Integrating Periodontal Care into Chronic Disease Prevention for Underserved Populations: A Narrative Review of Oral–Systemic Health Models in the United States

Review Article

Abstract

Periodontal disease disproportionately affects low-income, minority, and rural U.S. populations and shares bidirectional inflammatory pathways with type 2 diabetes mellitus and cardiovascular disease. Despite robust biological and epidemiological evidence linking oral and systemic health, structural separation between dental and medical care systems limits preventive impact in vulnerable communities. This narrative review synthesizes evidence on oral–systemic disease relationships, health disparities, medical–dental integration models, non-surgical periodontal therapy outcomes, health literacy strategies, and emerging technology-assisted approaches. Literature was identified via PubMed/MEDLINE using MeSH terms and Boolean operators. Periodontal inflammation contributes to glycemic dysregulation and cardiovascular risk through shared cytokine-mediated pathways. Federally Qualified Health Centers provide viable integration frameworks yet face persistent financing and workforce barriers. Non-surgical periodontal therapy demonstrates clinically relevant reductions in systemic inflammatory markers. Community health workers and culturally adapted interventions extend preventive reach. Artificial intelligence tools for risk stratification show promise but require equitable dataset development. Achieving population-level impact requires coordinated policy reform, reimbursement innovation, and interprofessional workforce training.