Periodontitis, Cardiovascular Disease, and Fungal Infection: A Scoping Review of Observational Evidence and Evidence Gaps

Background: Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth and represents one of the most prevalent oral conditions worldwide. Beyond its local effects, periodontitis has been increasingly associated with systemic conditions, including cardiovascular disease (CVD) and fungal infections, with chronic inflammation proposed as a central linking mechanism. Aim: To map and synthesize the existing evidence on (a) associations between periodontitis and CVD and (b) associations between periodontitis and fungal infections, and to identify evidence gaps regarding their concurrent evaluation within the same study populations. Methods: This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Electronic searches of PubMed, Scopus, Web of Science, and Google Scholar were performed for studies published between January 2013 and June 2025. A total of 66 records were identified, of which 24 studies met the inclusion criteria following screening and eligibility assessment. Data were charted descriptively, and no formal risk-of-bias or quality appraisal was undertaken, consistent with the objectives of a scoping review. Results: The mapped evidence indicates a consistent association between periodontitis and CVD, largely attributed to systemic inflammatory pathways and microbial dissemination. Emerging evidence also suggests an association between periodontitis and fungal colonization or infection, particularly involving Candida species, although this body of literature remains limited and methodologically heterogeneous. Conclusion: The current literature supports pairwise associations between periodontitis and CVD, and between periodontitis and fungal infection. However, studies concurrently evaluating all three conditions within the same cohorts are lacking. The findings of this scoping review are hypothesis-generating rather than confirmatory and highlight the need for well-designed longitudinal studies using standardized diagnostic criteria to elucidate integrated periodontal–fungal– cardiovascular interactions.