Temporomandibular disorders and associated comorbidities among brazilian dental students during COVID-19

Aim: This study aimed to assess the prevalence of temporomandibular disorders (TMD) and psychosocial comorbidities in undergraduate dental students in a southern Brazilian university, during the COVID-19 pandemic. Also, it aimed to verify the association between psychosocial factors and TMD. Methods: Fonseca Anamnestic Index, Depression Anxiety Stress Scale (DASS-21), a socioeconomic questionnaire, and questions about academic performance and social distancing were applied. Poisson regression analysis was used to assess the association of predictive variables with TMD. Results: The prevalence of TMD was found to be 82.4%, and more than half of the students had some degree of stress, anxiety, and depression. Students who had symptoms of stress (RR 1.11; 95% CI 1.04-1.19), anxiety (RR 1.19; 95% CI 1.12-1.27) and reported academic performance worsening (RR 1.12; 95% CI 1.07-1.19) had higher TMD scores. Conclusion: The findings suggest that TMD was highly prevalent among dental students at a federal university in southern Brazil during the pandemic, being associated with high levels of stress, anxiety, poor academic performance, and greater social distancing

Relationship assessment between mood disorders, headaches, and temporomandibular disorders in healthcare workers post-COVID-19 pandemic

Objectives: To evaluate the relationship between depression, anxiety, and stress levels, headaches, and symptoms of temporomandibular joint disorders in healthcare professionals in a post-pandemic setting. Method(s): A cross-sectional study conducted through an online questionnaire was distributed among healthcare professionals in Mainland Portugal. The sample's characterization was undertaken according to sociodemographic parameters. The following assessment instruments were used: 21-item Depression, Anxiety, and Stress Scale (DASS-21) for emotional parameters, namely depression, anxiety, and stress;International Classification of Headache Disorders (ICHD-3) for headache disorders;Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for temporomandibular joint dysfunction symptoms. Inferential analysis was performed using phi, Cramer's V, and gamma tests. Result(s): The sample comprised 118 individuals (93.2% female, 6.8% male). Results showed a prevalence of 38.1% for depression, 51.7% for anxiety, and 39.8% for stress. Regarding headaches, a prevalence of 62.7% was reported. Symptoms of temporomandibular disorders had a prevalence of 50%. Significant differences were found between headache and stress (p=0.034), headache and temporomandibular joint disorders symptoms (p=0.002), and symptoms of temporomandibular disorders and depression (p=0.009), anxiety (p=0.003), and stress levels (p=0.014). Conclusion(s): There seems to be a positive correlation between headaches and stress levels, between temporomandibular disorders symptoms and all psychosocial parameters, and between temporomandibular disorder symptoms and headaches. Data suggests that these symptoms worsened after the pandemic.Copyright © 2023 Sociedade Portuguesa de Estomatologia e Medicina Dentaria. Published by SPEMD.

Oro-Facial manifestations of COVID-19 infection in a sample of Iraqi people

Public health officials are gravely concerned about the harm that viral illnesses continue to pose to humanity, various viral outbreaks, including the Middle East Respiratory Syndrome Corona-Virus (MERS-CoV), H1N1 influenza, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) and SARS CoV-2 or COVID-19 that struck the globe in December 2019. A wide range of COVID-19 oral symptoms, such as ulceration, blisters, enanthems, hemorrhagic sores and cheilitis. Aim(s): to investigate the prevalence of oral symptoms amongst COVID-19 patients due to the disease's aggressive nature and diverse symptomatology and to assess the impact of oral health conditions on COVID-19 disease severity in a sample of Iraqi people. Material(s) and Method(s): a cross-sectional study was conducted on (200) patients in total, (81) male and (119) female, who were identified as SARS-COV2 patients. Result(s): COVID confirmed patients were involved in the present study with mean age (36.69+/-17.22) years & age range of (16-78) years. at least one of the oral manifestations was present in 72.5% of the patients, while about 27.5% did not experience any oro-facial symptoms. The oral symptom with the highest prevalence was dry mouth 50% followed by gustatory dysfunction 37% then burning mouth sensation 22.5% after that the oral pain 17%;myofacial pain 15.5 %;stomatitis\mucositis 14.5%;the prevalence of aphthous lesions, fissural cheilitis and tongue depapillation were at the same percentage which was 9.5%;then candidiasis 7.5%;the least prevalent oral symptoms was gingival bleeding at percentage of 2.5%. Conclusion(s): COVID-19 has a noticeable effect on oral cavity, there was a correlations between some general and orofacial manifestations of COVID-19.Copyright © 2023, Codon Publications. All rights reserved.

Covid-19 Fatigue: Diagnosis and Treatment for the Osteopathic Physician

The novel coronavirus disease 2019 (COVID-19) has given rise to a global pandemic, as well as a multitude of long-term sequelae that continue to perplex physicians around the world, including in the United States. Among the most common and impactful long-haul symptoms experienced by survivors is COVID-19 fatigue. This review will use long COVID-19, post-acute COVID-19 syndrome (PCS), and PostAcute Sequelae of COVID-19 (PASC) as synonymous terms to refer to the chronic symptomatology;chronic fatigue associated with PASC will be referred to as COVID-19 fatigue. While the knowledge and research on the exact pathophysiological mechanisms involved in the disease is still limited, parallels have been drawn between fatigue as a component of long COVID-19 and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). Current studies suggest applying principles of pathophysiology, diagnosis, and treatment similar to those for ME/CFS in order to aid in managing chronic fatigue in COVID-19 survivors, particularly in the primary care setting. The osteopathic family physician can use the proposed pharmacologic agents, along with osteopathic manipulative treatment (OMT), as therapeutic modalities that can be tailored to each patient's unique case. Nevertheless, research on proven successful treatments is still scarce. For that reason, it is essential that COVID-19 fatigue is recognized early, especially since its longitudinal impacts may be debilitating for many. This review of the available literature on COVID-19 fatigue aims to help provide quality care and lessen the disease burden experienced by patients.Copyright © 2023 by the American College of Osteopathic Family Physicians. All rights reserved.

Teledental Consultations Using a Messaging Application during the COVID-19 Pandemic: Experience from a Singapore COVID-19 Community Care Facility

Introduction: During the 'Circuit Breaker' period of the COVID-19 pandemic in Singapore from April to June 2020, governmental policies restricted the practice of dentistry nationwide to the provision of emergency treatment only, regardless of the patient's COVID status. As such, teledentistry was used as an alternative means to continue providing some form of dental care to COVID-19-positive patients who were admitted to a COVID-19 Community Care Facility. Description: The patients were physically triaged by physicians who would send clinical photos to the author via a messaging application, who would in turn triage the patients and assess if they required referral for emergency dental treatment. For patients who did not meet the criteria for referral, the author would advise the physicians on the subsequent management plan which included, but was not limited to, the provision of symptomatic relief. Conclusion(s): This article shows the feasibility of undertaking teledental consultations using clinical photos transmitted via a messaging application. The practical implication is a reduced barrier for patients and healthcare professionals to access teledentistry, without having to resort to sophisticated equipment. Hopefully, this will translate into the continued provision of some form of dental care to patients during the ongoing pandemic as opposed to no care at all.Copyright © The Author(s) 2022.

The Association between COVID-19 Related Anxiety, Stress, Depression, Temporomandibular Disorders, and Headaches from Childhood to Adulthood: A Systematic Review.

Objective: The coronavirus belongs to the family of Coronaviridae, which are not branched single-stranded RNA viruses. COVID-19 creates respiratory problems and infections ranging from mild to severe. The virus features mechanisms that serve to delay the cellular immune response. The host's response is responsible for the pathological process that leads to tissue destruction. Temporomandibular disorders are manifested by painful jaw musculature and jaw joint areas, clicks, or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or even speaks. The pandemic situation has exacerbated anxieties and amplified the vulnerability of individuals. Therefore, from this mechanism, how the COVID-19 pandemic may have increased the incidence of temporomandibular disorders is perceived. The purpose of this review is to evaluate whether COVID-19-related anxiety has caused an increase in temporomandibular dysfunction symptoms in adults to children. Methods: PubMed, Web of Science, Lilacs, and Scopus were systematically searched, until 30 July 2022, to identify studies presenting: the connection between COVID-19 with temporomandibular disorders. Results: From 198 papers, 4 studies were included. Literature studies have shown that the state of uncertainty and anxiety has led to an increase in the incidence of this type of disorder, although not all studies agree. Seventy-three studies were identified after viewing all four search engines; at the end of the screening phase, only four were considered that met the PECO, the planned inclusion, and the exclusion criteria. All studies showed a statistically significant correlation between temporomandibular disorders and COVID-19 with a p < 0.05. Conclusions: All studies agreed that there is an association between COVID-19 and increased incidence of temporomandibular disorders.

Psychological Outcomes on Anxiety and Depression after Interventions for Temporomandibular Disorders: A Systematic Review and Meta-Analysis.

Many studies have shown mutual interaction between temporomandibular disorders (TMD) and psychological distress. However, evidence on the effectiveness of therapeutic interventions for TMD on psychological outcomes is scarce. This review aimed to summarise the best evidence on the association between interventions for TMD and psychological outcomes regarding symptoms of anxiety and depression. Electronic search was carried out in databases, including Pubmed, Web of Science, Medline, Cochrane Library, and Scopus. All eligible studies were included for narrative synthesis. Eligible randomised controlled trials (RCTs) were included for the meta-analysis. The overall effect size of interventions for TMD was analysed in standardised mean difference (SMD) in levels of anxiety and depression. Ten studies were included in the systematic review. Of these, nine were included in the narrative analysis and four were included in the meta-analysis. All included studies and the result of the narrative analysis showed a statistically significant beneficial effect of interventions for TMD on improving symptoms of anxiety and depression (p < 0.0001); however, a statistically significant overall effect was not found in the meta-analyses. Current evidence is in favour of the interventions for TMD in improving symptoms of depression and anxiety. However, the effect is statistically uncertain and warrants future studies to enable the best synthesis of the evidence.

Novel Conservative Management For Recurrent Temporomandibular Joint Dislocation

Introduction/Aims: We present the difficulties of managing a medically compromised patient with recurrent Temporomandibular Joint Dislocation who presented to us during the COVID-19 pandemic. We describe the novel use of an anti-snore head strap, in conjunction with a soft cervical collar which was successful in preventing further TMJ dislocations. To our knowledge, this has not been previously reported in the literature. It is important that clinicians must explore all options in patients with limited scope for surgical management when treating recurrent TMJ dislocations. Material(s) and Method(s): An anti-snore device was acquired online and in conjuction with a soft cervical collar was used to maintain the TMJ in it's position and prevent further recurrent dislocations. Results/Statistics: This simple, cost-effective and comfortable device reduced the number of hospital admissions for the patient, thereby additionally reducing her risk of contracting COVID-19. Prior to this intervention, the patient had presented for admission 10 times, resulting in a total stay of 65 days - the cost for this was 66,121.09. The anti-snore head device cost 11.99. Conclusions/Clinical Relevance: We present a novel technique in managing TMJ dislocation in a patient with severe morbidity who is limited with surgical treatment options. Therefore, we suggest the use of an anti-snore chin strap in conjunction with a soft cervical collar as a conservative management in medically compromised recurrent TMJ dislocations. Copyright © 2022

Self-Report of the Perception of Stress and Signs of Bruxism Generated during the Pandemic in Student of the Health Area

Bruxism is the repetitive muscle-mandibular behavior characterized by clenching and/or grinding of the teeth, which reflects the presence of one or more underlying conditions or factors. The objective of this descriptive study was to determine the association between bruxism and stress self-perceived during the pandemic, as well as their frequency by gender and academic area. An interrogation and self-perceived stress scale PSS-14 were applied to students from the different areas of the Institute of Health Sciences (ICSa) to determine the presence or absence of stress and bruxism symptom, a Chi-square was used for the comparison between variables, considering a value of p<0.005 as significant, a two-way ANOVA was performed to evaluate the difference between the symptoms before and during the isolation of the pandemic. The total number of participants was 825, a final sample of 420 students was obtained, made up of 297 (70.72%) women and 123 (29.28%) men, with an average age of 20±1.75 years. We found an association between the frequency of bruxism and severe stress generated during the social isolation of the COVID-19 pandemic, with a high perception of stress in the medicine area and a high frequency of bruxism in the area of nutrition p>0.005. ICSa students between 18 and 24 age perceive symptoms of bruxism and high levels of stress caused during the pandemic. © 2022, Universidad de Costa Rica. All rights reserved.

Effects of COVID-19 on Oral Health-Related Quality of Life, Temporomandibular Joint Dysfunction and Depression: A Cross-Sectional Study: Turkiye Klinkeri Journal of Dental Sciences

Amaç: Bu çalışmanın amacı, koronavirüs ve salgın kaynaklı pandemilerin sonuçlarını temporomandibular disfonksiyon (TMD), depresyon ve aǧız saǧlıǧı ile ilişkili yaşam kalitesi açısından deǧerlendirmektir. Ayrıca koronavirüs hastalıǧı-2019 [coronavirus disease-2019 (COVID19)] pozitif grup, COVID-19 temas grubu ve kontrol grubu ile her hastanın depresyon, TMD ve aǧız saǧlıǧı ile ilgili yaşam kalitesi arasındaki ilişkileri belirlemeyi amaçladık. Gereç ve Yöntemler: 13-75 yaş aralıǧındaki 1.020 katılımcı, Aǧız Saǧlıǧı Etki Profili Anketi [Oral Health Impact Profile Questionnaire (OHIP-14)], Fonseca Anketi ve Hasta Saǧlıǧı Anketi-9'dan [Patient Health Questionnaire-9 (PHQ-9)] oluşan soruları yanıtladı. Bu çalışma, Türkiye genelinde çevrim içi olarak yapıldı. Ankete katılmayı kabul eden katılımcılar, COVID-19 ile ilgili durumlarını belirterek anket sorularını cevaplamaya devam etti. Katılımcılar, COVID19 ile ilgili durumlarına göre 3 gruba ayrıldı: COVID-19 pozitif, COVID19 temaslı ve kontrol grubu. Bulgular: Bu çalışmanın sonuçlarına göre OHIP-14, Fonseca ve PHQ-9 anket sonuçları ile gruplar arasında istatistiksel olarak anlamlı fark bulundu (sırasıyla p<0,001, p<0,05, p<0,001). COVID-19 pozitiflerin %17,3'ünün aǧız saǧlıǧıyla ilgili yaşam kalitesi kötüydü, %91,4'ünün hafif depresyon ile şiddetli depresyon arasında herhangi bir düzeyde depresyonu vardı ve %66,4'ü herhangi bir düzeyde TMD'ye sahipti. Sonuç: Mevcut çalışma sonuçlarına göre COVID-19 pozitiflerinde aǧız saǧlıǧı ile ilgili yaşam kalitesi en düşük, orta TMD ve şiddetli TMD daha yüksek ve şiddetli depresyon belirtileri daha fazlaydı. Ayrıca koronavirüs ve pandemi, depresyonu ve TMD'yi artırmakta, aǧız saǧlıǧı ile ilişkili yaşam kalitesini düşürmektedir.Alternate :Objective: The purpose of the present study is to evaluate the outcomes of coronavirus and outbreak-induced pandemics in terms of temporomandibular dysfunction (TMD), depression and oral health-related quality of life. We also aimed to determine any associations between the coronavirus disease-2019 (COVID-19) positive group, the COVID19 contact group and the control group and each patient's depression, TMD and their oral health-related quality of life. Material and Methods: One thousand-twenty participants in the 13-75 age range answered questions consisting of the Oral Health Impact Profile Questionnaire (OHIP14), the Fonseca Questionnaire and the Patient Health Questionnaire-9 (PHQ-9). The present study was done online in Turkey. Participants who agreed to participate in the survey continued to answer the survey questions by stating their status regarding COVID-19. Participants were divided into 3 groups according to their COVID-19-related status: COVID-19 positive, COVID-19 contact and control group. Results: According to the results of present study, a statistically significant difference was found between the OHIP-14, Fonseca and PHQ-9 survey results and the groups (p<0.001, p<0.05, p<0.001 respectively). Of COVID-19 positives, 17.3% had poor oral health-related quality of life, 91.4% had any level of depression between mild and severe depression, and 66.4% had any level of TMD. Conclusion: According to the results of the present study in COVID19 positives, the oral health-related quality of life was lowest, moderate TMD and severe TMD were higher, and symptoms of severe depression were more. Furthermore the coronavirus and pandemic increase depression and TMD, and reduce the quality of life related to oral health.

The Treatment of Temporomandibular Joint Dislocation during Covid-19 Pandemic: Result for 8 Patients in Central Sulawesi Tertiary Care Center

Temporomandibular joint dislocation is one of the emergency cases and requires immediate management because it causes pain and discomfort in the patient. Various causes are the pathophysiology of dislocations ranging from opening the mouth that is too wide unintentional to trauma to the jaw involving the temporomandibular joint. We present eight cases of TMJ dislocations identified and treated in Central Sulawesi tertiary care center. (Undata Hospital, Indonesia). We describe the chief complaint, diagnosis, and management of the patients during pandemic from March 2020 to March 2021. Temporomandibular joint dislocation is one of the cases in the emergency setting in our hospital that managed with specific technique and performed with prevention protocols according to WHO and CDC standards © 2022, Journal of International Dental and Medical Research.All Rights Reserved.

An Investigation of temporomandibular pain, headache, and fatigue in relation with long-term mask use during the COVID-19 pandemic period.

OBJECTIVE: To investigate the effects of long-term mask use on temporomandibular pain, headache, and fatigue during the COVID-19 pandemic period via a survey. METHODS: The survey was sent online, and symptoms associated with mask use, perception of mask discomfort, temporomandibular dysfunction, fatigue, headache, and trigger points of temporomandibular joint were evaluated. RESULTS: For the study, 909 people were screened. Head, neck, face, throat, ear, and jaw pain, cheek tension, teeth clamping, acne, mask trace, palpitation, and voice and sleep disorders were different between groups (p < 0.05). The individuals' temporomandibular dysfunction and fatigue were different between groups (p < 0.05). CONCLUSION: Long-term mask use can cause many symptoms, such as headache, jaw pain, and fatigue. Furthermore, increased mask-wearing time can trigger all these symptoms. The authors recommend relaxing breaks and exercises for neck, jaw, and face muscles along with the use of appropriate masks to minimize negative symptoms.

Physiotherapy for orofacial pain and temporomandibular joint dysfunction after prolonged CPAP therapy due to COVID-19: a case report

During this COVID-19 pandemic, intensive care units are being overwhelmed by several hypoxemic patients. Continuous Positive Airway Pressure (CPAP) full face masks are being used for these patients presenting with acute respiratory distress disease. Due to these masks, the movements of the face are restricted. The patient can experience orofacial pain and can further have temporomandibular disorders on a long-term basis. Early physiotherapy management can be done to reduce the pain and tenderness, release trigger points, elongate the shortened muscles, and reduce the jaw's restricted movements.

Case-based Virtual Seminars on Masticatory Muscle Disorders during the COVID-19 Pandemic.

Due to the significant influence of COVID-19 pandemic on dental education in the recent past, interactive educational strategies were explored to engage students. Case-based seminars (CBS) were proposed on masticatory muscle disorders (MMDs) for post-graduate dental students through integration of pathophysiology with its etiology, diagnosis, and management. Effectiveness of CBS was done at Kirkpatrick's level 1 and level 2 hierarchy with a pre-test and a post-test. CBS enhanced learning outcomes of post-graduate students in understanding MMDs. Thus, this report could serve as a useful model for other dental schools in prosthodontic post-graduate curriculum.

EFFECT of COVID-19 PANDEMIC on PATIENTS with TEMPOROMANDIBULAR DISORDERS over TWO-YEAR PERIOD

Introduction: The impact of Covid-19 on musculoskeletal problems is still under investigation. The effect of stress caused by lockdown and pandemic may exacerbate existing symptoms of temporomandibular disorders (TMD), painful masticatory system disorders. This study's aim was to investigate the somatic and psychological effects a two-year pandemic might have on individuals diagnosed with TMD. Materials and methods: A total of 186 TMD patients were contacted through email to take part in an online survey. The survey, created using Google forms, comprised of 20 questions on the long-term impact of the pandemic on present and/or new TMD-related symptoms, oral behavioral habits, other bodily pains, anxiety, depression and temporomandibular pain severity. Statistics included chi-square test and Spearman's correlation. Results: The response rate was 63.98%;57.98% of individuals were infected with COVID-19, and 73.94% said they had been vaccinated at least once. In a two-year period, 40.33% participants developed new TMD-related symptoms or their symptoms deteriorated. New symptoms (headache, difficulty while opening, other bodily pains, depressive symptoms) correlated with temporomandibular joint discomfort, while new symptoms (headaches, grinding, insomnia) correlated with masticatory muscle discomfort (p<0.05). There was no difference in the number of patients who developed new symptoms or developed deterioration of existing symptoms between those who had been infected with COVD-19 or had been vaccinated and those who hadn't been infected with COVID-19 or hadn't been vaccinated. (p>0.05). Patients experiencing anxiety more often reported other bodily pains (p=0.005) and headaches (p=0.002). Other bodily pains were more common in those experiencing depressive symptoms (p<0.001). Conclusion: Majority of somatic difficulties that emerged throughout pandemic, such as orofacial pain, might be attributed to a psychological response to stress rather than to COVID-19 infection or vaccination.

The Influence of SARS-CoV-2 Pandemic on TMJ Disorders, OSAS and BMI.

The pandemic of the 21st century had a significant influence on the lives of the world population in a negative way. This situation determined a change of lifestyle; it caused the necessity of social isolation for a great number of people. In fact, people tended to avoid crowded environments, social events, to reduce medical checks and sports activities, favoring sedentary life because of fear of the virus. This social attitude brought a high level of stress that worsened many health conditions. This study has the aim of evaluating the possible influence of the pandemic on temporomandibular joint (TMJ) disorders, obstructive sleep apnea syndrome (OSAS) and body mass index (BMI). An anonymized survey, available in two languages (Italian and English), was given to 208 patients from different private dental practices. In this questionnaire, the patients shared experiences about their life during the pandemic. The article highlighted that during this health emergency, there was an increase in body weight in the considered sample. This brought a worsening of OSAS in 65% of patients with a previous diagnosis. Eventually, an increase in TMJ disorders and orofacial pain was reported.

The Manifestations of Covid-19 Infection. Manifestations in Patients with Temporomandibular Joint Disorders.

The authors present a group of patients who were treated for exacerbation of temporomandibular joint disorders (TMD) following Covid-19 infection and who in the past had successfully undergone surgery of the temporomandibular joint (TMJ). The group consisted in total of 21 patients who relapsed after contracting Covid-19. There were 4 men and 17 women, the average age was 45.6 years (28-63). The most common complaint was pain. In all cases, the pain was located in the preauricular area, 4 patients had pain in the lateral side of the neck, 1 patient had pain of the nasal alae. During clinical examination, pain was present on palpation of the masseter muscle (19 patients), temporal muscle (4 patients) and the TMJ area (4 patients). In 4 cases, pain on palpation was present in the area of the nape and sternocleidomastoid muscles. Treatment in all cases was the same: thermotherapy, muscle relaxation massage and non-steroidal anti-inflammatory drugs. Symptoms subsided in all cases within 2 weeks. In light of the Covid-19 pandemic, it is also necessary to expect an increased number of patients with TMD. The authors recommend targeted patient histories regarding Covid-19 infection when examining patients with TMD symptoms - this will certainly facilitate determining the etiology of the pain.

Special Issue: Oral health in China. (Special Issue: Oral health in China.)

This special section includes 7 articles discussing oral health in China. Topics discussed are: socioeconomic-related inequality in dental care utilization among preschool children in China;ten-year changes in children's oral health disparities;Prevalence of toothache in Chinese adults aged 65 years and above;edentulism and select chronic diseases among adults aged 45 years in China, 2011-2018;temporomandibular disorder subtypes, emotional distress, impaired sleep, and oral health-related quality of life in Asian patients;validation of the Chinese version of the Short-Form Health Literacy in Dentistry (HeLD) scale;impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital.