Abstract
Background. One of the urgent problems of modern medicine is the formation and development of an interprofessional approach to the complex therapy of patients with combined pathology. An interdisciplinary approach to the examination and treatment of patients with concomitant diseases is due to the interconnection of the oral mucosa with systemic diseases. Literature data indicate the pathogenetic commonality of systemic connective tissue diseases, including rheumatoid arthritis with periodontitis and oral mucosa diseases, which is based on a diffuse inflammatory process.
 Objectives ― study of a clinical case of combined lesion of the oral mucosa of a patient with rheumatoid arthritis during treatment with methotrexate.
 Methods. We examined patient R. — an elderly man of 72-year-old with ulcerative and necrotic lesions of the oral mucosa, simultaneously suffering from rheumatoid arthritis and receiving methotrexate as maintenance therapy. The patient was sent to the Department of Therapeutic Dentistry of Omsk State Medical University, to the clinical base of dental clinic № 1 in Omsk in order to clarify the diagnosis and prescribe complex treatment.
 Results. Patient R. revealed a combined ulcerative-necrotic lesion of the oral mucosa and gums with rheumatoid arthritis. Joint general and local medical treatment by a dentist of lesions of the oral mucosa, gums, examination, observation in dynamics and the advice of a physician-therapist in terms of prescribing maintenance therapy for rheumatoid arthritis by reducing the dose of the drug (methotrexate) gave a joint positive effect in a comprehensive interdisciplinary approach to the treatment of a patient with comorbid pathology.
 Conclusions. Our research has shown that it is necessary to increase activity in the development of an interdisciplinary collaboration between dentists and internists. The continuity and friendship of doctors of different specialties make it possible to get a positive result in the treatment and improve the quality of life of patients.
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