key: cord-0806412-lckyeu0y
authors: ALMEIDA-LEITE, Camila Megale; STUGINSKI-BARBOSA, Juliana; CONTI, Paulo César Rodrigues
title: How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders?
date: 2020-05-11
journal: Journal of applied oral science : revista FOB
DOI: 10.1590/1678-7757-2020-0263
sha: 3b7d29c38a41710d65d4ec41f162774220beffd1
doc_id: 806412
cord_uid: lckyeu0y

nan

2020;28:e20200263 1/3

In January 2020, a novel coronavirus has been announced as the etiologic pathogen of COVID-19 disease that had become a major epidemic threat in China. It has widely spread since December 2019 not only in China but also in many countries around the world, which became a major challenge for public health. 1,2 World Health Organization (WHO) announced COVID-19 outbreak a pandemic in March 2020 and it constitutes a public health emergency of international concern. 3 As of April 20, 2020, there have been more than 2.3 million confirmed cases and 157.000 deaths globally. 4 In the current situation, there are many uncertainties concerning SARS-CoV-2 origin, nature, government capacity to prevent the spread of infection, and seriousness of the risk. 7 Moreover, the lack of faith in the healthcare system to deal with new cases, worries about becoming infected, fear of death, increase in hygienic and avoidance behaviors, lack of information and misinformation fuel excessive fear and create an environment of anxiety and depression that interfere with basic daily activities, including sleep quality. 7, 8, 9 In addition, people who are quarantined lose social connections and feelings of loneliness and anger may develop. 10,11 It has already been well documented the strong J Appl Oral Sci. 2020;28:e20200263 2/3 impact that COVID-19 is having on the psychological issues in China, where a significant portion of population has reported moderate-to-severe anxiety. 12

Medical health-care workers, mainly females, are also facing increased levels of anxiety and stress. 9, 13 It is well established the importance of psychosocial factors in development and maintenance of Temporomandibular Disorders (TMD) and the high prevalence of psychological disturbances in TMD patients, mainly in those who suffer from masticatory muscle disorders. [14] [15] [16] Moreover, there is a significant relationship between painful TMD, depression, and anxiety. [16] [17] [18] [19] All psychological issues involved Sustained muscle contraction of head and neck is also related to a required body posture associated to fight-or-flight response. Therefore, muscle contraction in awake bruxism could be part of the defense behavior associated with anxiety and stress. 28

The anxiety-related processes occur in the CNS and involves interactions among prefrontal cortex, limbic, paralimbic structures (amygdala, insula, anterior cingulate gyrus) and motor regions of the brain stem that leads to motor and physiological responses not only to stress, but also increased alertness and 

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