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The temporomandibular joint in juvenile idiopathic arthritis, focusing on quality of life, oral microbiome and intervention

 Thesis, Paula Frid 2020

Arthritis of the jaw with pain or no symptoms, reduced mouth opening and abnormal growth is common in chronic childhood arthritis (juvenile idiopathic arthritis, JIA). In this thesis new knowledge was obtained from cross-sectional, observational multicenter studies and a systematic literature review. We found that arthritis in the jaw was associated with reduced quality of life, higher disability and disease activity. Clinicians should pay special attention to the jaw in children with cervical spine involvement, a polyarticular course or a longer disease duration. Bacteria associated with chronic inflammation are more common in saliva in JIA compared to healthy, and is associated with increased disease activity. Single steroid injection in the jaw of older children with JIA as a supplement to systemic treatment is safe and found to reduce joint inflammation. Finally, existing literature although with low evidence, supports surgical corrections of jaw deformities in patients with JIA.