Introduction

Due to similar features in the pathobiology and prevalence of periodontal disease and rheumatoid arthritis (RA), it has been proposed these diseases have a biologic interrelationship. It has been reported that individuals with periodontitis are up to four times more likely to have a self-reported history of RA than those without periodontal disease.6 In the same population of patients with RA, 62.5% had advanced forms of periodontitis.6 For both of these diseases, the host response determines, in large part, the tissue destruction and inflammatory response.8 Additionally, because of the similarity of tissues destroyed by such a response, the cells, enzymes, and inflammatory mediators that cause the damage to bone and soft tissue share a common pathway.8-11 Finally, due to this common pathway, strategies to treat and/or modulate these diseases are similar and may have effects on both conditions. Therefore, it is imperative that physicians managing RA and oral health care providers are aware of this interaction and are able to identify and manage the common pathophysiology.9-13