A study of people in Israel and Poland finds that many are experiencing stress-related facial and jaw pain during the pandemic.

Stress from the COVID-19 pandemic can manifest in various ways, including orofacial and jaw pain, which are products of jaw-clenching during the day and teeth-grinding at night.

Experts collectively describe such behaviors as temporomandibular disorders (TMD), while teeth-grinding is also known as bruxism.

A study from Tel Aviv University (TAU) in Israel finds that during the first lockdowns in Israel and Poland, there was a significant rise in TMD incidence.

The study appears in the Journal of Clinical Medicine. The lead authors are Alona Emodi-Perlman and Ilana Eli of Goldschleger School of Dental Medicine at TAU’s Sackler Faculty of Medicine, who say:

“Our study, conducted during the first lockdown of the COVID-19 pandemic, found a significant rise in the symptoms of jaw and facial pain, jaw-clenching, and teeth-grinding — well-known manifestations of anxiety and emotional distress.”

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The total lockdown in Israel began March 19, 2020, and the researchers collected data from the country for the study from April 16 to May 20, 2020. Poland’s comprehensive lockdown commenced on March 31, with the scientists gathering data from April 29 to May 3.

In total, 700 people in Israel and 1,092 people in Poland completed the research questionnaire.

General findings

The research found that the effect was stronger in Poland than in Israel, with respondents reporting a 34% increase in the incidence of TMD symptoms during lockdown. In Israel, the increase was 15%, while the scientists also found within Israel:

• The incidence of TMD symptoms increased from prior levels of roughly 35% to 47% of participants during the lockdown.
• People who already had TMD before the pandemic found its severity increased by about 15%.
• Bruxism increased from 10% to 25%. In a breakdown, jaw-clenching went from 17% to 32%, while teeth grinding rose from 10% to 36%.

The researchers confirmed there was a link between a higher incidence of TMD and people reporting greater stress levels.

A more granular look

The study found that pandemic stress had a more significant effect on women, who exhibited a greater increase in TMD than men.

The researchers also divided the study participants into three age groups, 18–34, 35–55, and over 56, to investigate age-related differences.

Participants in Poland within the first two age groups exhibited significantly more TMD symptoms than individuals from Israel — the odds of them experiencing an increase in symptoms was higher by several hundred percent.

Overall, however, the researchers found that people in the middle group in both countries were the most likely to experience an increase in TMD.

The most profoundly affected group overall was women aged 35–55.

Of this group, 48% reported having symptoms of TMD, 46% reported clenching their jaws while awake, with 50% saying they grind their teeth at night.

The study’s authors tell Tel Aviv University News:

“We believe that our findings reflect the distress felt by the middle generation, who were cooped up at home with young children, without the usual help from grandparents, while also worrying about their elderly parents, facing financial problems and often required to work from home under trying conditions.”

Stressful times

The researchers write, “Apparently, anxiety, depression, and personal worries evoked by the coronavirus pandemic increased the prevalence of TMD and bruxism.”

They note that with continually changing circumstances and ongoing concerns regarding coronavirus, “uncertainty and worries about the present and future were common and unavoidable.” The study reports that this anxiety has been further compounded by home confinement, unemployment, and a steady stream of “apocalyptic news.”

The authors conclude that their study leaves little doubt:

“The aggravation of the psychoemotional status caused by the coronavirus pandemic can result in bruxism and TMD symptom intensification, thus leading to increased orofacial pain.”

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