Looking good on the outside can be deceptive when living with chronic pain on the inside. Within the world of autoimmune diseases patients may present with varying degrees of pain, fatigue and altered lifestyles. Increased risk of periodontal diseases and dental caries are common hallmarks of many autoimmune conditions fueled by chronic inflammation. We will evaluate risk factors for autoimmune diseases, the implications of immune-suppressing medications, and methods to reduce oral complications.