Effects of Mask Usage During the COVID-19 Pandemic on Sign and Symptoms of Temporomandibular Joint Disorder: A Survey Study.

Objective: To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and identify potentially effective factors. Methods: An online questionnaire consisting of three parts was sent to dentists and clinical dental students. The first part included questions regarding sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD, if any, before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing patterns while wearing a mask were evaluated. Results: TMD symptoms and stress levels were significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared with daily life in dentists whose professional mask selection was an N95 respirator. The change in temporomandibular joints pain and muscle pain at rest between T0 and T1 was higher in those whose professional mask choice was N95 respirators than in those who chose to wear one surgical mask. Conclusion: The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may increase TMD.