Background: Evidence on the relationship between rheumatoid arthritis (RA) and oral health remains inconsistent. In this cross-sectional study, the authors compared oral health–related quality of life (OHRQoL), caries experience, salivary function, periodontal status, and risk of developing caries in adults with RA and systemically healthy control participants. Methods: Sixty-seven adults with RA (confirmed diagnosis for ≥ 2 years) and 64 age- and sex-comparable healthy control participants underwent comprehensive oral examinations including decayed, missing, and filled teeth and decayed, missing, and filled surfaces indexes, initial caries assessment, root caries evaluation, and Community Periodontal Index scoring. Unstimulated and stimulated salivary flow rates, pH, and buffering capacity were measured. Cariogram software, Version 1.3 (Malmö University) was used for caries risk profiling. Participants completed validated OHRQoL questionnaires. Results: Patients with RA had significantly reduced salivary flow (both, P < .001), higher buffering capacity (P = .034), and greater caries experience (decayed, missing, and filled teeth index: P = .035; missing teeth: P = .002). Results of a cariogram revealed lower caries-free probability in patients with RA (33% vs 52%). Periodontal findings were comparable (P = .075). OHRQoL was better in patients with RA (median, 5 vs 7; P = .047). Conclusions: RA is associated with salivary hypofunction and increased risk of developing caries. Although patients with RA reported better OHRQoL, objective clinical assessments revealed elevated risk of developing caries, underscoring the need for comprehensive preventive strategies tailored to this population. Practical Implications: Dental care professionals should implement regular caries risk assessments, salivary function monitoring, high-fluoride regimens, and oral hygiene protocols adapted to functional limitations for patients with RA to prevent progressive caries and tooth loss.