COVID-19, Mental Health and Neuropathophysiology of Pain Related to Temporomandibular Disorder

Temporomandibular disorders (TMDs) are a group of disorders related to pain and dysfunction that affect the temporomandibular joint (TMJ) and the masticatory system. TMD patients often suffer from orofacial pain and have symptoms that are less specific, including ear pain and ear fullness, tinnitus, dizziness, neck pain, and headache. Thus, individuals with TMD and orofacial pain deserve special attention, since neurological events such as headache, tinnitus, and muscle pain, which are present in these conditions, can also be found in cases of COVID-19. In addition, mental health disorders, such as anxiety and depression, are more common in patients with TMD than in the general population. Consequently, individuals with psychological disabilities, such as TMD patients, may have their pain perpetuated as a result. COVID-19 is not only affecting physical health — it has brought direct and indirect psychological and social consequences that can influence mental health both during the pandemic and in the future. Therefore, it is believed that psychological factors in connection with the pandemic may lead to a great risk of developing, worsening, and prolonging TMD, since these factors can lead to autonomic responses that result in sleep disorders. This chapter will address the impact of the COVID-19 pandemic on the mental health of TMD patients, focusing on brain changes involving the trigeminal pathway and maladaptive changes in the default mode network (DMN).

Keywords: Anxiety, Coronavirus, COVID-19, Default mode network, Depression, Headache, Mental health, Post-traumatic stress disorder, Psychological factors, Sleep bruxism, Spinal trigeminal nucleus, Temporomandibular joint disorders, Tinnitus, TMD pain, Trigeminal system.