Coronavirus Lockdown as a Major Life Stressor: Does It Affect TMD Symptoms?

Abstract

Temporomandibular disorders are multi-factorial conditions that are caused by both physical and psychological factors. It has been well established that stress triggers or worsens TMDs. This paper looks to present early research, still unfolding, on the relationship between COVID-19 as a major life stressor and TMDs. The main aims of this study were to: investigate the presence of symptoms related to TMDs and the time of onset and the worsening of painful symptoms in relation to the changes in social life imposed by the coronavirus pandemic; and to evaluate the perception of COVID-19 as a major stressful event in subjects who report worsening of painful TMD symptoms. One hundred and eighty-two subjects answered questionnaires-Axis II of the RDC/TMD, the PSS, and specific items about coronavirus as a stressful event-during the lockdown period for COVID-19 in Italy to evaluate the presence of reported symptoms of TMD and the level of depression, somatization, and stress perceived. The results showed that 40.7% of subjects complained about TMD symptoms in the past month. Regarding the time of onset, 60.8% of them reported that facial pain started in the last three months, while 51.4% of these subjects reported that their symptoms worsened in the last month and were related to the aggravation of pain due to the coronavirus lockdown as a major life event and to the stress experienced. The results of this study seem to support the hypothesis that stress during the pandemic lockdown influenced the onset of temporomandibular joint disorders and facial pain, albeit with individual responses.

Keywords: COVID-19; lockdown; orofacial pain; stress; temporomandibular disorders.

Figure 1

Graded Chronic Pain Scale (GCPS) class and pain variation in the last month. The main box represents the interquartile range. The black line represents the median and the confidence interval. Subjects #59 and #175 were outliers.

Figure 2

Perceived Stress Scale score (PSS) in relation to temporomandibular joint pain variation over the last three months. The box represents the interquartile range, and the black line represents the median and the confidence interval. Subjects #147, #151, and #175 showed outlier values.