Protective Masks During the SARS-COV-2 Pandemic: Is there a Relationship with Temporomandibular Disorders? An Observational Cross-sectional Survey

Background: Wearing protective face masks has been one of the indispensable measures to prevent droplets and aerosol particles transmission during the SARS-CoV-2 pandemic. This observational cross-sectional survey investigated the different types and modalities of protective mask wearing and the possible association with referred temporomandibular disorders by respondents. Methods An online-questionnaire was developed, calibrated and administered anonymously to subjects with an age of ≥ 18 years. It consisted of different sections: demographics, type and wearing modalities of the protective masks, pain in the preauricular area, noise at the temporomandibular joints and headache. Statistical analysis was performed with R software. Results The questionnaire received 665 replies mainly from participants aged 18–30 years (315 males, 350 females). 37% of participants were healthcare professionals, 21.2% of them were dentists. 334 subjects (50.3%) mostly used the Filtering Facepiece 2/ Filtering Facepiece 3 (FFP2/FFP3) mask, and 578 (87%) wore the mask with two elastics behind the ears. 400 participants referred pain while wearing the mask, and 36.8% of them referred pain with a consecutive use of more than 4 hours ( p  = 0.042). 92.2% of participants did not report any TMJ noise. 57.7% of subjects referred headaches associated with the FFP2/FFP3 ( p  = 0.033). Conclusions This survey highlighted the increased referred presence of orofacial pain in the preauricular area and temporal headache associated with a prolonged use of protective face masks for more than 4 hours during the SARS-CoV-2 pandemic.