Psychological impact of COVID-19 pandemic on TMD subjects

OBJECTIVE: The aim of the study was to assess the psychological impact of COVID-19 pandemic on subjects with temporomandibular disorders (TMD), as for symptomatology and presence of parafunctions and sleep disorders. PATIENTS AND METHODS: Two hundred fourteen subjects completed an online questionnaire, including Perceived Stress Scale (PSS), a temporomandibular screening and a specific item about the impact of such event on the psycho-physical side. Non-parametric tests - Mann-Whitney and Kruskal-Wallis - were performed to compare sex and age groups, as for PSS and "COVID-19 pandemic impact score (CpIS)", and the groups Improved/stationary and Worsened in symptomatology as for the "CpIS". Data of subjects undergoing gnathological therapy and not were compared, using Chi-squared test. Orofacial symptomatology values before and during pandemic were compared. The level of statistical significance was set at p<0.05. RESULTS: The most prevalent category of perceived stress was the one of "moderate stress". Participants on average attributed to the pandemic a medium-low impact. The reported symptomatology actually showed a significant negative trend only as for neck pain. The intensity of orofacial symptomatology during pandemic was lower than before. Differences between age groups were statistically significant, as for CpIS. Subjects belonging to the group Worsened in one or more fields examined - TMD symptoms, comorbidities, sleep disturbances and fatigue - reported a significantly higher CpIS (p<0.0001). Awake and sleep bruxism, dental grinding, alteration in the quality and quantity of sleep and fatigue increased. Gnathological therapy was not a protective factor. CONCLUSIONS: The most evident fact during pandemic was the increase of parafunctions and sleep disorders. The trend of symptoms was more variable and complex.