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Halbig JM, Jönsson B, Gil EG, Åstrøm AN, Rypdal V, Frid P, Augdal TA, Fischer J, Cetrelli L, Rygg M, Lundestad A, Tylleskär K, Nordal E. Oral health-related quality of life, impaired physical health and orofacial pain in children and adolescents with juvenile idiopathic arthritis - a prospective multicenter cohort study. BMC Oral Health 2023; 23:895. [PMID: 37986155 PMCID: PMC10662257 DOI: 10.1186/s12903-023-03510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Knowledge on oral health-related quality of life (OHRQoL) in children and adolescents with juvenile idiopathic arthritis (JIA) is limited, and longitudinal studies are lacking. We aimed to describe OHRQoL in children and adolescents with JIA compared to controls, and to explore the validity and internal consistency of the Early Childhood Oral Health Impact Scale (ECOHIS) and the Child Oral Impact on Daily Performance (Child-OIDP). Furthermore, we wanted to investigate associations between OHRQoL and orofacial pain, physical health, disease activity, and temporomandibular joint (TMJ) involvement in JIA. METHODS The Norwegian prospective, multicenter cohort study recruited participants with JIA between 4 and 16 years of age and corresponding controls from three pediatric university hospital departments and public dental health services. In the present study, we analyzed OHRQoL in all children < 12 years with the ECOHIS and adolescents ≥ 12 years with the Child-OIDP at the first visit and the two-year follow-up. Associations between OHRQoL and JIA characteristics, collected in clinical exam and questionnaires, were analyzed in logistic regressions. RESULTS The same OHRQoL questionnaire was completed both at first visit and two-year follow-up in 101 children < 12 years (47 JIA, 54 controls) and 213 adolescents ≥ 12 years (111 JIA, 102 controls). The frequency of OHRQoL impacts in children was similar at the first visit and the two-year follow-up (ECOHIS > 0: JIA group 81% and 85%, p = 0.791; control group 65% and 69%, p = 0.815), while adolescents with JIA reported fewer impacts at the two-year follow-up (Child OIDP > 0: JIA group 27% and 15%, p = 0.004; control group 21% and 14%, p = 0.230). The internal consistency of the OHRQoL instruments was overall acceptable and the criterion validity indicated that the instruments were valid at both visits. Orofacial pain was more frequent in children and adolescents with JIA than in controls. We found associations between OHRQoL impacts and orofacial pain, impaired physical health, disease activity, and TMJ involvement. CONCLUSIONS Children and adolescents with orofacial pain or impaired physical health were more likely to report impacts on daily life activities than those without. Pediatric rheumatologists and dentists should be aware of impaired OHRQoL in individuals with JIA with active disease or temporomandibular joint involvement. TRIAL REGISTRATION Registered on clinicaltrials.gov (NCT03904459, 05/04/2019).
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Affiliation(s)
- Josefine M Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.
- Research Group Child and Adolescent Health, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
| | - Birgitta Jönsson
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway
- Department of Periodontology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth G Gil
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Anne N Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Veronika Rypdal
- Research Group Child and Adolescent Health, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Dentistry, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Thomas A Augdal
- Research Group Child and Adolescent Health, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Section of Pediatric Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Lena Cetrelli
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Anette Lundestad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Ellen Nordal
- Research Group Child and Adolescent Health, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway
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Gil EG, Åstrøm AN, Lie SA, Rygg M, Fischer J, Rosén A, Bletsa A, Luukko K, Shi XQ, Halbig J, Frid P, Cetrelli L, Tylleskär K, Rosendahl K, Skeie MS. Dental plaque and gingival bleeding in adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis. Acta Odontol Scand 2023; 81:50-65. [PMID: 35635806 DOI: 10.1080/00016357.2022.2078505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes. MATERIAL AND METHODS In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual. RESULTS 144 and 159 adolescents with JIA were evaluated according to OHI-S and GBI; corresponding numbers of controls were 154 and 161. Plaque and gingival bleeding were more frequent in individuals with JIA than controls. Adjusted analyses showed association between JIA status and OHI-S > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups. CONCLUSIONS Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.
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Affiliation(s)
| | | | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway, Vestland, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Xie-Qi Shi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Josefine Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Cetrelli
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karen Rosendahl
- Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
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Gil EG, Skeie MS, Halbig J, Jönsson B, Lie SA, Rygg M, Fischer J, Rosén A, Bletsa A, Luukko K, Shi XQ, Frid P, Cetrelli L, Tylleskär K, Rosendahl K, Åstrøm AN. Oral health-related quality of life in 4-16-year-olds with and without juvenile idiopathic arthritis. BMC Oral Health 2022; 22:387. [PMID: 36068497 PMCID: PMC9450232 DOI: 10.1186/s12903-022-02400-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have investigated oral health-related quality of life (OHRQoL) in young individuals with juvenile idiopathic arthritis (JIA). Aims were to investigate whether OHRQoL differs between children and adolescents with JIA compared to controls without JIA, while adjusting for socio-demographic-, behavioral- and oral health-related covariates. Furthermore, to explore whether socio-behavioral and oral health-related covariates of OHRQoL vary according to group affiliation and finally, specifically for individuals with JIA, to investigate whether disease-specific features associate with OHRQoL. We hypothesized that participants with JIA have poorer OHRQoL compared to participants without JIA. METHODS In this comparative cross-sectional study participants with JIA (n = 224) were matched to controls without JIA (n = 224). OHRQoL was assessed according to Early Childhood Oral Health Impact Scale (ECOHIS) (4-11-years-olds) and the child version of Oral Impacts on Daily Performances (Child-OIDP) (12-16-years-olds). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-demographic, behavioral and self-reported oral health information collected by questionnaires. Index teeth were examined for caries by calibrated dentists. Multiple variable analyses were performed using logistic regression, reporting odds ratio (OR) and 95% confidence interval (CI). Two-way interactions were tested between group affiliation and the socio-behavioral- and oral health-related variables on the respective outcome variables. RESULTS In total, 96 participants with JIA and 98 controls were evaluated according to ECOHIS, corresponding numbers for Child-OIDP was 125 and 124. Group affiliation was not associated with impaired ECOHIS or Child-OIDP in adjusted analyses (OR = 1.95, 95% CI 0.94-4.04 and OR = 0.99, 95% CI 0.46-2.17, respectively). Female adolescents with JIA were more likely than males to report oral impacts according to Child-OIDP. Continued activity or flare was found to adversely affect Child-OIDP, also self-reported outcome measures in JIA associated with Child-OIDP. CONCLUSIONS This study did not provide consistent evidence to confirm the hypothesis that children and adolescents with JIA are more likely to have impaired OHRQoL compared to their peers without JIA. However, female adolescents with JIA were more likely than males to report impacts on OHRQoL. Furthermore, within the JIA group, adolescents with continued disease activity, flare or reporting pain, physical disability, had higher risk than their counterparts of impaired OHRQoL.
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Affiliation(s)
- Elisabeth G Gil
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
| | - Marit S Skeie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Center for Oral Health Services and Research, TkMidt, Trondheim, Norway
| | - Josefine Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Birgitta Jönsson
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Periodontology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway, Vestland, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Xie-Qi Shi
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Cetrelli
- Center for Oral Health Services and Research, TkMidt, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karen Rosendahl
- Department of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway.,Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Anne N Åstrøm
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Gil EG, Åstrøm AN, Lie SA, Rygg M, Fischer J, Rosén A, Bletsa A, Luukko K, Shi XQ, Halbig J, Frid P, Cetrelli L, Tylleskär K, Rosendahl K, Skeie MS. Dental caries in children and adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis. BMC Oral Health 2021; 21:417. [PMID: 34433437 PMCID: PMC8390188 DOI: 10.1186/s12903-021-01758-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries. Methods In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4–16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC). Results At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24–3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries. Conclusions No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01758-y.
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Affiliation(s)
- Elisabeth G Gil
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.
| | - Anne N Åstrøm
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway-Vestland, Bergen, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Xie-Qi Shi
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Josefine Halbig
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway
| | - Paula Frid
- Public Dental Health Competence Centre of Northern Norway (TkNN), Tromsø, Norway.,Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Cetrelli
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Center for Oral Health Services and Research (TKMidt), Trondheim, Norway
| | - Karin Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karen Rosendahl
- Department of Clinical Dentistry, The Arctic University of Norway, Tromsø, Norway.,Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Marit S Skeie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway.,Center for Oral Health Services and Research (TKMidt), Trondheim, Norway
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Skakodub AA, Admakin OI, Mamedov AA, Nikulin PA, Vatyan AS. Analysis of the condition of solid tissues of teeth and the level of dental care provided to children with rheumatic diseases. Pediatr Dent 2021. [DOI: 10.33925/1683-3031-2021-21-1-4-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Relevance. Rheumatic diseases strongly influence the condition of the oral cavity, salivary glands and the temporomandibular joint, that, along with poor oral hygiene in children and active growth, increases the risk of oral disease development. The growing number of rheumatic diseases in children requires evaluation of the oral cavity condition and assessment of the provided dental services; enhancement of the professional oral care in children with rheumatic diseases through the comprehensive evaluation of the quality of the performed dental procedures and development of caries prevention measures based on the analysis of the epidemiological survey results.Materials and methods. 316 children with rheumatic pathology aged 1 to 18 years were examined. The children were divided into three age groups: group I – 1-5 years, group II – 6-12 years, group III – 13-17 years. The Oral hygiene and past dental experience questionnaire was developed for each group. Hard dental tissue condition and caries intensity level (df – in group I, df+DMF – in group II, DMF – in group III) were assessed, the oral hygiene index was calculated by the child age. On dental examination, past caries treatment and its complications were considered, the level of dental care (LDC) according to Leus was assessed.Results. The received data on caries intensity in all age groups and all medical conditions were analyzed. The values corresponded to the high and very high intensity (4.2 to 13); the values were 1.89 – 3 times higher than the values received during the epidemiological survey in children of the same age groups in Russia. Multiple primary and secondary (as a complication after the previous dental treatment) caries, associated with poor oral hygiene, was detected. The data revealed that the dental care level in children with rheumatic diseases was ‘poor’ and ‘insufficient’ The interview of the children and their parents showed that 91% of children had never had preventive treatment and 89% of children visited the dentist less than twice a year. The examination revealed that secondary caries, that had developed in 50% of children after the treatment of caries and its complications, and bad fillings, that had to be replaced.Conclusions. Thus, indirect influence of the main disease on the hard dental tissues in children was revealed – motivation for dental treatment and good oral hygiene was decreased for the lack of knowledge. The analysis of dental treatment quality in such children was insufficient. Only emergency dental visits as well as inappropriate materials and methods used for the treatment of caries and its complications result in secondary caries. So, customized treatment approach and prevention programs should be developed and introduced for the oral care in children with rheumatic diseases according to the main disease course, administered background therapy and the level of dental health education.
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Affiliation(s)
- A. A. Skakodub
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - O. I. Admakin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - Ad. A. Mamedov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - P. A. Nikulin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. S. Vatyan
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Frid P, Baraniya D, Halbig J, Rypdal V, Songstad NT, Rosèn A, Berstad JR, Flatø B, Alakwaa F, Gil EG, Cetrelli L, Chen T, Al-Hebshi NN, Nordal E, Al-Haroni M. Salivary Oral Microbiome of Children With Juvenile Idiopathic Arthritis: A Norwegian Cross-Sectional Study. Front Cell Infect Microbiol 2020; 10:602239. [PMID: 33251163 PMCID: PMC7672027 DOI: 10.3389/fcimb.2020.602239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background The oral microbiota has been connected to the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. The objective of this study was to characterize the salivary oral microbiome associated with juvenile idiopathic arthritis (JIA), and correlate it with the disease activity including gingival inflammation. Methods Fifty-nine patients with JIA (mean age, 12.6 ± 2.7 years) and 34 healthy controls (HC; mean age 12.3 ± 3.0 years) were consecutively recruited in this Norwegian cross-sectional study. Information about demographics, disease activity, medication history, frequency of tooth brushing and a modified version of the gingival bleeding index (GBI) and the simplified oral hygiene index (OHI-S) was obtained. Microbiome profiling of saliva samples was performed by sequencing of the V1-V3 region of the 16S rRNA gene, coupled with a species-level taxonomy assignment algorithm; QIIME, LEfSe and R-package for Spearman correlation matrix were used for downstream analysis. Results There were no significant differences between JIA and HC in alpha- and beta-diversity. However, differential abundance analysis revealed several taxa to be associated with JIA: TM7-G1, Solobacterium and Mogibacterium at the genus level; and Leptotrichia oral taxon 417, TM7-G1 oral taxon 352 and Capnocytophaga oral taxon 864 among others, at the species level. Haemophilus species, Leptotrichia oral taxon 223, and Bacillus subtilis, were associated with healthy controls. Gemella morbillorum, Leptotrichia sp. oral taxon 498 and Alloprevotella oral taxon 914 correlated positively with the composite juvenile arthritis 10-joint disease activity score (JADAS10), while Campylobacter oral taxon 44 among others, correlated with the number of active joints. Of all microbial markers identified, only Bacillus subtilis and Campylobacter oral taxon 44 maintained false discovery rate (FDR) < 0.1. Conclusions In this exploratory study of salivary oral microbiome we found similar alpha- and beta-diversity among children with JIA and healthy. Several taxa associated with chronic inflammation were found to be associated with JIA and disease activity, which warrants further investigation.
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Affiliation(s)
- Paula Frid
- Department of ENT, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, Tromsø, Norway.,Public Dental Service Competence Centre of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Divyashri Baraniya
- Oral Microbiome Laboratory, Kornberg School of Dentistry, Temple University, Philadelphia, PA, United States
| | - Josefine Halbig
- Public Dental Service Competence Centre of North Norway, Tromsø, Norway.,Department of Clinical Dentistry, UiT the Arctic University of Norway, Tromsø, Norway
| | - Veronika Rypdal
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Nils Thomas Songstad
- Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Annika Rosèn
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Johanna Rykke Berstad
- Department of ENT, Division of Oral and Maxillofacial Surgery, Oslo University Hospital, Oslo, Norway
| | - Berit Flatø
- Department of Rheumatology and Infectious Diseases, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Rheumatology, Oslo University Hospital, Oslo, Norway
| | - Fadhl Alakwaa
- Department of Computational Medicine and Bioinformatics, University Michigan, Ann Arbor, MI, United States
| | | | - Lena Cetrelli
- Center of Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Tsute Chen
- Department of Microbiology, Forsyth Institute, Cambridge, MA, United States
| | - Nezar Noor Al-Hebshi
- Oral Microbiome Laboratory, Kornberg School of Dentistry, Temple University, Philadelphia, PA, United States
| | - Ellen Nordal
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.,Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Mohammed Al-Haroni
- Department of Clinical Dentistry, UiT the Arctic University of Norway, Tromsø, Norway
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Merle CL, Hoffmann R, Schmickler J, Rühlmann M, Challakh N, Haak R, Schmalz G, Ziebolz D. Comprehensive Assessment of Orofacial Health and Disease Related Parameters in Adolescents with Juvenile Idiopathic Arthritis-A Cross-Sectional Study. J Clin Med 2020; 9:jcm9020513. [PMID: 32069957 PMCID: PMC7074230 DOI: 10.3390/jcm9020513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/03/2020] [Accepted: 02/11/2020] [Indexed: 12/11/2022] Open
Abstract
Background: The aim of this cross-sectional study was to investigate oral health and functional status of adolescents with juvenile idiopathic arthritis (JIA) and its possible link to disease specific parameters. Methods: Patients with JIA were recruited (November 2012–October 2014) and disease specific information was extracted from patients’ records. Oral examination included: dental findings (decayed-, missing- and filled-teeth-index (dmf-t/DMF-T)), gingival inflammation (papilla-bleeding-index (PBI)) and periodontal screening index (PSI). Functional examination followed Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Additionally, modified Helkimo’s Clinical Dysfunction Index and radiographic scoring were recorded. Results: 59 JIA patients were included. The mean dmf-t/DMF-T was 2.6. Only one patient showed no signs of gingival inflammation, while 57.6% had a maximum PSI of 2 or less. Positive functional findings were assessed clinically in more than half of the patients. Major diagnosis by RDC/TMD was osteoarthrosis. Patients with at least one positive anamnestic or clinical functional finding revealed significantly higher radiographic scores (CI = 0.440, p = 0.022). Patients with increased c-reactive-protein had a significantly higher PBI (Z = –2.118, p = 0.034) and increased radiographic scores (CI = 0.408, p = 0.043). Conclusions: Adolescents suffering from JIA show high levels of caries experience and gingival inflammation. Temporomandibular joint dysfunction is often seen in JIA patients. Consequently, special dental care programs would be recommendable.
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Affiliation(s)
- Cordula Leonie Merle
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Robin Hoffmann
- Dental Practice Pröpper, Flachsenberg, Hoffmann, 34119 Kassel, Germany;
| | - Jan Schmickler
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Michael Rühlmann
- Medical Practice for Pediatricy And Pediatric Rheumatology M. Rühlmann, 37073 Goettingen, Germany;
- Department of Pediatricy II (Pediatric Neurology), University of Goettingen, 37075 Goettingen, Germany
| | - Nadia Challakh
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (C.L.M.); (J.S.); (N.C.); (R.H.); (G.S.)
- Correspondence: ; Tel.: +49-341-97-21211
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Skeie MS, Gil EG, Cetrelli L, Rosén A, Fischer J, Åstrøm AN, Luukko K, Shi X, Feuerherm AJ, Sen A, Frid P, Rygg M, Bletsa A. Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. BMC Oral Health 2019; 19:285. [PMID: 31856793 PMCID: PMC6921440 DOI: 10.1186/s12903-019-0965-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/21/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Observational studies examining the association between oral health and juvenile idiopathic arthritis (JIA) among children and adolescents have reported inconsistent findings. The aims of this systematic review and meta-analysis were to ascertain a potential difference in oral health and oral health-related quality of life (OHRQoL) among children and adolescents with JIA and healthy peers, and to assess the association of prevalence of oral diseases/conditions, temporomandibular disorders (TMD), including temporomandibular joint (TMJ) diseases, in relation to activity and severity of JIA. METHOD Medline Ovid, Embase, CINAHL, SweMed+ and Cochrane Library were searched up to 25 November 2018. All articles published in English, German and Scandinavian languages focusing on children and adolescents with JIA and without JIA in relation to oral health measures, were considered. Two authors independently evaluated observational studies for inclusion. The study quality was assessed using modified Newcastle Ottawa Scale. Meta-analysis was performed for studies focusing on dental caries as an outcome. RESULTS Nineteen articles met the inclusion criteria, covering a range of oral diseases/conditions and OHRQoL. Eighteen studies had cross-sectional design. No mean difference of dmft/DMFT indices (decayed/missed/filled teeth) was observed between the JIA - and healthy group. None of the oral health measures including dental erosive wear, enamel defects, dental maturation and OHRQoL, indicated better oral health among children and adolescents with JIA compared to healthy group. However, periodontal conditions and TMD were more predominant among children and adolescents with JIA compared to healthy peers. CONCLUSIONS Based on the cross-sectional studies, periodontal diseases and TMD were found to be more frequent in children and adolescents with JIA compared to healthy peers. Furthermore, more high-quality studies with large sample size are needed before we infer any concrete conclusion regarding the association between the prevalence of oral and TMJ diseases or oral conditions in relation to activity and severity of JIA.
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Affiliation(s)
- Marit S Skeie
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway.
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
| | - Elisabeth G Gil
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Lena Cetrelli
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Annika Rosén
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Johannes Fischer
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Keijo Luukko
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
| | - Xieqi Shi
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
- Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Astrid J Feuerherm
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Abhijit Sen
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Public health and Nursing, Faculty of Medical and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paula Frid
- Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromso, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromso, Norway
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North, Tromso, Norway
| | - Marite Rygg
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - Athanasia Bletsa
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Norway, Årstadveien 19, N-5009, Bergen, Norway
- Oral Health Centre of Expertise in Western Norway- Hordaland, Trondheim, Norway
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Faker K, Tostes MA, Paula VACD. Impact of untreated dental caries on oral health-related quality of life of children with special health care needs. Braz Oral Res 2018; 32:e117. [DOI: 10.1590/1807-3107bor-2018.vol32.0117] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/01/2018] [Indexed: 02/05/2023] Open
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