Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis

Abstract

Clinical TMJ involvement in JIA is associated with higher disease activity, higher disability, and impaired HRQOL. Our findings indicate the need for dedicated clinical and imaging evaluation of TMJ arthritis, especially in children with cervical spine involvement, polyarticular course, and longer disease duration.

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

“…This finding is in contrast with Engstrom et al who reported a higher prevalence of orofacial symptoms over time in their 15 year follow-up study [ 11 ]. In agreement with Frid et al we found an increased prevalence of orofacial symptoms in patients with a polyarticular disease course [ 9 ].…”

“…In this study, the presence of orofacial pain and/or functional disability significantly impacted general health related quality of life. This is in agreement with a previous study by Leksell et al and Frid et al [ 9 , 15 ] but contrasts with findings of Twilt et al [ 13 ] who reported no significant impact on general quality of life between patients with and without TMJ involvement. However, an only moderate association ( r = 0.54) between the pain index variable and the impact of an orofacial condition on general quality of life demonstrates that a high level of orofacial pain may not negatively impact general quality of life and vice versa.…”

2021 American College of Rheumatology Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and Systemic Juvenile Idiopathic Arthritis

“…TMJ disease may be isolated or part of generalized arthritis. Treatment of TMJ arthritis is critical, as patients/caregivers noted high impact on oral health–related quality of life and challenges with diagnosis and effective pharmacologic treatment (50,51). In this guideline, therefore, treatment of TMJ arthritis is recommended regardless of presence of clinical symptoms.…”

Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus‐Based Recommendations

“…Additionally, orofacial symptoms and dysfunction and dentofacial deformity that results from prior TMJ arthritis can persist and progress even after active arthritis has been managed. These sequelae have a significant negative impact on health‐related quality of life, and as such they must be equally included in management principles ( 9 , 10 , 11 ).…”