The Impact of COVID-19-Related Distress on General Health, Oral Behavior, Psychosocial Features, Disability and Pain Intensity in a Cohort of Italian Patients With Temporomandibular Disorders

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Abstract

This study aimed to understand the impact of COVID-19 distress on psychological status, features of central sensitization, and facial pain severity in people with temporomandibular disorders (TMDs). In this prospective cohort study, 45 adults (19 chronic, 26 acute/subacute TMD) were recruited prior to the COVID-19 outbreak. Baseline assessment took place before the outbreak while a follow-up was performed immediately after the lockdown period. Multiple variables were investigated including age, gender, perceived life quality, sleep quality, anxiety, and depression, coping strategies, central sensitization, pain intensity, pain-related disability, and oral behavior. COVID Stress Scales (CSS) were applied at follow-up to measure the extent of COVID-related distress. COVID Stress Scales were significantly higher in those with chronic temporomandibular disorders compared to those with acute/subacute temporomandibular disorders. In people with chronic temporomandibular disorders, the variation in anxiety and depression from baseline to follow-up significantly correlated with scores on the COVID Stress Scales. Variations of the central sensitization inventory and graded chronic pain scale significantly correlated with scores on the COVID Stress Scales. These initial findings indicate that people with chronic temporomandibular disorders were more susceptible to COVID-19 distress with deterioration of psychological status, worsening features of central sensitization and increased chronic facial pain severity. These findings reinforce the role of stress as a possible amplifier of central sensitization, anxiety, depression, chronic pain, and pain-related disability in people with temporomandibular disorders.

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