TMJ) pain reported significantly higher CPDI scores in each group (p<0.01). Multivariate linear analysis showed that patients aged above 18 years old (p<0.01), emergencies in fixed appliance patients (p<0.05), emergencies among clear aligner patients (p<0.01), and higher TMJ-pain scores were significantly associated with increasing CPDI scores. Conclusions: Orthodontic patients encountered emergencies, especially those who suffered from TMJ pain and were at higher risk of psychological distress related to COVID-19; thus, targeted intervention and self-management guidelines should be designed to relieve anxiety and strengthen coping capacity for orthodontic patients during the pandemic.