Pediatric Rheumatology Online Journal → June 2003 → Miscellaneous Topics→ Abstract #85

INCREASED DENTAL DECAY AND POOR ORAL HYGIENE IN JUVENILE IDIOPATHIC ARTHRITIS (JIA)

H. E. Foster,^1,2 J. Fitzgerald,³ N. M. Marshall,¹ I. Steen,⁴ J. M. Thomason,³ R. R. Welbury.⁵

¹Rheumatology Department, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom; ²Child Health, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom; ³School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom; ⁴Department of Statistics, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom; ⁵Dental Hospital and School, University of Glasgow, Glasgow, United Kingdom

Aim. Poor oral hygiene and dental decay cause significant morbidity. This study aimed to investigate patients with JIA using standardised measures of oral health.
Methods. Patients with JIA were recruited from the Regional paediatric rheumatology service and adults with JIA were attending the adult Rheumatology clinic. Random age and sex matched healthy controls were recruited from a dental teaching hospital. The structured dental examination included standard epidemiological indices of oral hygiene (gingival index, plaque index, oral cleanliness index) and dental decay (DMFT index).
Results. 149 patients (females n=107) were recruited. The median age was 17.9 years (range 2-50), with a median disease duration of 10.8 years (range 1-42). A spectrum of JIA subtypes was seen (oligoarticular onset n=65, including those with extended course n=20), polyarticular onset (n= 49, including 14 who were rheumatoid factor positive), systemic onset (n=33 ), psoriatic arthritis (n=13 ) and enthesitis related arthritis (n=11). JIA patients, at all ages, had increased levels of dental decay and poor oral hygiene. This increased level of decay was statistically significant in the 0-11 year olds (the dmft was 1.46 ± 2.58, compared to controls 0.56 ± 0.96 (p=0.027)). Significant levels of untreated caries and increased levels of missing teeth were found in JIA suggesting that patients with JIA had less restorative dental treatment with tooth extraction often being the chosen option for treatment of dental decay.
Conclusions. This is the largest study of oral health in JIA and is case controlled. It shows significantly increased levels of poor oral hygiene and dental decay in patients with JIA. The high levels of untreated dental decay suggest barriers to dental care. These results emphasise the role of regular dental care in the multidisciplinary management of JIA.