Impact of COVID-19 on Portuguese Dental Students: A Cohort Study
Abstract
:1. Introduction
2. Material and Methods
2.1. Population and Sample
2.2. Questionnaires
- A.
- Anxiety and Depression Questionnaire adapted from The Hospital of Anxiety and Depression Scale (HADS). HADS was used to evaluating the symptoms of participants’ anxiety and depression. Consisting of 14 questions, 7 evaluate anxiety (HADS-A) and the remaining 7 evaluate depression (HADS-D) [36]. Each item can be punctuated from 0 to 3, resulting in 21 points as the maximum for each scale.
- B.
- DTM symptom questionnaire according to diagnostic criteria for temporomandibular dysfunctions. According to the Diagnostic Criteria for Temporomandibular Disorders: Clinical Protocol and Assessment Instruments (DC/TMD) Questionnaire. The participant was given the option to complete the questionnaire because the questions in it have an objective character about the symptoms of TMDs [18,37].
- C.
- Questionnaire on the presence of habits for functional and oral behaviors, according to the DC/TMD Oral Behavior Checklist (OBC) questionnaire, an evaluation list of oral behaviors (ELOB). This questionnaire was also translated and validated in Portuguese. Participants answered objective questions about the frequency with which they carried out certain habits during sleep and while awake during the period in question. Five response options varied, and each had a given quotation, from 0 to 4, both at the time the participant was awake and when he was sleeping, and the options differed from each moment. Each participant was given a score that resulted from the sum of the quotations of the chosen answers. The greater the score, the greater the presence of oral behaviors [18].
2.3. Eligibility Criteria and Variables Studied
2.4. Positive Hypothesis Formulated
2.5. Statistical Analysis
3. Results
3.1. Sociodemographic Characterization
3.2. Descriptive and Statistical Analysis
3.2.1. TMD
3.2.2. Anxiety and Depression (HADS)
3.2.3. Oral Behavior (OB)
3.2.4. Correlation between TMD and Gender, Age, Academic Degree, Anxiety, and Depression
3.2.5. Association between OBs and Anxiety, Depression, and TMD
4. Discussion
Study Limitations and Prospects
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Umakanthan, S.; Sahu, P.; Ranade, A.V.; Bukelo, M.M.; Rao, J.S.; Abrahao-Machado, L.F.; Dahal, S.; Kumar, H.; Kv, D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad. Med. J. 2020, 96, 753–758. [Google Scholar]
- Hakami, Z.; Khanagar, S.B.; Vishwanathaiah, S.; Hakami, A.; Bokhari, A.M.; Jabali, A.H.; Alasmari, D.; Aldrees, A.M. Psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on dental students: A nationwide study. J. Dent. Educ. 2021, 85, 494–503. [Google Scholar] [CrossRef] [PubMed]
- Ita, K. Coronavirus Disease (COVID-19): Current Status and Prospects for Drug and Vaccine Development. Arch. Med. Res. 2021, 52, 15–24. [Google Scholar] [CrossRef]
- Harapan, H.; Itoh, N.; Yufika, A.; Winardi, W.; Keam, S.; Te, H.; Megawati, D.; Hayati, Z.; Wagner, A.L.; Mudatsir, M.; et al. Coronavirus disease 2019 (COVID-19): A literature review. J. Inf. Public Health 2020, 13, 667–673. [Google Scholar] [CrossRef] [PubMed]
- Gorbalenya, A.E.; Baker, S.C.; Baric, R.S.; de Groot, R.J.; Drosten, C.; Gulyaeva, A.A.; Haagmans, B.L.; Lauber, C.; Leontovich, A.M.; Neuman, B.W.; et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses—A statement of the Coronavirus Study Group. bioRxiv 2020, 2020, 937862. [Google Scholar]
- Burki, T.K. Coronavirus in China. Lancet Respir. Med. 2020, 8, 238. [Google Scholar] [CrossRef] [PubMed]
- Sharma, A.; Ahmad Farouk, I.; Lal, S.K. COVID-19: A review on the novel coronavirus disease evolution, transmission, detection, control and prevention. Viruses 2021, 13, 202. [Google Scholar] [CrossRef]
- Wang, C.; Horby, P.W.; Hayden, F.G.; Gao, G.F. A novel coronavirus outbreak of global health concern. Lancet 2020, 395, 470–473. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Vitiello, A.; Ferrara, F.; Troiano, V.; la Porta, R. COVID-19 vaccines and decreased transmission of SARS-CoV-2. Inflammopharmacology 2021, 29, 1357–1360. [Google Scholar] [CrossRef]
- Agyapong, V.I.O.; Hrabok, M.; Vuong, W.; Gusnowski, A.; Shalaby, R.; Mrklas, K.; Li, D.; Urichuk, L.; Snaterse, M.; Surood, S.; et al. Closing the psychological treatment gap during the covid-19 pandemic with a supportive text messaging program: Protocol for implementation and evaluation. JMIR Res. Protoc. 2020, 9, e19292. [Google Scholar] [CrossRef] [PubMed]
- Zhang, S.X.; Wang, Y.; Rauch, A.; Wei, F. Unprecedented disruption of lives and work: Health, distress and life satisfaction of working adults in China one month into the COVID-19 outbreak. Psychiatr. Res. 2020, 288, 112958. [Google Scholar] [CrossRef] [PubMed]
- Zhang, W.R.; Wang, K.; Yin, L.; Zhao, W.F.; Xue, Q.; Peng, M.; Min, B.Q.; Tian, Q.; Leng, H.X.; Du, J.L. Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China. Psychother. Psychosom. 2020, 89, 242–250. [Google Scholar] [CrossRef] [PubMed]
- Beaglehole, B.; Mulder, R.T.; Frampton, C.M.; Boden, J.M.; Newton-Howes, G.; Bell, C.J. Psychological distress and psychiatric disorder after natural disasters: Systematic review and meta-analysis. Br. J. Psychiatr. 2018, 213, 716–722. [Google Scholar] [CrossRef] [Green Version]
- Brooks, S.K.; Webster, R.K.; Smith, L.E.; Woodland, L.; Wessely, S.; Greenberg, N.; Rubin, G.J. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020, 395, 912–920. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cai, H.; Tu, B.; Ma, J.; Chen, L.; Fu, L.; Jiang, Y.; Zhuang, H. Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID-19) in Hubei, China. Med. Sci. Monit. 2020, 26, e924171. [Google Scholar]
- Yuan, S.; Liao, Z.; Huang, H.; Jiang, B.; Zhang, X.; Wang, Y.; Zhao, M. Comparison of the Indicators of Psychological Stress in the Population of Hubei Province and Non- Endemic Provinces in China During Two Weeks During the Coronavirus Disease 2019 (COVID-19) Outbreak in February 2020. Med. Sci. Monit. 2020, 26, e923767. [Google Scholar] [CrossRef]
- Gdanska, P.; Drozdowicz-Jastrzebska, E.; Grzechocinska, B.; Radziwon-Zaleska, M.; Wegrzyn, P.; Wielgos, M. Anxiety and depression in women undergoing infertility treatment. Ginekol. Polska 2017, 88, 109–112. [Google Scholar] [CrossRef] [Green Version]
- Medeiros, R.A.; Vieira, D.L.; da Silva, E.V.F.; de Rezende, L.V.M.L.; dos Santos, R.W.; Tabata, L.F. Prevalence of symptoms of temporomandibular disorders, oral behaviors, anxiety, and depression in dentistry students during the period of social isolation due to COVID-19. J. Appl. Oral Sci. 2020, 28, e20200445. [Google Scholar] [CrossRef]
- Michaelis, S.; Bandelow, B. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin. Neurosci. 2015, 17, 327–335. [Google Scholar] [CrossRef]
- Tiller, J.W.G. Depression and anxiety. Med. J. Aust. 2012, 1, 28–32. [Google Scholar] [CrossRef]
- Moreira de Sousa, J.; Moreira, C.A.; Telles-Correia, D. Anxiety, depression and academic performance: A study amongst Portuguese medical students versus non-medical students. Acta Med. Port. 2018, 31, 454–462. [Google Scholar] [CrossRef]
- Ayuso-Mateos, J.L.; Vázquez-Barquero, J.L.; Dowrick, C.; Lehtinen, V.; Dalgard, O.S.; Casey, P.; Wilkinson, C.; Lasa, L.; Page, H.; Dunn, G.; et al. Depressive disorders in Europe: Prevalence figures from the ODIN study. Br. J. Psychiatr. 2001, 179, 308–316. [Google Scholar] [CrossRef] [PubMed]
- COVID-19 Mental Disorders Collaborators. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 2021, 398, 1700–1712. [Google Scholar] [CrossRef] [PubMed]
- Theroux, J.; Stomski, N.; Cope, V.; Mortimer-Jones, S.; Maurice, L. A cross-sectional study of the association between anxiety and temporomandibular disorder in Australian chiropractic students. J. Chiropr. Educ. 2019, 33, 111–117. [Google Scholar] [CrossRef]
- Benke, C.; Autenrieth, L.K.; Asselmann, E.; Pané-Farré, C.A. Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany. Psychiatr. Res. 2020, 293, 113462. [Google Scholar] [CrossRef]
- Wang, C.; Pan, R.; Wan, X.; Tan, Y.; Xu, L.; McIntyre, R.S.; Choo, F.N.; Tran, B.; Ho, R.; Sharma, V.K.; et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav. Immun. 2020, 87, 40–48. [Google Scholar] [CrossRef]
- Wu, P.; Fang, Y.; Guan, Z.; Fan, B.; Kong, J.; Yao, Z.; Liu, X.; Fuller, C.J.; Susser, E.; Lu, J.; et al. The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception, and altruistic acceptance of risk. Can. J. Psychiatr. 2009, 54, 302–311. [Google Scholar] [CrossRef]
- Liu, X.; Kakade, M.; Fuller, C.J.; Fan, B.; Fang, Y.; Kong, J.; Guan, Z.; Wu, P. Depression after exposure to stressful events: Lessons learned from the severe acute respiratory syndrome epidemic. Compr. Psychiatr. 2012, 53, 15–23. [Google Scholar] [CrossRef]
- Bai, Y.; Lin, C.C.; Lin, C.Y.; Chen, J.Y.; Chue, C.M.; Chou, P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr. Serv. 2004, 55, 1055–1057. [Google Scholar] [CrossRef]
- Zhu, S.; Wu, Y.; Zhu, C.Y.; Hong, W.C.; Yu, Z.X.; Chen, Z.K.; Chen, Z.L.; Jiang, D.G.; Wang, Y.G. The immediate mental health impacts of the COVID-19 pandemic among people with or without quarantine managements. Brain Behav. Immun. 2020, 87, 56–58. [Google Scholar] [CrossRef] [PubMed]
- Zhang, J.; Lu, H.; Zeng, H.; Zhang, S.; Du, Q.; Jiang, T.; Du, B. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain Behav. Immun. 2020, 87, 49–50. [Google Scholar] [CrossRef] [PubMed]
- Wang, Y.; Xu, B.; Zhao, G.; Cao, R.; He, X.; Fu, S. Is quarantine related to immediate negative psychological consequences during the 2009 H1N1 epidemic? Gen. Hosp. Psych. 2011, 33, 75–77. [Google Scholar] [CrossRef]
- Badami, Z.A.; Mustafa, H.; Maqsood, A.; Aijaz, S.; Altamash, S.; Lal, A.; Saeed, S.; Ahmed, N.; Yousofi, R.; Heboyan, A.; et al. Comparison of General Anxiety among Healthcare Professionals before and after COVID-19 Vaccination. Vaccines 2022, 10, 2076. [Google Scholar] [CrossRef] [PubMed]
- Halim, M.S.; Noorani, T.Y.; Karobari, M.I.; Kamaruddin, N. COVID-19 and dental education: A Malaysian perspective. J. Int. Oral Health 2021, 13, 201–206. [Google Scholar]
- Vilelas, J. O Processo de Construção do Conhecimento, 3rd ed.; Edições Sílabo, LDA: Lisboa, Portugal, 2009; ISBN 978-989-561-097-6. [Google Scholar]
- Marcolino, J.A.M.; Suzuki, F.M.; Alli, L.A.C.; Gozzani, J.L.; Mathias, L.A.S.T. Measurement of anxiety and depression in preoperative patients. Comparative study. Rev. Bras. Anestesiol. 2007, 57, 157–166. [Google Scholar] [CrossRef] [PubMed]
- Castro, M.M.C.; Quarantini, L.; Batista-Neves, S.; Kraychete, D.C.; Daltro, C.; Miranda-Scippa, A. Validity of the hospital anxiety and depression scale in patients with chronic pain. Rev. Bras. Anestesiol. 2006, 56, 470–477. [Google Scholar]
- Silva, T.V.S.; da Vieira, L.M.; Cardoso, A.M.R.; de Oliveira, R.V.D. Qualidade de vida, ansiedade e depressão em estudantes de Odontologia na pandemia da COVID-19 e fatores relacionados. Res. Soc. Dev. 2021, 10, e34710817481. [Google Scholar]
- Sójka, A.; Stelcer, B.; Roy, M.; Mojs, E.; Pryliński, M. Is there a relationship between psychological factors and TMD? Brain Behav. 2019, 9, e01360. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kong, X.; Zheng, K.; Tang, M.; Kong, F.; Zhou, J.; Diao, L.; Wu, S.; Jiao, P.; Su, T.; Dong, Y. Prevalence and Factors Associated with Depression and Anxiety of Hospitalized Patients with COVID-19. medrXiv 2020. [Google Scholar] [CrossRef] [Green Version]
- Radeef, A.S.; Faisal, G.G. Stressors and their association with symptoms of depression, anxiety and stress in dental students. Makara J. Health Res. 2018, 22, 58–62. [Google Scholar] [CrossRef]
- Aboalshamat, K.; Hou, X.Y.; Strodl, E. Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study. Med. Teach. 2015, 37 (Suppl. S1), S75. [Google Scholar] [CrossRef]
- Uraz, A.; Tocak, Y.S.; Yozgatligil, C.; Cetiner, S.; Bal, B. Psychological well-being, health, and stress sources in Turkish dental students. J. Dent. Educ. 2013, 77, 1345–1355. [Google Scholar] [CrossRef]
- Vedolin, G.M.; Lobato, V.V.; Conti, P.C.R.; Lauris, J.R.P. The impact of stress and anxiety on the pressure pain threshold of myofascial pain patients. J. Oral Rehabil. 2009, 36, 313–321. [Google Scholar] [CrossRef] [PubMed]
- Machado, N.A.G.; Costa, Y.M.; Quevedo, H.M.; Stuginski-Barbosa, J.; Valle, C.M.; Bonjardim, L.R.; Garib, D.G.; Conti, P.C.R. The association of self-reported awake bruxism with anxiety, depression, pain threshold at pressure, pain vigilance, and quality of life in patients undergoing orthodontic treatment. J. Appl. Oral Sci. 2020, 28, e20190407. [Google Scholar] [CrossRef]
- Naidu, R.S.; Adams, J.S.; Simeon, D.; Persad, S. Sources of stress and psychological disturbance among dental students in the West Indies. J. Dent. Educ. 2002, 66, 1021–1030. [Google Scholar] [CrossRef]
- Paolone, G.; Mazzitelli, C.; Formiga, S.; Kaitsas, F.; Breschi, L.; Mazzoni, A.; Tete, G.; Polizzi, E.; Gherlone, E.; Cantatore, G. One-year impact of COVID-19 pandemic on Italian dental professionals: A cross-sectional survey. Minerva Dent. Oral Sci. 2022, 71, 212–222. [Google Scholar] [CrossRef]
- Sanders, A.E.; Slade, G.D. Gender modifies effect of perceived stress on orofacial pain symptoms: National Survey of Adult Oral Health. J. Orofac. Pain 2011, 25, 317–326. [Google Scholar] [PubMed]
- Huang, G.J.; LeResche, L.; Critchlow, C.W.; Martin, M.D.; Drangsholt, M.T. Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD). J. Dent. Res. 2002, 81, 284–288. [Google Scholar] [CrossRef]
- Graue, A.M.; Jokstad, A.; Assmus, J.; Skeie, M.S. Prevalence among adolescents in Bergen, Western Norway, of temporomandibular disorders according to the DC/TMD criteria and examination protocol. Acta Odontol. Scand. 2016, 74, 449–455. [Google Scholar] [CrossRef] [PubMed]
- Magnusson, T.; Egermark, I.; Carlsson, G.E. A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. J. Orofac. Pain 2000, 14, 310–319. [Google Scholar] [PubMed]
- Pedroni, C.R.; de Oliveira, A.S.; Guaratini, M.I. Prevalence study of signs and symptoms of temporomandibular disorders in university students. J. Oral Rehabil. 2003, 30, 283–289. [Google Scholar] [CrossRef]
- Bueno, C.H.; Pereira, D.D.; Pattussi, M.P.; Grossi, P.K.; Grossi, M.L. Gender differences in temporomandibular disorders in adult populational studies: A systematic review and meta-analysis. J. Oral Rehabilit. 2018, 45, 720–729. [Google Scholar] [CrossRef]
- Jo, J.H.; Chung, J.W. Gender differences in clinical characteristics of korean temporomandibular disorder patients. Appl. Sci. 2021, 11, 3583. [Google Scholar] [CrossRef]
- Kindler, S.; Samietz, S.; Houshmand, M.; Grabe, H.J.; Bernhardt, O.; Biffar, R.; Kocher, T.; Meyer, G.; Völzke, H.; Metelmann, H.R.; et al. Depressive and anxiety symptoms as risk factors for temporomandibular joint pain: A prospective cohort study in the general population. J. Pain 2012, 13, 1188–1197. [Google Scholar] [CrossRef]
- List, T.; Wahlund, K.; Larsson, B. Psychosocial functioning and dental factors in adolescents with temporomandibular disorders: A case-control study. J. Orofac. Pain 2001, 15, 218–227. [Google Scholar] [PubMed]
- Scrivani, S.J.; Keith, D.A.; Kaban, L.B. Temporomandibular disorders. N. Engl. J. Med. 2008, 359, 2693–2705. [Google Scholar] [CrossRef] [PubMed]
- Auerbach, S.M.; Laskin, D.M.; Frantsve, L.M.; Orr, T. Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients. J. Oral Maxillofac. Surg. 2001, 59, 628–633, discussion 634. [Google Scholar] [CrossRef]
- Eli, I. Psychosocial factors in the etiology, diagnosis and management of temporomandibular disorders. Alpha Omegan 2003, 96, 20–23. [Google Scholar]
- Michelotti, A.; Farella, M.; Tedesco, A.; Cimino, R.; Martina, R. Changes in pressure- pain thresholds of the jaw muscles during a natural stressful condition in a group of symptom-free subjects. J. Orofac. Pain 2000, 14, 279–285. [Google Scholar]
- Gameiro, G.H.; da Silva Andrade, A.; Nouer, D.F.; Ferraz de Arruda Veiga, M.C. How may stressful experiences contribute to the development of temporomandibular disorders? Clin. Oral Investig. 2006, 10, 261–268. [Google Scholar] [CrossRef]
- Özdin, S.; BayrakÖzdin, S. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int. J. Soc. Psychiatry 2020, 66, 504–511. [Google Scholar] [CrossRef] [PubMed]
- Wang, Y.; Di, Y.; Ye, J.; Wei, W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol. Health Med. 2021, 26, 13–22. [Google Scholar] [CrossRef] [Green Version]
- Asher, M.; Asnaani, A.; Aderka, I.M. Gender differences in social anxiety disorder: A review. Clin. Psychol. Rev. 2017, 56, 1–12. [Google Scholar] [CrossRef]
- Naz, N.; Iqbal, S.; Mahmood, A. Stress, anxiety and depression among the Dental Students of University College of Medicine and Dentistry Lahore; Pakistan. Pak. J. Med. Health Sci. 2017, 11, 1277–1281. [Google Scholar]
- Shaw, S.; Wherton, J.; Vijayaraghavan, S.; Morris, J.; Bhattacharya, S.; Hanson, P.; Jaffar, A.; Ismail, A.; Mahadevan, R. Advantages and limitations of virtual online consultations in a NHS acute trust: The VOCAL mixed-methods study. Health Serv. Del. Res. 2018, 6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shamsuddin, K.; Fadzil, F.; Ismail, W.S.W.; Shah, S.A.; Omar, K.; Muhammad, N.A.; Jaffar, A.; Ismail, A.; Mahadevan, R. Correlates of depression, anxiety and stress among Malaysian university students. Asian J. Psychiatr. 2013, 6, 318–323. [Google Scholar] [CrossRef] [PubMed]
- Chow, J.C.; Cioffi, I. Effects of trait anxiety, somatosensory amplification, and facial pain on self-reported oral behaviors. Clin. Oral Investig. 2019, 23, 1653–1661. [Google Scholar] [CrossRef]
- Suzuki, S.; Castrillon, E.E.; Arima, T.; Kitagawa, Y.; Svensson, P. Blood oxygenation of masseter muscle during sustained elevated muscle activity in healthy participants. J. Oral Rehabil. 2016, 43, 900–910. [Google Scholar] [CrossRef]
- Delcanho, R.E.; Kim, Y.J.; Clark, G.T. Haemodynamic changes induced by submaximal isometric contraction in painful and non-painful human masseter using near-infra-red spectroscopy. Arch. Oral Biol. 1996, 41, 585–596. [Google Scholar] [CrossRef]
- Almeida-Leite, C.M.; Stuginski-Barbosa, J.; Conti, P.C.R. How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders? J. Appl. Oral Sci. 2020, 28, e20200263. [Google Scholar] [CrossRef]
n | % | ||
---|---|---|---|
Gender | Female | 100 | 59.9 |
Male | 67 | 40.1 | |
Age | Average (±SD) | Minimum/Maximum | |
23.5 (6.7) | 19/53 | ||
Groups by age | <26 | 138 | 82.6 |
≥26 | 29 | 17.4 | |
Marital status | Married | 12 | 7.2 |
Never married | 145 | 86.8 | |
Separated | 6 | 3.6 | |
Union | 3 | 1.8 | |
Widower | 1 | 0.6 | |
Academic level | High school | 56 | 33.5 |
College | 95 | 56.9 | |
Master or PhD | 16 | 9.6 | |
Currently studying | Dental Medicine—3rd year | 51 | 30.5 |
Dental Medicine—4th and 5th years | 115 | 68.9 | |
Higher levels | 1 | 0.6 |
Temporomandibular Disorders (TMD) Questions | n | % | |
---|---|---|---|
In the mentioned period, did you have some headaches that included the sources of your head? * | No | 148 | 88.6 |
Yes | 19 | 11.4 | |
How many months ago your headache arose in the source zone for the first time? | 1 | 3 | 16.7 |
2 | 2 | 11.1 | |
4 | 1 | 5.6 | |
6 | 3 | 16.7 | |
7 | 1 | 5.6 | |
12 | 4 | 22.2 | |
24 | 2 | 11.1 | |
26 | 1 | 5.6 | |
30 | 1 | 5.6 | |
In the mentioned period, did the following activities alter a headache in the source zone on any side? | No response | 138 | 82.6 |
No | 22 | 13.2 | |
Chew hard or hard food | Yes | 7 | 4.2 |
In the mentioned period, did the following activities alter a headache in the source zone on any side? Open your mouth, or move your jaw forward or side | No response | 138 | 82.6 |
No | 20 | 12.0 | |
Yes | 9 | 5.4 | |
In the period mentioned, did the following activities change any source-zone headaches on either side? Habits with the jaws, such as keeping the teeth together, clenching/grinding the teeth, or chewing gum | No response | 138 | 82.6 |
No | 17 | 10.2 | |
Yes | 12 | 7.2 | |
In the period mentioned, did the following activities change any source-zone headaches on either side? Other jaw activities like talking, kissing, or yawning | No response | 139 | 83.2 |
No | 24 | 14.4 | |
Yes | 4 | 2.4 | |
Did you have any joint sound (or sounds) when you moved or used your jaw during the mentioned period? * | Right | 4 | 2.4 |
Left | 3 | 1.8 | |
No | 110 | 65.9 | |
Do not know | 13 | 7.8 | |
Yes | 37 | 22.2 | |
Have you ever had your jaw blocked or trapped, even for a moment, so you didn’t open it FULLY? * | Left | 1 | 0.6 |
No | 144 | 86.2 | |
Do not know | 5 | 3.0 | |
Yes | 17 | 10.2 | |
Is the jaw blocked or trapped severely enough to limit opening and interfere with your feeding ability? | No response | 131 | 78.4 |
No | 30 | 18.0 | |
Do not know | 1 | 0.6 | |
Yes | 5 | 3.0 | |
In the past 30 days, did your jaw lock so that you could not open it FULLY, even for a moment, and then unlock it to open it FULLY? | No response | 130 | 77.8 |
No | 29 | 17.4 | |
Yes | 8 | 4.8 | |
Is your jaw blocked or limited, so it does not open FULLY? | No response | 143 | 85.6 |
No | 23 | 13.8 | |
Do not know | 1 | 0.6 | |
In the last 30 days, when you opened your mouth a lot, did your jaw lock or catch even for a moment so that you couldn’t close it from this wide opening position? * | Right | 1 | 0.6 |
No | 157 | 94.0 | |
Do not know | 2 | 1.2 | |
Yes | 7 | 4.2 | |
In the last 30 days, when your jaw was locking or binding with your mouth wide open, did you have to do anything to get it closed, including resting, moving, pushing, or maneuvering it? | No response | 138 | 82.6 |
No | 23 | 13.8 | |
Do not know | 2 | 1.2 | |
Yes | 4 | 2.4 |
Hads | 0 | 1 | 2 | 3 | NR | |||||
---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | |
I felt tense or constricted | 45 | 26.9 | 87 | 52.1 | 29 | 17.4 | 4 | 2.4 | 2 | 1.2 |
I had a taste for the same things as before | 90 | 53.9 | 64 | 38.3 | 8 | 4.8 | 3 | 1.8 | 2 | 1.2 |
I felt a kind of fear, as if something negative was going to happen | 56 | 33.5 | 62 | 37.1 | 39 | 23.4 | 8 | 4.8 | 2 | 1.2 |
I laughed and had fun when I saw funny things | 116 | 69.5 | 43 | 25.7 | 6 | 3.6 | 0 | 0 | 2 | 1.2 |
My head was full of worries | 48 | 28.7 | 72 | 43.1 | 30 | 18 | 15 | 9 | 2 | 1.2 |
I felt happy | 38 | 22.8 | 98 | 58.7 | 27 | 16.2 | 2 | 1.2 | 2 | 1.2 |
I was able to sit at ease and feel relaxed | 60 | 35.9 | 72 | 43.1 | 33 | 19.8 | 0 | 0 | 2 | 1.2 |
I was slow to think and do things | 38 | 22.8 | 85 | 50.9 | 34 | 20.4 | 8 | 4.8 | 2 | 1.2 |
I had a feeling of fear, like butterflies in his stomach or a tightness | 77 | 46.1 | 77 | 46.1 | 11 | 6.6 | 0 | 0 | 2 | 1.2 |
I lost interest in taking care of my appearance | 54 | 32.3 | 72 | 43.1 | 25 | 15 | 14 | 8.4 | 2 | 1.2 |
I felt restless, as if I could not sit still | 72 | 43.1 | 65 | 38.9 | 21 | 12.6 | 7 | 4.2 | 2 | 1.2 |
I felt excited when thinking about the future | 67 | 40.1 | 69 | 41.3 | 25 | 15 | 4 | 2.4 | 2 | 1.2 |
I suddenly had a feeling of panic | 109 | 65.3 | 37 | 22.2 | 15 | 9 | 4 | 2.4 | 2 | 1.2 |
I was able to feel pleasure when watching a good program on television or radio or when I read something | 80 | 47.9 | 64 | 38.3 | 18 | 10.8 | 3 | 1.8 | 2 | 1.2 |
Variable | Average (± SD) | Minimum–Maximum |
---|---|---|
HADS—Anxiety | 5.73 (±3.82) | (0–17) |
HADS—Depression | 5.36 (±3.13) | (0–13) |
OBs | 11.87 (±10.24) | (0–52) |
Not Once | A Little Part of the Time | Some Part of the Time | Most of the Time | All the Time | Average | Median | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
I gnashed his teeth during his waking hours | 129 | 77.2% | 26 | 15.6% | 8 | 4.8% | 3 | 1.8% | 1 | 0.6% | 0.33 | 0 |
Clenched teeth during waking hours | 98 | 58.7% | 38 | 22.8% | 24 | 14.4% | 5 | 3% | 2 | 1.2% | 0.65 | 0 |
Pressed, touched, or held teeth together other than to eat (i.e., contact between upper and lower teeth) | 79 | 47.3% | 46 | 27.5% | 29 | 17.4% | 9 | 5.4% | 4 | 2.4% | 0.88 | 1.0 |
Grasping, squeezing, or creating muscle tension without grinding or bringing teeth together | 102 | 61.1% | 34 | 20.4% | 23 | 13.8% | 7 | 4.2% | 1 | 0.6% | 0.63 | 0 |
Maintained or projected the mandible forward or to the side | 127 | 76% | 24 | 14.4% | 14 | 8.4% | 1 | 0.6% | 1 | 0.6% | 0.35 | 0 |
I pressed his tongue hard against his teeth. | 124 | 74.3% | 28 | 16.8% | 11 | 6.6% | 2 | 1.2% | 2 | 1.2% | 0.38 | 0 |
Put your tongue between your teeth | 126 | 75.4% | 21 | 12.6% | 15 | 9% | 3 | 1.8% | 2 | 1.2% | 0.41 | 0 |
Biting, chewing, or playing with your tongue, cheeks, or lips | 103 | 61.7% | 36 | 21.6% | 21 | 12.6% | 5 | 3% | 2 | 1.2% | 0.60 | 0 |
I held the jaw in a rigid or tense position as if preparing for an impact or protecting the jaw. | 127 | 76% | 24 | 14.4% | 11 | 6.6% | 5 | 3% | 0 | 0 | 0.37 | 1.0 |
Kept between teeth or bit objects, such as hair, pipe, pencils, pens, fingers, nails, etc. | 108 | 64.7% | 30 | 18% | 20 | 12% | 6 | 3.6% | 3 | 1.8% | 0.6 | 0 |
Chewing gum | 77 | 46.1% | 46 | 27.5% | 27 | 16.2% | 12 | 7.2% | 5 | 3% | 0.93 | 1.0 |
Played a musical instrument that involved the use of the mouth or jaw (for example, brass, woodwind, or string instruments) | 151 | 90.4% | 7 | 4.2% | 8 | 4.8% | 1 | 0.6% | 0 | 0 | 0.16 | 0 |
Leaning with the jaw over hand, e.g., cupping or resting chin on hand | 85 | 50.9% | 38 | 22.8% | 31 | 18.6% | 10 | 6% | 3 | 1.8% | 0.85 | 0 |
Chewing food on one side | 107 | 64.1% | 37 | 22.2% | 21 | 12.6% | 2 | 1.2% | 0 | 0 | 0.51 | 0 |
Eat between meals (i.e., food that requires chewing) | 64 | 38.3% | 42 | 25.1% | 35 | 21% | 17 | 10.2% | 9 | 5.4% | 1.19 | 1.0 |
Talked for extended periods (e.g., taught, sold, customer support) | 121 | 72.5% | 27 | 16.2% | 12 | 7.2% | 6 | 3.6% | 1 | 0.6% | 0.44 | 0 |
Sang | 89 | 53.3% | 46 | 27.5% | 20 | 12% | 7 | 4.2% | 5 | 3% | 0.76 | 0 |
Yawned | 45 | 26.9% | 68 | 40.7% | 33 | 19.8% | 14 | 8.4% | 7 | 4.2% | 1.22 | 1.0 |
I held the phone between his head and shoulders | 101 | 60.5% | 40 | 24% | 19 | 11.4% | 5 | 3% | 2 | 1.2% | 0.6 | 0 |
None | Less than 1 Night/Month | 1–3 Nights/Month | 1–3 Nights/Week | 4–7 Nights/Month | Average | Median | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Clenched or ground teeth in sleep, based on any information he/she might have | 94 | 56.3% | 28 | 16.8% | 16 | 9.6% | 18 | 10.8% | 11 | 0.6% | 0.95 | 0 |
Sleeping in a position that puts pressure on the jaw (e.g., on your stomach, on your side) | 66 | 39.5% | 18 | 10.8% | 22 | 13.2% | 21 | 12.6% | 40 | 24% | 1.71 | 1.0 |
Without Depression (<8), n (%) | With Depression (≥8), n (%) | x2 (p) | Without Anxiety (<8), n (%) | With Anxiety (≥8), n (%) | x2 (p) | High School n (%) | College n (%) | Master/Ph.D. n (%) | x2 (p) | <26 y. n (%) | ≥26 y. n (%) | x2 (p) | Female n (%) | Male n (%) | x2 (p) | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
without TMD | 91 (72.8%) | 17 (43.5%) | 13.07 (0.001) | 90 (76.9%) | 18 (37.5%) | 29.52 (<0.001) | 36 (64.3%) | 61 (64.2%) | 12 (75%) | 8.34 (0.08) | 85 (61.6%) | 24 (82.8%) | 4.96 (0.084) | 59 (59%) | 50 (74.6%) | 8.47 (0.014) |
TMD with pain | 17 (43.5%) | 9 (22.5%) | 5 (4.3%) | 14 (29.2%) | 17 (30.4%) | 18 (18.9%) | 4 (25%) | 35 (25.4%) | 4 (13.8%) | 17 (17%) | 2 (3%) | |||||
TMD without pain | 25 (19.2%) | 14 (35%) | 22 (18.8%) | 16 (33.3%) | 3 (5.4%) | 16 (16.8%) | 0 (0%) | 18 (13%) | 1 (3.4%) | 24 (24%) | 15 (22.4%) | |||||
Total | 125 (100%) | 40 (100%) | 117 (100%) | 48 (100%) | 56 (100%) | 95 (100%) | 16 (100%) | 138 (100%) | 29 (100%) | 100 (100%) | 67 (100%) |
High School n (%) | College n (%) | Master/Ph.D. n (%) | x2 (p) | <26 y.o. n (%) | ≥26 y.o. n (%) | x2 (p) | Female n (%) | Male n (%) | x2 (p) | |
---|---|---|---|---|---|---|---|---|---|---|
without anxiety (<8) | 41 (74.5%) | 65 (69.1%) | 11 (68.8%) | 0.53 (0.767) | 97 (70.3%) | 20 (74.1%) | 0.16 (0.692) | 60 (60.6%) | 57 (86.4%) | 12.74 (0.00001) |
with anxiety (≥8) | 14 (25.5%) | 29 (30.9%) | 5 (31.3%) | 41 (29.7%) | 7 (25.95%) | 39 (39.4%) | 9 (13.6%) | |||
Total | 55 (100%) | 95 (100%) | 16 (100%) | 138 (100%) | 27 (100%) | 99 (100%) | 66 (100%) | |||
without depression (<8) | 39 (70.9%) | 75 (79.8%) | 11 (68.8%) | 1.96 (0.375) | 101 (73.2%) | 24 (88.9%) | 3.03 (0.082) | 69 (69%) | 56 (84.8%) | 4.95 (0.026) |
with depression (≥8) | 16 (29.1%) | 19 (20.2%) | 5 (31.3%) | 37 (26.8%) | 3 (11.1%) | 30 (30.3%) | 10 (15.2%) | |||
Total | 55 (100%) | 94 (100%) | 16 (100%) | 138 (100%) | 27 (100%) | 99 (100%) | 66 (100%) |
OBC | DTM | Anxiety | Depression |
---|---|---|---|
Correlation coeficient | 0.391 | 0.361 | 0.215 |
p | 0.0001 | 0.0001 | 0.006 |
N | 167 | 165 | 165 |
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dos Santos Gonçalves, R.M.; Fernandes, G.V.O.; Fernandes, J.C.H.; Seabra, M.; Figueiredo, A. Impact of COVID-19 on Portuguese Dental Students: A Cohort Study. Healthcare 2023, 11, 818. https://doi.org/10.3390/healthcare11060818
dos Santos Gonçalves RM, Fernandes GVO, Fernandes JCH, Seabra M, Figueiredo A. Impact of COVID-19 on Portuguese Dental Students: A Cohort Study. Healthcare. 2023; 11(6):818. https://doi.org/10.3390/healthcare11060818
Chicago/Turabian Styledos Santos Gonçalves, Rodrigo Melo, Gustavo Vicentis Oliveira Fernandes, Juliana Campos Hasse Fernandes, Mariana Seabra, and Andreia Figueiredo. 2023. "Impact of COVID-19 on Portuguese Dental Students: A Cohort Study" Healthcare 11, no. 6: 818. https://doi.org/10.3390/healthcare11060818
APA Styledos Santos Gonçalves, R. M., Fernandes, G. V. O., Fernandes, J. C. H., Seabra, M., & Figueiredo, A. (2023). Impact of COVID-19 on Portuguese Dental Students: A Cohort Study. Healthcare, 11(6), 818. https://doi.org/10.3390/healthcare11060818