COVID‐19 pandemic and Zagreb earthquakes as stressors in patients with temporomandibular disorders

Abstract

Objective To evaluate stress effect of COVID‐19 pandemic and Zagreb earthquakes on symptoms of temporomandibular disorders (TMD). Materials and Methods One hundred and two previously diagnosed TMD patients were contacted by email to participate in an online survey about impact of those events on current and/or new symptoms, perceived stress, anxiety and symptom intensity in time‐points at the baseline, following pandemic and following earthquake. We compared data between earthquake‐affected and non‐affected respondents. Results Response rate was 79.4%. Effects stress had on deterioration of symptoms were significantly different between earthquake‐affected and non‐affected (p = .024). In earthquake‐affected, numerical pain rating scale (NPRS) scores significantly increased between baseline and after COVID‐19 (p > .001) and between baseline and after earthquakes (p > .05). However, scores insignificantly dropped from COVID‐19 to after earthquakes time‐points. In earthquake‐affected, positive correlation was found between impact of COVID‐19 on stress and NPRS (p < .001) and between earthquakes’ impact on stress and NPRS (p < .001). Earthquake‐affected respondents reported significantly more new behavioral habits when compared to non‐affected (p = .048). Conclusions A series of stressful events do not necessarily have a cumulative effect, but are likely to have a complex interaction (e.g., acute stress might trigger the protective mechanisms), which could have decreased pain scores after the earthquakes.

The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders

“…As revealed in this study and earlier studies, a global stressor event (e.g. COVID-19 pandemic, war) can strongly affect the life of patients with TMDs [20][21][22][23][24]. Our results revealed that participants who presented with chronic TMD before the COVID-19 pandemic were more susceptible to COVID-related stress in comparison to those with acute/subacute TMD.…”

“…The prospective research methodology allowed us to examine the correlation between stress and the observed variables in addition to the correlation between stress and the variation of observed variables during the lockdown period. This methodological aspect is relevant as it allowed us to understand not only if people with TMD were affected by COVID-19 related stress (as previous studies have examined), but how they were affected [ 23 , 24 ]. Thus, our study is the first prospective study to report how a global stressor can influence people with TMD in relation to their general health, oral behaviours, psychosocial features, disability and pain intensity.…”

“…Such studies however have investigated these variables in people with TMD versus asymptomatic individuals but no study had prospectively examined the variation of these variables in relation to the psychosocial distress experienced during a global stressor event [18,41,[56][57][58]. Previous cross-sectional, case-control studies on the influence of COVID-19 on TMDs showed a significantly higher impact of COVID-related stress in those with TMDs in comparison to control populations, albeit without differentiating the analysis between chronic and acute/subacute forms [23,24].…”

“…war) on people with TMD revealing a tremendous influence on TMD signs and symptoms [20][21][22]. With regards to the impact of COVID-19 on patients with TMDs, two cross-sectional, case-control studies have recently been reported but, given the nature of the research design, these studies were not able to examine the variation of TMD signs and symptoms pre and post COVID-19 lockdown in relation to the psychosocial distress experienced [23,24]. Additionally, previous reports did not differentiate the analysis between chronic and acute/subacute forms and were not able to examine several key variables in people with TMDs such as general health variables, oral behaviours, coping strategies and disability.…”

Health System Preparedness for Coincidence of Natural Disasters and COVID-19: A Systematic Literature Review

“…Relevant evaluation can identify the psychological information of patients. Such evaluation can help understand the pain and disability problems of patients who were affected by co-occurrence of COVID-19 and natural disasters (27). In addition, COVID-19 pandemic which is reinforced by disastrous events affected people's mental health remarkably.…”