title: Increased prevalence of dental caries and poor oral hygiene in juvenile idiopathic arthritis.
abstract: OBJECTIVE
  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.
authors.affiliation: Glasgow Dental Hospital and School, University of Glasgow and North Glasgow NHS Trust, UK. r.welbury@dental.gla.ac.uk
authors.forename: R R
authors.initials: RR
authors.lastname: Welbury
authors.forename: J M
authors.initials: JM
authors.lastname: Thomason
authors.forename: J L
authors.initials: JL
authors.lastname: Fitzgerald
authors.forename: I N
authors.initials: IN
authors.lastname: Steen
authors.forename: N J
authors.initials: NJ
authors.lastname: Marshall
authors.forename: H E
authors.initials: HE
authors.lastname: Foster
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000150:complications* / Q000628:therapy; D005260:Female; D005891:Gingivitis / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene / Q000592:standards*; D009911:Oral Hygiene Index; D010512:Periodontal Index; D014081:Tooth Extraction