Abstract

Juvenile idiopathic arthritis (JIA) is the most common autoimmune inflammatory disease of connective tissue in children. It is characterized by progressive joint destruction which causes preserved changes in the musculoskeletal system. The literature describes fully clinical symptoms and radiological images in different subtypes of JIA. However, there is still a limited number of studies reporting on the medical condition of the oral cavity of ill children. JIA can affect hard and soft tissues of the oral cavity by: the general condition of the child’s health, arthritis of the upper limbs, as the result of the pharmacotherapy, changes in secretion and composition of saliva, inflammation of the temporomandibular joint and facial deformity.The study summarizes the available literature on the condition of the teeth and periodontal and oral hygiene in the course of JIA. The presence of diverse factors that modify the oral cavity, such as facial growth, functioning of salivary glands, or the supervision and care provided by adults, prevents clear identification if JIA leads to severe dental caries and periodontal disease. Despite conflicting results in studies concerning the clinical oral status, individuals with JIA require special attention regarding disease prevention and maintenance of oral health.

References

• 1. Abramowicz S., Susarla H.K., Kim S., Kaban L.B.: Physical findingsassociated with active temporomandibular joint inflammation inchildren with juvenile idiopathic arthritis. J. Oral Maxillofac. Surg.,2013; 71: 1683-1687
  Google Scholar
• 2. Ahmed N., Bloch-Zupan A., Murray K.J., Calvert M., Roberts G.J.,Lucas V.S.: Oral health of children with Juvenile Idiopathic Arthritis.J. Rheumatol., 2004; 31: 1639-1643
  Google Scholar
• 3. Alrayyes S., Hart T.C.: Periodontal disease in children. Dis. Mon.,2011; 57: 184-191
  Google Scholar
• 4. Barr T., Carmichael N.M., Sándor G.K.: Juvenile idiopathic arthritis:a chronic pediatric musculoskeletal condition with significantorofacial manifestations. J. Can. Dent. Assoc., 2008; 74: 813-821
  Google Scholar
• 5. Bartold P.M., Marshall R.I., Haynes D.R.: Periodontitis and rheumatoidarthritis: a review. J. Periodontol., 2005; 76: 2066-2074
  Google Scholar
• 6. Billiau A.D., Hu Y., Verdonck A., Carels C., Wouters C.: Temporomandibularjoint arthritis in juvenile idiopathic arthritis: prevalence,clinical and radiological signs, and relation to dentofacialmorphology. J. Rheumatol., 2007; 34: 1925-1933
  Google Scholar
• 7. Borchers A.T., Selmi C., Cheema G., Keen C.L., Shoenfeld Y., GershwinM.E.: Juvenile idiopathic arthritis. Autoimmun. Rev., 2006;5: 279-298
  Google Scholar
• 8. Brik R., Livnat G., Pollack S., Catz R., Nagler R.: Salivary glandinvolvement and oxidative stress in juvenile idiopathic arthritis:novel observation in oligoarticular-type patients. J. Rheumatol.,2006; 33, 2532-2537
  Google Scholar
• 9. Brik R., Rosen I., Savulescu D., Borovoi I., Gavish M., Nagler R.:Salivary antioxidants and metalloproteinases in juvenile idiopathicarthritis. Mol. Med., 2010; 16: 122-128
  Google Scholar
• 10. Burbage M.L., Mason M.B., Nabors L.A., Kichler J.C.: An evaluationof a juvenile idiopathic arthritis retreat for families. Pediatr.Reumatol. Online, 2015; 13: 12
  Google Scholar
• 11. Caiello I., Minnone G., Holzinger D., Vogl T., Prencipe G., ManzoA., De Benedetti F., Strippoli R: IL-6 amplifies TLR mediated cytokineand chemokine production: implications for the pathogenesisof rheumatic inflammatory diseases. PLoS One, 2014; 9: e107886
  Google Scholar
• 12. Cedströmer A.L., Ahlqwist M., Andlin-Sobocki A., Berntson L.,Hedenberg-Magnusson B., Dahlström L.: Temporomandibular condylaralterations in juvenile idiopathic arthritis most common inlongitudinally severe disease despite medical treatment. Pediatr.Reumatol. Online, 2014; 12: 43
  Google Scholar
• 13. Engstrom A.L., Wanman A., Johansson A., Keshishian P., ForsbergM.: Juvenile arthritis and development of symptoms of temporomandibulardisorders: a 15-year prospective cohort study. J.Orofac. Pain., 2007; 21: 120-126
  Google Scholar
• 14. Feres de Melo A.R., Ferreira de Souza A., de Oliveira PerestreloB., Leite M.F.: Clinical oral and salivary parameters of children withjuvenile idiopathic arthritis. Oral Surg. Oral Med. Oral Pathol. OralRadiol., 2014; 117: 75-80
  Google Scholar
• 15. Fitsgerald J., Welbury R.R., Foster H.E.: The dental health ofchildren and young adults with JIA in the north of England. Int. J.Paed. Dent., 1999; 9: 6, Abs 05.04
  Google Scholar
• 16. Genco R.J., Borgnakke W.S.: Risk factors for periodontal disease.Periodontol. 2000, 2013; 62: 59-94
  Google Scholar
• 17. Gmyrek-Marciniak A., Herman K., Kaczmarek U.: Salivary flowrate, activity of lysozyme and peroxidase in the saliva of childrenwith juvenile idiopathic arthritis – preliminary study. Dent. Med.Probl. 2008; 45: 33-36
  Google Scholar
• 18. Gmyrek-Marciniak A., Kaczmarek U.: Stan narządu żucia u dziecii młodzieży chorujących na młodzieńcze idiopatyczne zapaleniestawów. Dent. Med. Probl., 2012; 49: 216-222
  Google Scholar
• 19. Gueddari S., Amine B., Rostom S., Badri D., Mawani N., EzzahriM., Moussa F., Shyen S., Abouqal R., Chkiart B., Hajjaj-Hassouni N.:Physical activity, functional ability, and disease activity in childrenand adolescents with juvenile idiopathic arthritis. Clin. Rheumatol.,2014; 33: 1289-1294
  Google Scholar
• 20. Haasnoot A.J., Van Tent-Hoeve M., Wulffraat N.M., Schalij-DelfosN.E., Los L.I., Armbrust W., Zuithoff N.P., De Boer J.H.: Erythrocytesedimentation rate as baseline predictor for the development ofuveitis in children with juvenile idiopathic arthritis. Am. J. Ophtalmol.,2015; 159: 372-377
  Google Scholar
• 21. Hashkes P.J., Laxer R.M.: Medical treatment of juvenile idiopathicarthritis. JAMA, 2005; 294: 1671-1684
  Google Scholar
• 22. Heiligenhaus A., Heinz C., Edelsten C., Kotaniemi K., Minden K.:Review for disease of the year: epidemiology of juvenile idiopathicarthritis and its associated uveitis: the probable risk factors. Ocul.Immunol. Inflamm., 2013; 21: 180-191
  Google Scholar
• 23. Herman K., Wrzyszcz-Kowalczyk A., Jankowska K.: Ocena stanuzdrowia jamy ustnej u dzieci z zespołem Downa lub z mózgowymporażeniem dziecięcym. Dent. Med. Probl., 2011; 48: 30-36
  Google Scholar
• 24. Hoeksma A.F., Va Rossum M.A., Zinger W.G., Dolman K.M., DekkerJ., Roorda L.D.: High prevalence of hand – and wrist-related symptoms,impairments, activity limitations and participation restrictionsin children with juvenile idiopathic arthritis. J. Rehabil. Med.,2014; 46: 991-996
  Google Scholar
• 25. Jordan A., McDonagh J.E.: Juvenile idiopathic arthritis: the paediatricperspective. Pediatr. Radiol., 2006; 36: 734-742
  Google Scholar
• 26. Kaczmarek U., Sołtan E., Kowalczyk-Zając E.: Stan uzębieniai przyzębia u pacjentów z chorobą refluksową przełyku. Dent. Med.Probl., 2008; 45: 149-155
  Google Scholar
• 27. Kobus A.: Zmiany biochemiczne i fizykochemiczne śliny w przebiegumłodzieńczego idiopatycznego zapalenia stawów u dziecii młodzieży. Rozprawa doktorska, Uniwersytet Medyczny w Białymstoku,Białystok 2014
  Google Scholar
• 28. Kobus A., Kierklo A., Jankowska A., Szajda S.D., Zwierz K.: Tempowydzielania śliny a stan uzębienia i higiena jamy ustnej w przebiegumłodzieńczego przewlekłego zapalenia stawów u dzieci. Czas. Stomatol.,2008; 61: 547-553
  Google Scholar
• 29. Koos B., Gassling V., Bott S., Tzaribachev N., Godt A.: Pathologicalchanges in the TMJ and the length of the ramus in patients withconfirmed juvenile idiopathic arthritis. J. Craniomaxillofac. Surg.2014; 42: 1802-1807
  Google Scholar
• 30. Leksell E., Ernberg M., Magnusson B., Hedenberg-MagnussonB.: Intraoral condition in children with juvenile idiopathic arthritiscompared to controls. Int. J. Paediatr. Dent., 2008; 18: 423-433
  Google Scholar
• 31. Leksell E., Ernberg M,.Magnusson B., Hedenberg-Magnusson B.:Orofacial pain and dysfunction in children with juvenile idiopathicarthritis: a case-control study. Scand. J. Rheumatol., 2012; 41: 375-378
  Google Scholar
• 32. Lien G., Flatø B., Haugen M., Vinje O., Sørskaar D., Dale K., JohnstonV., Egeland T., Førre Ø.: Frequency of osteopenia in adolescentswith early-onset juvenile idiopathic arthritis: a long-termoutcome study of one hundred five patients. Arthritis Rheum., 2003;48: 2214-2223
  Google Scholar
• 33. Mazurek-Mochol M., Banach J.: Czy istnieją wspólne mechanizmypatogenetyczne w inicjowaniu zapaleń przyzębia i reumatoidalnegozapalenia stawów. Dent. Med. Probl., 2009; 46: 465-469
  Google Scholar
• 34. Mercado F.B., Marshall R.I., Bartold P.M.: Inter-relationshipsbetween rheumatoid arthritis and periodontal disease. A review. J.Clin. Periodontol., 2003; 30: 761-772
  Google Scholar
• 35. Mercado F., Marshall R.I., Klestov A.C., Bartold P.M.: Is there a relationshipbetween rheumatoid arthritis and periodontal disease?J. Clin. Periodontol., 2000; 27: 267-272
  Google Scholar
• 36. Miranda L.A., Braga F., Fisher R.G., Sztajnbok F.R., FigueredoC.M., Gustafsson A.: Changes in periodontal and rheumatologicalconditions after 2 years in patient with juvenile idiopathic arthritis.J. Periodontol., 2006; 77: 1695-1700
  Google Scholar
• 37. Miranda L.A., Fisher R.G., Sztajnbok F.R., Figueredo C.M.S., GustafssonA.: Periodontal conditions in patients with juvenile idiopathicarthritis. J. Clin. Periodontol., 2003; 30: 969-974
  Google Scholar
• 38. Moynihan P.J., Welbury R.R., Foster H.E., Thomason J.M., KerberM.: Is juvenile idiopathic arthritis associated with dietary practiceswhich increase the risk of caries. EULAR Congress 1999. Ann. Rheumatol.Dis., 1999; 6: 356
  Google Scholar
• 39. Müller L., Kellenberger C.J., Cannizzaro E., Ettlin D., Schraner T.,Bolt I.B., Peltomäki T., Saurenmann R.K.: Early diagnosis of temporomandibularjoint involvement in juvenile idiopathic arthritis: a pilotstudy comparing clinical examination and ultrasound to magneticresonance imaging. Rheumatology, 2009; 48: 680-685
  Google Scholar
• 40. Nigrovic P.A., White P.H.: Care of adult with juvenile rheumatoid arthritis. Arthritis Rheum., 2006; 55: 208-216
  Google Scholar
• 41. Petty R.E., Southwood T.R., Baum J., Bhettay E., Glass D.N., MannersP., Maldonado-Cocco J., Suarez-Almazor M., Orozco-Alcala J.,Prieur A.M.: Revision of the proposed classification criteria for juvenileidiopathic arthritis: Durban 1997. J. Rheumatol., 1998; 25:1991-1994
  Google Scholar
• 42. Petty R.E., Southwood T.R., Manners P., Baum J., Glass D.N., GoldenbergJ., He X., Maldonado-Cocco J., Orozco-Alcala J., Prieur A.M.,Suarez-Almazor M., Woo P.: International League of Associations forRheumatology classification of juvenile idiopathic arthritis: secondrevision, Edmonton 2001. J. Rheumatol. 2004; 31: 390-392
  Google Scholar
• 43. Ravelli A., Martini A.: Juvenile idiopathic arthritis. Lancet, 2007;369: 767-778
  Google Scholar
• 44. Reichert S., Haffner M., Keyßer G., Schäfer C., Stein J., SchallerH.G., Wienke A., Strauss H., Heide S., Schulz S.: Detection of oral bacterialDNA in synovial fluid. J. Clin. Periodontol., 2013; 40: 591-598
  Google Scholar
• 45. Reichert S., Machulla H.K., Fuchs C., John V., Schaller H.G., SteinJ.: Is there a relationship between juvenile idiopathic arthritis andperiodontitis? J. Clin. Periodontol., 2006; 33: 317-323
  Google Scholar
• 46. Reichert S., Stein J., Fuchs C., John V., Schaller H.G., MachullaH.K.: Are there common human leukocyte antigen associations injuvenile idiopathic arthritis and periodontitis? J. Clin. Periodontol.,2007; 34: 492-498
  Google Scholar
• 47. Ringold S., Thapa M., Shaw E.A., Wallace C.A.: Heterotopic ossificationof the temporomandibular joint in juvenile idiopathicarthritis. J. Rheumatol., 2011; 38: 1423-1428
  Google Scholar
• 48. Romicka A.: Młodzieńcze idiopatyczne zapalenie stawów – obrazkliniczny, przebieg i leczenie. Standardy medyczne. Pediatria,2010; 2: 189-193
  Google Scholar
• 49. Romicka A.M., Musiej-Nowakowska E., Szymańska-Jagiełło W.:Kryteria klasyfikacyjne i obraz kliniczny młodzieńczego idiopatycznegozapalenia stawów. Pol. Merkuriusz Lek., 2002; 12: 157-159
  Google Scholar
• 50. Rosenstein E.D., Greenwald R.A., Kushner L.J., Weissmann G.:Hypothesis: the humoral immune response to oral bacteria providesa stimulus for the development of rheumatoid arthritis. Inflammation,2004; 28: 311-318
  Google Scholar
• 51. Rutkowska-Sak L., Tuszkiewicz-Misztal E., Brózik H., NiedzielaM., Żuber Z., Tłustochowicz W., Wiland P.: Stanowisko Zespołu Ekspertówds. Reumatologii Dziecięcej przy Konsultancie Krajowymw Dziedzinie Reumatologii dotyczące terapii biologicznej w leczeniumłodzieńczego idiopatycznego zapalenia stawów. Reumatologia,2009; 47: 111-115
  Google Scholar
• 52. Santos D., Silva C., Silva M.: Oral health and quality of life of childrenand adolescents with juvenile idiopathic arthritis according totheir caregivers’ perceptions. Spec. Care Dentist., 2015; 35: 272-278
  Google Scholar
• 53. Savioli C., Silva C.A., Ching L.H., Campos L.M., Prado E.F., SiqueiraJ.T.: Dental and facial characteristics of patients with Juvenile IdiopathicArthritis. Rev. Hosp. Clin. Fac. Med. Sao Paulo, 2004; 59: 93-98
  Google Scholar
• 54. Sen V., Ece A., Uluca Ü., Günes A., Yel S., Tan I., Karabel D., YildirimB., Haspolat K.: Evaluation of children with juvenile idiopathicarthritis in southeastern Turkey: a single center experience. Hippokratia,2015; 19: 63-68
  Google Scholar
• 55. Shaw K.L., Southwood T.R., Duffy C.M., McDonagh J.E.: Healthrelatedquality of life in adolescents with juvenile idiopathic arthritis Arthritis Rheum., 2006; 55: 199-207
  Google Scholar
• 56. Shaw L., Glenwright H.D.: The roles of medications in dentalcaries formation: need for sugar-free medications for children. Pediatrician,1989; 16: 153-155
  Google Scholar
• 57. Siamopoulou A., Mavridis A.K., Vasakos S., Benecos P., TzioufasA.G., Andonpoulos A.P.: Sialochemistry in juvenile chronic arthritis.Br. J. Rheumatol., 1989; 28: 383-385
  Google Scholar
• 58. Sikorska M.H., Mielnik-Błaszczak M., Kapeć E.: The relationshipbetween the levels of SigA, lactoferrin and α1 proteinase inhibitorin saliva and permanent dentition caries in 15-year-olds. Oral Microbiol.Immunol., 2002; 17: 272-276
  Google Scholar
• 59. Silva T.L., Braga F.S., Sztajnbok F.R., Souza A.A., Silva F.B., FischerR.G., Figueredo C.M.: Reduction in alveolar bone density of patientswith juvenile idiopathic arthritis. Rev. Bras. Reumatol., 2012;52: 38-43
  Google Scholar
• 60. Stoll M.L., Sharpe T., Beukelman T., Good J., Young D., CronR.Q.: Risk factors for temporomandibular joint arthritis in childrenwith juvenile idiopathic arthritis. J. Rheumatol., 2012; 39: 1880-1887
  Google Scholar
• 61. Synodinos P.N., Polyzois I.: Oral health and orthodontic considerationsin children with juvenile idiopathic arthritis: review of theliterature and report of a case. J. Ir. Dent. Assoc., 2008; 54; 1: 29-36
  Google Scholar
• 62. Touger-Decker R., van Loveren C.: Sugars and dental caries. Am.J. Clin. Nutr., 2003; 78: 881S-892S
  Google Scholar
• 63. Vaid Y.N., Dunnavant F.D., Royal S.A., Beukelman T., Stoll M.L.,Cron R.Q.: Imaging of the temporomandibular joint in the juvenileidiopathic arthritis. Arthritis Care Res., 2014; 66: 47-54
  Google Scholar
• 64. Verstappen S.M., Cobb J., Foster H.E., Fu B., Baildam E., WedderburnL.R., Davidson J.E., Ioannou J., Chieng A., Hyrich K.L., ThomsonW.: The association between low socioeconomic status with highphysical limitations and low illness self-perception in patients withjuvenile idiopathic arthritis: results from the Childhood ArthritisProspective Study (CAPS). Arthritis Care Res., 2015; 67: 382-389
  Google Scholar
• 65. Walton A.G., Foster H.E., Welbury R.R., Thomason J.M.: Juvenileidiopathic arthritis, dental caries, and long term liquid oral medicines.Int. J. Paediatr. Dent., 1999; 9: 55
  Google Scholar
• 66. Walton A.G., Welbury R.R., Foster H.E., Wright W.G., ThomasonJ.M.: Sialochemistry in juvenile idiopathic arthritis. Oral Dis.,2002; 8: 287-290
  Google Scholar
• 67. Weiss, J.E., Ilowite N.T.: Juvenile idiopathic arthritis. Pediatr.Clin. North Am., 2005; 52: 413-442
  Google Scholar
• 68. Welbury R.R., Thomason J.M., Fitzgerald J.L., Steen I.N., MarshallN.J., Foster H.E.: Increased prevalence of dental caries andpoor oral hygiene in juvenile idiopathic arthritis. Rheumatology,2003; 42: 1445-1451
  Google Scholar
• 69. Wolny-Niedzielska A.: Choroby układu ruchu u dzieci kierowanychdo Poradni Reumatologicznej w Kielcach w latach 1999-2003.Reumatologia, 2005; 43: 265-273
  Google Scholar
• 70. World Health Organization Oral Health Surveys, Basic Methods,4th edition, 2013, http://www.paho.org/hq/dmdocuments/2009/OH_st_Esurv.pdf (06.02.2016)
  Google Scholar

Full text