The pulp and periodontium are intimately related and their inter-relationship has been subject to controversy for many years. Research has shown that periodontal diseases may lead to changes in the pulp, however, when both apparatus are affected, periodontal and endodontic therapy is indicated because the disease of one may influence and alter the physiological condition of the other. Some publications have suggested that periodontal disease is more deleterious to the pulp than both caries and restorations combined. Others publications have shown negligible effect. This presentation is directed to discuss these difference and analyze these changes.