Background Periodontitis increases the risk of cardiovascular disease in the general population by triggering systemic inflammation. Aim To investigate the relationship between systemic inflammation and periodontitis, and clarify any association between severe periodontitis and the medications used by patients receiving haemodialysis. Design A cross-sectional study. Participants The study was undertaken with 56 patients receiving haemodialysis. Measurements Demographic and laboratory data and prescribed drugs regularly used by patients were recorded from hospital records. During the dialysis session, a validated Xerostomia Inventory score was completed. A complete dental/periodontal examination was also undertaken on all patients by the same periodontist. Results In the study population, stage I periodontitis was determined in 41%, stage II periodontitis in 17%, stage III periodontitis in 21%, and stage IV periodontitis in 21%. Male gender, hypertension, coronary artery disease, beta antagonists, calcium channel blockers, sodium polystyrene sulphonate, teeth brushing less than twice a day and high sensitive C-reactive protein > 8 mg/l were significantly associated with severe periodontitis. Conclusion Drugs, including beta antagonists, calcium channel blockers, polystyrene sulphonate, co-morbid conditions and poor or insufficient oral care could facilitate an increase in the severity of periodontitis in patients receiving haemodialysis. Severe periodontitis also seems to be associated with cardiovascular disease and inflammation in patients with chronic renal disease.