Clinical factors affecting depression in patients with painful temporomandibular disorders during the COVID-19 pandemic.

Temporomandibular disorders (TMD) are a multifactorial condition associated with both physical and psychological factors. Stress has been known to trigger or worsens TMD. We aimed to investigate whether the novel coronavirus disease-2019 (COVID-19) pandemic aggravates depression in patients with painful TMD, and the factors that affect their level of depression. We included 112 patients with painful TMD (74 females, 38 males; mean age: 35.90 ± 17.60 years; myalgia [n = 38], arthralgia [n = 43], mixed joint-muscle TMD pain [n = 31]). TMD was diagnosed based on the Diagnostic Criteria for TMD Axis I. Physical pain intensity was recorded using the visual analog scale (VAS); psycho-emotional status (depression: Beck Depression Inventory [BDI], anxiety: Beck Anxiety Inventory [BAI], and generalized stress related to COVID19: Global Assessment of Recent Stress [GARS]) was investigated twice (before [BC] and after COVID-19 [AC]). Additionally, factors affecting BDI-AC were investigated. BDI (p < 0.001), BAI (p < 0.001), GARS (p < 0.001), and VAS (p < 0.01) scores were significantly increased at AC than BC. The depression, anxiety, and stress levels were significantly positively correlated, and the AC and BC values of each factor showed a high correlation. In the mixed TMD group, BDI-AC was positively correlated with VAS-AC (p < 0.001). In the multiple regression analysis, clenching habit was the strongest predictor of an increase in the BDI scores from moderate to severe, followed by psychological distress, muscle stiffness, female sex, BAI-AC, and TMJ sounds. COVID-19 has negatively affected the psycho-emotional state of patients with painful TMD, and several clinical factors, including female sex and clenching habits, have influenced depression.

Psychological distress and its relationship to orthodontic emergencies in orthodontic patients during the COVID-19 lockdown in Shanghai, China (preprint)

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.

Trends in Online Searches for Oral and Maxillofacial Surgery During the COVID-19 Pandemic (preprint)

Background: Dentists and dental staff involved in oral and maxillofacial surgery (OMS) are at high risk of infection during the coronavirus disease (COVID-19) pandemic. Therefore, prevention of viral infection is essential in OMS, and attention should be paid to the trends in OMS during COVID-19. In this study, we aimed to investigate the search trends in OMS during the COVID-19 pandemic using Google Trends (GT). Methods: : COVID-19 was considered prevalent from December 2019, and the search period on GT was set to 1 year (January 1, 2020–January 1, 2021). We observed trends for the following OMS-related terms: “wisdom teeth,” “TMJ” (temporomandibular joint), “dental implants,” “jaw surgery,” and “jaw fracture.” Additionally, the terms “aerosol” and “PPE” (personal protective equipment) were also used in the study. We identified the top five countries for all the aforementioned terms to confirm the trends by country. The multivariate Steel–Dwass test was used to compare the relative search volume (RSV) of the OMS-related terms, and the Mann–Whitney U test was used for comparison between the two groups of the COVID-19 prevention terms “aerosol” and “PPE.” Results: : The RSV showed a decreasing trend from March to April for the terms “wisdom teeth,” “TMJ,” and “dental implants”; however, there was an increasing trend for the same terms from May onward. The term “PPE” showed a sharp increase from March to April. In comparison by country during the 1-year period, the United States had the highest RSV for “wisdom teeth” and “jaw fracture,” and Malaysia had the highest RSV for “TMJ.” Similarly, the highest RSV for “dental implants” and “jaw surgery” was in Laos and Canada, respectively. Conclusions: : The COVID-19 pandemic may have altered the search trends for the terms “wisdom teeth,” “TMJ,” and “dental implants”.