Temporomandibular disorders: Guidelines and Self-Care for Patients During COVID-19 Pandemic

Authors

  • Simone Saldanha Ignacio de Oliveira Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Sergio Luiz Melo Gonçalvez Department of General and Specialized Surgery, School of Medicine of Fluminense Federal University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Karin de Mello Weig Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Thales Ribeiro Magalhães Filho Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Omar Efrain Roque Martinez Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Maria Theresa Alves da Cunha Kalil Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • George Patrick Boggiss Department of Pain Control and Palliative Care of Oncology, Antonio Pedro Universitary Hospital, School of Medicine of Fluminense Federal University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Denise Mandarino Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • João Paulo Colesanti Tanganeli Department of Orofacial Pain, Post-Graduation Program, Nove de Julho University (UNINOVE) – Sao Paulo – Brazil.
  • Thiago Sousa Almada Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Martha Alayde Alcantara Salim Venancio Department of Oral and Maxillofacial Surgery, School of Dentistry of Federal University of Espírito Santos (UFES) – Espírito Santo – Brazil.
  • Roberto Prado Department of Maxillofacial Traumatology, School of Dentistry of State University of Rio de Janeiro (UERJ) – Rio de Janeiro – Brazil.
  • Renata Matuck Roque Rangel Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Luciana Uemoto Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Rafael Bonato Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Fatima Henriques Cantini Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Sunny Yamaguche Nogueira Barreto Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Taísa Chagas Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Camila Diuana Almeida Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Julio Anibal Tablada Sanchez Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Jennifer Guedes Sobral Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Fillipi Babiere Matta Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Edilania Andrade Furley Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Edicleia Neves Lima Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Karoline Ferreira Farias Catarino Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Julia Mattos Fedozzi Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Bianca Bravim Department of General and Specialized Surgery, School of Medicine of Fluminense Federal University (UFF) - Rio de Janeiro – RJ – Brazil.
  • Klenise Paranhos Department of Periodontology and Implant Dentistry, NYU College of Dentistry (NYU) - New York – NY – USA.
  • Adalsa Hernandez-Andara Coordenator of Oral Radiology and Imaginology, Felix Boada Clinic, Caracas – Venezuela.

DOI:

https://doi.org/10.14295/bds.2020.v23i2.2255

Abstract

Background: Temporomandibular disorder (TMD) belongs to a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, musculature and adjacent components. These conditions can generate signs and symptoms and be influenced by an altered biopsychosocial condition. Objective: This study aims to seek information to assist the patient in the presence of TMD signs and symptoms and Orofacial Pain, associated with the period of social isolation during the COVID-19 pandemic. Material and methods: For the preparation of this manual, a bibliographic search was performed in the databases PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), BBO (BVS), Scopus, Web of Science and The Cochrane Library, using the keywords: orofacial pain, temporomandibular disorders, bruxism, stress, anxiety, biopsychosocial, diagnosis, self-care with important information on how to reduce and control the signs and symptoms of TMD and Orofacial Pain in this moment of pandemic that we are experiencing a social detachment. Results: The results show that the pandemic of COVID-19 and the need for social isolation, generates psychological impact that raises the pattern of anxiety and can directly affect patients with bruxism and TMD. Conclusion: Psychological factors associated with the pandemic can lead to an increased risk of developing, worsening and perpetuating bruxism, especially waking bruxism and TMD, so dentists should be aware of the occurrence of signs and symptoms to manage the multifactorial aspects of this condition. At that time, individual self-management strategies are advised for the patient, which consist of self-massage techniques, body education, exercise practices, sleep hygiene, meditation and making available the use of tools and online devices that facilitate this activity.

Keywords

Orofacial pain; Temporomandibular disorders; Bruxism; Stress; Anxiety; Biopsychosocial; Diagnosis; Self-care; COVID-19.

Author Biography

Simone Saldanha Ignacio de Oliveira, Center of TMD and Orofacial Pain, School of Dentistry of Federal Fluminense University (UFF) - Rio de Janeiro – RJ – Brazil.


Associate Professor at Occlusion and TMD Orofacial Pain, School of Dentistry of Fluminense Federal University ( UFF)

Expertise in TMD and Orofacial Pain

Head of TMD and Orofacial Pain  of School of Dentistry of Fluminense Federal University (UFF)

USP/ ICOI/ NYU / Researcher

IDREF Researcher Grant

Master at Fluminense Federal University (UFF)

PhD and Post Doctoral at São Paulo University (USP)

Member of the Brazilian Society Temporomandibular Disorder and Orofacial Pain

References

Qu X, Zhou X. Psychological intervention for patients with oral disease during the pandemic period of COVID-19. Zhonghua Kou Qiang Yi Xue Za Zhi. 2020;55(4):235‐40. doi:10.3760/cma.j.cn112144-20200213-00053

Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD Consortium Network* and orofacial pain special interest group†. J Oral Facial Pain Headache. 2014;28(1):6‐27. doi:10.11607/jop.1151

De la Torre Canales G, Bonjardim LR, Poluha RL, Soares FFC, Guarda-Nardini L, Conti PR, et al. Correlation between physical and psychosocial findings in a population of temporomandibular disorder patients. Int J Prosthodont. 2020;33(2):155‐9. doi:10.11607/ijp.5847

Sarycheva I, Yanushevich O, Minakov D. Diagnostics of non-carious lesions of dental hard tissues with the methods of optical spectroscopy and radiography. Braz Dent Sci 2020 Apr / Jun; 23(2):1-8. doi:

https://doi.org/10.14295/bds.2020.v23i2.1866

Fricton J, Crandall JA. Orofacial pain as a new dental specialty. Cranio. 2020;38(2):69‐72. doi:10.1080/08869634.2020.1716140

Sassi FC, Silva AP, Santos RKS, Andrade CRF. Oral motor rehabilitation for temporomandibular joint disorders: a systematic review. AudiolCommun Res. 2018; 23:1-13. doi: http://dx.doi.org/10.1590/2317-6431-2017-1871

Bianchini EM, Paiva G, de Andrade CR. Movimentos mandibulares na fala: interferência das disfuncções temporomandibulares segundo indices de dor [Mandibular movements in speech: interference of temporomandibular disfunction according to pain indexes]. Pro Fono. 2007;19(1):7‐18. doi:10.1590/s0104-56872007000100002

Felicio CM, Faria TG, Silva MAMR, Aquino AMC, Junqueira, P. Temporomandibular disorder: relationships between otological and orofacial symptoms. Rev.Bras. Otorhinolaryngol. 2004 Nov-Dec; 76(6): 786-93.

Liu YZ, Wang YX, Jiang CL. Inflammation: the common pathway of stress-related diseases. Front Hum Neurosci. 2017;11:316. Published 2017 Jun 20. doi:10.3389/fnhum.2017.00316

Gudsnuk K, Champagne FA. Epigenetic influence of stress and the social environment. ILAR J. 2012;53(3-4):279‐88. doi:10.1093/ilar.53.3-4.279

Park C, Rosenblat JD, Brietzke E, Pan Z, Lee Y, Cao B, et al. Stress, epigenetics and depression: a systematic review. Neurosci Biobehav Rev. 2019;102:139‐52. doi:10.1016/j.neubiorev.2019.04.010

Koutsimani P, Montgomery A, Georganta K. The relationship between burnout, depression, and anxiety: a systematic review and meta-analysis. Front Psychol. 2019;10:284. Published 2019 Mar 13. doi:10.3389/fpsyg.2019.00284

Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol. 2004;5(10):617‐25. doi:10.1016/S1470-2045(04)01597-9

Smardz J, Martynowicz H, Wojakowska A, Michalek-Zrabkowska M, Mazur G, Wieckiewicz M. Correlation between sleep bruxism, stress, and depression-a polysomnographic Study. J Clin Med. 2019;8(9):1344. Published 2019 Aug 29. doi:10.3390/jcm8091344

World Health Organization - WHO. WHO announces COVID-19 outbreak a pandemic [internet]. Copenhagen: WHO; 2020 [cited 2020 Apr [19]. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who- announces-covid-19-outbreak-a -pandemic)

Firmani M, Reyes M, Becerra N, Flores G, Weitzman M, Espinosa P. Bruxismo de sueño en niños y adolescentes [Sleep bruxism in children and adolescents]. Rev Chil Pediatr. 2015;86(5):373‐9. doi:10.1016/j.rchipe.2015.05.001

Oliveira SS, Pannuti CM, Paranhos KS, Tanganeli JPC, Laganá DC, Sesma N, et al. Effect of occlusal splint and therapeutic exercises on postural balance of patients with signs and symptoms of temporomandibular disorder. Clin Exp Dent Res. 2019;5(2):109‐15. Published 2019 Feb 12. doi:10.1002/cre2.136

Ohayon M, Wickwire EM, Hirshkowitz M, Albert SM, Avidan A, Daly FJ, et al. National sleep foundation's sleep quality recommendations: first report. Sleep Health. 2017;3(1):6‐19. doi:10.1016/j.sleh.2016.11.006

Brazilian Sleep Medicine Association [Internet]. [cited 2020 May 10]. Rochester : Brazilian Sleep Medicine Association. Available from: https //abmsono.org/artigos.html

Schwartz D, Addy N, Levine M, Smith H. Oral appliance therapy should be prescribed as a first-line therapy for OSA during the COViD-19 Pandemic. J Dent Sleep Med. 2020;7(3). doi:https://www.aadsm.org/docs/COVID_Position_Statement.pdf

Masse JF. The Role of DMS during the COVID 19 disease crisis: management with CPAP and oral appliances. J Dent Sleep Med. 2020;7(2). doi: http://dx.doi.org/10.15331/jdsm.7116

Lee S, Kang H, Shin G. Head flexion angle while using a smartphone. Ergonomics. 2015;58(2):220‐6. doi:10.1080/00140139.2014.967311

Yu Z, James C, Edwards S, Snodgrass SJ. Differences in posture kinematics between using a tablet, a laptop, and a desktop computer in sitting and in standing. Work. 2018;61(2):257‐66. doi:10.3233/WOR-182796

Ferreira CL, Silva MA, Felício CM. Signs and symptoms of temporomandibular disorders in women and men. Codas. 2016;28(1):17‐21. doi:10.1590/2317-1782/20162014218

Crowley C, Kapitula LR, Munk D. Mindfulness, happiness, and anxiety in a sample of college students before and after taking a meditation course [published online ahead of print, 2020 May 5]. J Am Coll Health. 2020;1‐8. doi:10.1080/07448481.2020.1754839

Gu Q, Hou JC, Fang XM. Mindfulness meditation for primary headache pain: a meta-analysis. Chin Med J (Engl). 2018;131(7):829‐38. doi:10.4103/0366-6999.228242

Behan C. The benefits of Meditation and Mindfulness practices during times of crisis such as Covid-19 [published online ahead of print, 2020 May 14]. Ir J Psychol Med. 2020;1‐8. doi:10.1017/ipm.2020.38

Tenreiro M. ATM Healthy Manual. Rio de Janeiro: Editora Theano; 2019.

Cassar PM. Manual of therapeutic massage. Sãp Paulo: Manole; 2001.

Dutton M. Physioterapia ortopédica. São Paulo: ArtMed; 2006.

Harper DE, Schrepf A, Clauw DJ. Pain mechanisms and centralized pain in temporomandibular disorders. J Dent Res. 2016;95(10):1102‐08. doi:10.1177/0022034516657070

Teixeira MJ. Pain: manual for the clinician. São Paulo: Atheneu; 2006.

Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: report of a work in progress. J Oral Rehabil. 2018;45(11):837‐44. doi:10.1111/joor.12663

Downloads

Published

2020-06-12

Issue

Vol. 23 No. 2 (2020): SUPP. 2 - Dentistry and Sars-CoV-2

Section

COVID special issue