Creaky Joints and Bleeding Gums: The Interaction Between Periodontal Disease and Rheumatoid Arthritis

This course seeks to improve dental health-care providers’ understanding of the interaction between periodontal disease and RA as well as aid in the clinical decision-making process in caring for patients with RA in a dental setting.

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Rheumatoid arthritis (RA) is an inflammatory form of arthritis affecting 1.3 million individuals in the United States. RA symptoms are due to an overactive autoimmune response that leads to joint damage and, subsequently, a significant societal burden related to patient discomfort, declining quality of life, and increased treatment costs. Several studies have indicated patients with RA have a higher prevalence of periodontal disease than those without RA or with other forms of arthritis. Current understanding of the pathogenesis of RA lacks a clear picture of the autoantibody response and its potential initiators. However, specific serum antibodies directed to citrullinated peptides are associated with smoking, disease severity, periodontal disease, and periopathogenic microbiota. Additionally, the underlying mechanisms of bone resorption and synovial inflammation are analogous in RA and periodontitis. These common pathologic processes, shared risk factors, and potential initiating role of periodontal bacteria highlight the need for interprofessional management of patients with RA and periodontitis. This course seeks to improve dental health-care providers’ understanding of the interaction between periodontal disease and RA as well as aid in the clinical decision-making process in caring for patients with RA in a dental setting.

Educational objectives
Upon completion of this course, the dental professional should be able to:

1. Understand the current scientific literature concerning the association between periodontal health and rheumatoid arthritis (RA) and discuss the interactions between these two conditions with patients
2. Discuss with patients the common risk factors and potential shared etiologic factors associated with periodontitis and RA, and become familiarized with strategies to treat those risk factors
3. Evaluate the evidence supporting delivery of nonsurgical periodontal treatment and adjunctive therapies in patients with RA and periodontitis and their potential impact on RA development and symptoms
4. Evaluate patients’ risk factors and oral home-care practices while focusing on individualized patient needs and severity of RA disease markers
5. Discuss with members of the interprofessional team about the importance of, and effective methods for, treatment of periodontal disease in patients with RA

Photo credit:  © Jan Mika |
Quick Access Code: 20006

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Course Includes

  • 1 Lesson
  • 1 Test
  • Course Certificate
  • CE credit(s): 3

    Course Type: Written

    Published Date: September 2020

    This continuing education (CE) activity was developed by Endeavor Business Media with no commercial support.

    This course was written for dentists, dental hygienists, and dental assistants, from novice to skilled.

    Educational methods: This course is a self-instructional journal and web activity.

    Provider disclosure: Endeavor Business Media neither has a leadership position nor a commercial interest in any products or services discussed or shared in this educational activity. No manufacturer or third party had any input in the development of the course content.

    Requirements for successful completion: To obtain 3 CE credits for this educational activity, you must pay the required fee, review the material, complete the course evaluation, and obtain an exam score of 70% or higher.

    CE planner disclosure: Laura Winfield, Endeavor Business Media dental group CE coordinator, neither has a leadership nor commercial interest with the products or services discussed in this educational activity. Ms. Winfield can be reached at

    Educational disclaimer: Completing a single continuing education course does not provide enough information to result in the participant being an expert in the field related to the course topic. It is a combination of many educational courses and clinical experience that allows the participant to develop skills and expertise.

    Image authenticity statement: The images in this educational activity have not been altered.

    Scientific integrity statement: Information shared in this CE course is developed from clinical research and represents the most current information available from evidence-based dentistry.

    Known benefits and limitations of the data: The information presented in this educational activity is derived from the data and information contained in the reference section.

    Registration: The cost of this CE course is $39.00 for 3 CE credits.

    Cancellation and refund policy: Any participant who is not 100% satisfied with this course can request a full refund by contacting Endeavor Business Media in writing.

    Provider information:

    Dental Board of California: Provider RP5933. Course registration number CA code: 03-5933-20006. Expires August 31, 2023. “This course meets the Dental Board of California’s requirements for 3 units of continuing education.”


    Endeavor Business Media is a nationally approved PACE program provider for FAGD/MAGD credit.
    Approval does not imply acceptance by any regulatory authority or AGD endorsement.
    11/1/2022 to 10/31/2024.
    Provider ID# 320452
    AGD code: 730


    Endeavor Business Media is designated as an approved Provider by the American Academy of Dental Hygiene, Inc. #AADHPNW (January 1, 2022–December 31, 2024). Approval does not imply acceptance by a state or provincial Board of Dentistry. Licensee should maintain this document in the event of an audit. AADH code:


    Endeavor Business Media is an ADA CERP–recognized provider.

    ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of dental continuing education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

    Concerns or complaints about a CE provider may be directed to the provider or to CERP at



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