The interrelationship between pulpal and periodontal disease is genuine and is histologically demonstrated using radiograph , histological and clinical criteria. However , over the years this relationship has been both confirmed and denied by numerous investigators using a wide variety of evaluation methodologies and parameters. Although , the opinion may vary on which disease came first , a thorough diagnosis and evaluation must ensure to determine the most probable etiology , course of disease and most reasonable treatment. That means when pulpal disease exists, the periodontal status must be evaluated and likewise when periodontal disease is present, the clinical pulpal status must be evaluated with utmost care. If an interrelationship in disease entities exit or if the potential for the occurance is anticipated, appropriate treatment must be rendered to remove the true etiologic factors and enhance the prognosis for retention of tooth.