Oral Connections

RA has been defined as a chronic disease linked with inflammatory factors resulting in destruction of connective tissue and bone deterioration. 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. . However, a 2025 systematic review and meta-showed that no significant association exists between rheumatoid arthritis (RA) and periodontal disease.⁸³ However, it did show that controlling periodontal infections and gingival inflammation through scaling/root planing and plaque control in individuals with moderate periodontal disease may contribute to a reduction in the signs and symptoms of active rheumatoid arthritis.⁸³ This may contribute to a reduction in the signs and symptoms of active rheumatoid arthritis. Each disease exhibits dysfunctional immune systems, genetic risk factors and inflammatory mediators compounding susceptibility; suggesting a co-existing relationship is probable.⁸⁴ Chronic inflammation has been defined as a common link supporting systemic manifestations and risk factors for various medical conditions. Research studies continue to explore co-existing factors and their relationships between RA and periodontal disease. A 2025 study showed that periodontal treatment is locally effective in patients with RA and impacts RA disease activity and anti-CCP2 antibody levels in patients with severe periodontitis. The data suggest that periodontal assessment and treatment should be integrated in the management of RA patients within a treat-to-target strategy.⁸⁵ A study in 2005 conducted by Al-Shammari and colleagues⁸⁶ 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.