Most of the time, we associate arthritis with the elderly, but it can actually affect children. Most often, this is what is known as juvenile rheumatoid arthritis or juvenile idiopathic arthritis (JIA). The condition is an autoimmune disorder. For reasons that remain somewhat mysterious the immune system begins to attack tissues of the body, especially joint tissues, causing degradation of the soft tissue, and, eventually the bone. It seems to run in families, so it likely has a genetic component, but it is also triggered by environmental factors such as a viral or bacterial infection. Like TMJ, it seems to affect mostly girls. (Although TMJ may not affect females as much as we thought.)
Children and teens who develop JIA will usually have their jaw joint affected. The temporomandibular joint is involved in up to 80% of JIA cases. When JIA impacts the jaw, children may experience:
Although these symptoms may be constant, they may tend to be worse during the morning or after naps.
No Standard Treatment Protocol
The problem is that doctors don’t really know how best to treat temporomandibular joint involvement in JIA, kind of like the lack of consensus about TMJ treatment in general. A survey by researchers in Germany and the US found a wide range of treatments were used by the 87 practices they surveyed about the condition.
Screening for involvement of the temporomandibular joint usually included a physical examination (100%) and medical history (98%), but only 2% of centers used medical imaging as part of the screening process. When imaging was used, whether for screening or diagnosis, practices most commonly used MRI, followed by x-ray, ultrasound, and CT.
There were huge disagreements about which frontline treatment to use on the condition.
- 36% targeted the underlying disease with DMARD (Disease-modifying antirheumatic drugs)
- 33% use ibuprofen, naproxen, and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- 26% use intra-articular corticosteroid injection
- 5% use an anti-tumor necrosis factor (TNF)
Although it can lead to growth problems in developing joints, 65% of the practices used steroid injection as part of their treatment plan.
Researchers propose that the lack of standard treatment protocol may lead to poor treatment for children and teens, and they called for experts to develop a medical consensus on the best treatment options.
Another problem is that teens are also susceptible to developing TMJ. If your child is experiencing jaw joint problems, it’s important to eliminate TMJ as a possibility to ensure proper treatment. Please call (303) 691-0267 for an appointment with a Denver TMJ dentist at the TMJ Therapy and Sleep Center of Colorado.