RA has been defined as a chronic disease linked with inflammatory factors resulting in destruction of connective tissue and bone deterioration.29 Those well defined characteristics are also distinguishing features defining periodontal disease. With each condition, inflammation appears to separate diseased conditions from health. Numerous research studies have suggested relationships may exist between RA and periodontal disease.44 Each disease exhibits dysfunctional immune systems, genetic risk factors and inflammatory mediators compounding susceptibility; suggesting a co-existing relationship is probable.45 Chronic inflammation has been defined as a common link supporting systemic manifestations and risk factors for various medical conditions.4 Research studies continue to explore co-existing factors and their relationships between RA and periodontal disease. A recent study published in the Journal of Clinical Periodontology found RA patients were nearly eight times more likely to have periodontal disease compared to the control subjects.46 A study in 2005 conducted by Al-Shammari and colleagues47 reported tooth loss from periodontitis and risk factors for severe periodontal disease shared RA as the strongest risk indicator for periodontally-induced tooth loss. Independent of other risk factors, the mechanism by how RA creates the increased risk remains unknown. Early recognition of risk factors and proper treatment protocols are essential in any disease management.