Skip to main content
Top

13-07-2018 | Juvenile idiopathic arthritis | Article

Orofacial symptoms and oral health-related quality of life in juvenile idiopathic arthritis: a two-year prospective observational study

Journal: Pediatric Rheumatology

Authors: Hanna Rahimi, Marinka Twilt, Troels Herlin, Lynn Spiegel, Thomas Klit Pedersen, Annelise Küseler, Peter Stoustrup

Publisher: BioMed Central

Abstract

Background

Little is known about the chronicity of orofacial symptoms and how this influences the oral health-related quality of life in juvenile idiopathic arthritis (JIA). Therefore, our objectives were to study the long-term changes in self-reported orofacial symptoms, and to define the impact of orofacial symptoms on oral health-related quality of life in JIA.

Methods

At baseline (T0), 157 consecutive JIA patients ≤20 years completed a patient pain questionnaire that incorporates domains related to the orofacial area. At the 2 year follow-up (T1), 113 patients completed the same questionnaire (response rate 72%) in addition to the Child Perception’s Questionnaire; a validated 31-item questionnaire addressing oral health-related quality of life.

Results

At T0, 53% (60/113) of patients reported the presence of orofacial pain, and 36% (41/113) of patients reported compromised orofacial function. At T1, 77% (46/60) of patients with pain at T0 reported persistent pain, and 66% (27/41) of patients with functional disability at T0 reported persistent disability. Patients with orofacial symptoms reported a significantly greater prevalence of negative impact of orofacial conditions on general quality of life and within the domains of emotional and social well-being compared to asymptomatic patients.

Conclusion

Self-reported orofacial pain and functional disability were common findings in a cohort of JIA patients followed over 2 years. These symptoms seem to persist over time in most patients, and have a significant negative impact on oral health-related quality of life.
Literature
1.
Kuseler A, Pedersen TK, Gelineck J, Herlin T. A 2 year followup study of enhanced magnetic resonance imaging and clinical examination of the temporomandibular joint in children with juvenile idiopathic arthritis. J Rheumatol. 2005;32:162–9.PubMed
2.
Weiss PF, Arabshahi B, Johnson A, Bilaniuk LT, Zarnow D, Cahill AM, et al. High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound. Arthritis Rheum. 2008;58:1189–96.CrossRefPubMed
3.
Cannizzaro E, Schroeder S, Muller LM, Kellenberger CJ, Saurenmann RK. Temporomandibular joint involvement in children with juvenile idiopathic arthritis. J Rheumatol. 2011;38:510–5.CrossRefPubMed
4.
Kristensen KD, Stoustrup P, Kuseler A, Pedersen TK, Twilt M, Herlin T. Clinical predictors of temporomandibular joint arthritis in juvenile idiopathic arthritis: a systematic literature review. Semin Arthritis Rheum. 2016;45:717–32.CrossRefPubMed
5.
Stoll ML, Sharpe T, Beukelman T, Good J, Young D, Cron RQ. Risk factors for temporomandibular joint arthritis in children with juvenile idiopathic arthritis. J Rheumatol. 2012;39:1880–7.CrossRefPubMed
6.
Stoustrup P, Kristensen KD, Verna C, Kuseler A, Herlin T, Pedersen TK. Orofacial symptoms related to temporomandibular joint arthritis in juvenile idiopathic arthritis: smallest detectable difference in self-reported pain intensity. J Rheumatol. 2012;39:2352–8.CrossRefPubMed
7.
Stoustrup P, Twilt M, Spiegel L, Kristensen KD, Koos B, Pedersen TK, et al. Clinical orofacial examination in juvenile idiopathic arthritis: international consensus-based recommendations for monitoring patients in clinical practice and research studies. J Rheumatol. 2017;44:326–33.CrossRefPubMed
8.
Cedstromer AL, Andlin-Sobocki A, Berntson L, Hedenberg-Magnusson B, Dahlstrom L. Temporomandibular signs, symptoms, joint alterations and disease activity in juvenile idiopathic arthritis -- an observational study. Ped Rheumatol Online J. 2013;11:37.CrossRef
9.
Frid P, Nordal E, Bovis F, Giancane G, Larheim TA, Rygg M, et al. Temporomandibular joint involvement in association with quality of life, disability, and high disease activity in juvenile idiopathic arthritis. Arthritis Care Res. 2017;69:677–86.CrossRef
10.
Bakke M, Zak M, Jensen BL, Pedersen FK, Kreiborg S. Orofacial pain, jaw function, and temporomandibular disorders in women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endo. 2001;92:406–14.CrossRef
11.
Engstrom AL, Wanman A, Johansson A, Keshishian P, Forsberg M. Juvenile arthritis and development of symptoms of temporomandibular disorders: a 15-year prospective cohort study. J Orofac Pain. 2007;21:120–6.PubMed
12.
Beukelman T, Patkar NM, Saag KG, Tolleson-Rinehart S, Cron RQ, DeWitt EM, et al. 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res. 2011;63:465–82.CrossRef
13.
Twilt M, Schulten AJ, Verschure F, Wisse L, Prahl-Andersen B, Suijlekom-Smit LW. Long-term followup of temporomandibular joint involvement in juvenile idiopathic arthritis. Arthritis Rheum. 2008;59:546–52.CrossRefPubMed
14.
Zwir LM, Terreri MT, Sousa SA, Fernandes AR, Guimaraes AS, Hilario MO. Are temporomandibular joint signs and symptoms associated with magnetic resonance imaging findings in juvenile idiopathic arthritis patients? A longitudinal study. Clin Rheumatol. 2015;34:2057–63.CrossRefPubMed
15.
Leksell E, Ernberg M, Magnusson B, Hedenberg-Magnusson B. Orofacial pain and dysfunction in children with juvenile idiopathic arthritis: a case-control study. Scand J Rheumatol. 2012;41:375–8.CrossRefPubMed
16.
Ruperto N, Ravelli A, Pistorio A, Malattia C, Cavuto S, Gado-West L, et al. Cross-cultural adaptation and psychometric evaluation of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ) in 32 countries. Review of the general methodology Clin Exp Rheumatol. 2001;19:S1–9.PubMed
17.
Petty RE, Southwood TR, Baum J, Bhettay E, Glass DN, Manners P, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol. 1998;25:1991–4.PubMed
18.
Jokovic A, Locker D, Stephens M, Kenny D, Tompson B, Guyatt G. Validity and reliability of a questionnaire for measuring child oral-health-related quality of life. J Dent Res. 2002;81:459–63.CrossRefPubMed
19.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.CrossRefPubMed
20.
Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group. J Oral Facial Pain Headache. 2014;28:6–27.CrossRefPubMedPubMedCentral
21.
Østensjø V, Moen K, Storesund T, Rosén A. Prevalence of painful temporomandibular disorders and correlation to lifestyle factors among adolescents in Norway. Pain Res Manag, 2017;2164825.