JIA can affect a child's neck or jaw, and this can affect their dental health. If a child has difficulty moving their jaw or neck, it can make brushing and or flossing their teeth difficult. To help with this, their dentist may suggest different types of toothbrush handles, electric toothbrushes, or floss holders to help maintain healthy teeth and gums.
The temporomandibular joint (TMJ) is the joint in front of the ears where the lower jaw connects to the base of the skull. JIA may affect this joint in the same way it affects other joints. Often patients have no symptoms at all of JIA in the TMJ. By the time a child develops symptoms, they may already have damage to the TMJ. This may cause pain and stiffness in the jaw. It can also alter growth so that one side of the jaw grows faster than the other. If both sides are affected, a child may develop a small, receded chin, and may get crowding of the teeth. If the lower jaw does not develop properly, it may create an overbite. To detect JIA in the TMJ, a doctor may need to do an MRI of the jaw. A child may also need to see an orthodontist, who can order a panorex x-ray. The rheumatologist can treat TMJ arthritis with medication. An orthodontist can help with mouth splints and/or braces. Sometimes, patients require surgery once their jaw has finished growing.
Dental check-ups and surgery
Keep the dentist informed about the status of the JIA and any medications your child is taking, since they can also affect oral health. For example, the dentist needs to know if your child has had a joint replacement, as they might need an antibiotic before any dental work.
If your child has active JIA, they may find it difficult to keep their mouth open for routine dental check-ups. If this is the case, work with the dentist to make dental care as easy as possible. Sometimes more frequent, shorter visits may be helpful. If your child needs any type of dental surgery, talk to the dentist to see if you need to meet with the anesthesiologist prior to the surgery. This is especially important if your child has trouble opening their mouth or if they have difficulty moving their neck.