Juvenile Idiopathic Arthritis (JIA) is the most common rheumatologic disorder found in children, affecting millions worldwide. It has no known cause, prevention, or cure, and can lead to debilitating destruction of the joints. In adult Rheumatoid Arthritis (RA), previous research suggests a connection between RA and oral bacteria that cause inflammatory diseases. Specifically, Porphyromonas gingivalis, found in patients with periodontitis, expresses an enzyme that modifies the amino acid arginine to citrulline, which the immune system recognizes as foreign, reacting to produce anti--citrullinated protein antibodies (ACPAs), which attack otherwise healthy proteins in the body. Therefore, we hypothesize that in JIA, the unique bacterial colonies of the mouth induce a chronic ACPA production that leads to arthritis. We use enzyme-linked immunosorbent assays to assay patient plasma for ACPAs with 6 peptides. We have tested plasma from 79 patients with JIA, 56 children recruited from dental clinic, and 29 healthy children for antibodies to citrullinated filaggrin, a known autoantigen in RA. Compared to healthy controls, JIA patients had a significant increase in anti-citrullinated filaggrin antibodies (relative levels 0.88 vs. 0.45, p=0.001 by t-test). Anti-filaggrin antibodies were elevated in patients with oligoarticular JIA, (mean 0.62, p=0.0012) and extended-oligoarticular JIA, (mean 0.88, p=0.007), but not polyarticular JIA (mean 0.49, p=0.47). In addition, there is a higher prevalence of bleeding on probing (BOP, an indicator of gingival inflammation) in JIA, with an average BOP score of more than two times that of children from dental clinic (p=0.008). Our next step is to see if there are any specific microbes associated with higher BOP scores and ACPA levels. If we find that oral pathogens are associated with inflammatory disease, prevention can be designed to eliminate plaque-associated pathogens through various dental hygiene practices.