The JIA-Oral Health Study

Oral Health as a Determinant of Childhood Arthritis Occurrence and Outcomes: Towards Improving Care of Childhood Arthritis by Optimizing Oral Health

Innovation

While understanding and care of children with arthritis have improved, the disease continues to be profoundly burdensome. The cause of juvenile idiopathic arthritis (JIA), the most common class of childhood arthritis, is unknown (the word 'idiopathic means the cause is unknown); the underlying mechanisms of the disease not fully understood; treatments, while improved, are not as predictably effective or safe as desired, and we have no insights into cure and prevention. The reasons why some children have more severe JIA, poorer outcomes, and require more aggressive therapy are unknown.

Coincident with the high prevalence of JIA is a correspondingly high rate of oral disease in Saskatchewan children. Canadian children, and especially Saskatchewan children, have a high rate of dental disease that is over-represented in children from lower socioeconomic strata.

There is compelling evidence to support our hypothesis that in children with JIA, poor oral health results in more severe joint disease that is less responsive to therapy. This study aims to elucidate the relationships between oral health status and childhood arthritis occurrence, courses, and outcomes.

Discovery

This study is in the early stages of enrolment. Although we had anticipated beginning enrollment sooner, it was not possible to do so during the height of the COVID-19 pandemic.

We anticipate that the results of this research will transform the understanding and care of many children with JIA who have associated oral diseases. We intend to develop clear, succinct protocols, presented in infographic formats, to guide healthcare providers in clinical assessments of oral health status and when and how to collect, process, assay, and interpret biologic samples as part of the diagnostic work-up for oral health in children with JIA.

Engagement

This project is possible because of the strong collaboration between pediatric rheumatologists, dentists, and investigators with expertise in assessing oral health, including the oral microbiome. The team also includes those with lived experience with childhood arthritis.

Action

Showing that poor oral health influences JIA will inform treatment and prevention strategies to optimize oral health in Saskatchewan children afflicted with JIA. Low-cost, safe oral health treatments will lead to improved JIA outcomes and treatment responses and reduced patient, family, and societal burden. The knowledge generated from this research will benefit Saskatchewan children and children elsewhere in Canada and globally.