Rheumatology Advance Access originally published online on June 16, 2003
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Rheumatology 2003; 42: 1445-1451
© 2003 British Society for Rheumatology
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Increased prevalence of dental caries and poor oral hygiene in juvenile idiopathic arthritis
Glasgow Dental Hospital and School, University of Glasgow and North Glasgow NHS Trust, Glasgow, 1School of Dental Sciences, Statistics and 2Child Health and Rheumatology, 3Department of Statistics, University of Newcastle upon Tyne and Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
Correspondence to:
R. Welbury, Department of Paediatric Dentistry, Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow G2 3JZ, UK. E-mail: r.welbury{at}dental.gla.ac.uk
Abstract
Objectives. Recent decades have seen a trend to treat juvenile idiopathic arthritis (JIA) with increasing immunosuppression to improve the long-term outcome. Poor oral hygiene and dental decay cause significant morbidity, and patients with chronic disease (who may be further immunocompromised by treatment) are at greater risk. This study investigated patients with JIA using standard measures of oral health.
Methods. One hundred and forty-nine patients with JIA were included. The children were attending a regional paediatric rheumatology service and the adults were attending an 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 (decayed, missing or filled teeth) index].
Results. 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 patients aged 0–11 yr. 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 the chosen option for the treatment of dental decay.
Conclusions. This is the largest study of oral health in JIA and is cross-sectional with non-diseased controls. 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 emphasize the role of regular dental care in the multidisciplinary management of JIA.
KEY WORDS: Juvenile arthritis, Juvenile idiopathic arthritis, Dental decay, Caries, Oral cleanliness, Outcome, Complications.
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