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Periodontitis is a chronic inflammatory disease caused by microbial dysbiosis, leading to tissue destruction and systemic immune activation. Emerging evidence reveals a bidirectional relationship between periodontitis and asthma, linked through shared inflammatory and microbial pathways. Both involve cytokine dysregulation, oxidative stress, and immune cell activation, particularly type 2 innate lymphoid cells and matrix metalloproteinases that drive tissue remodeling. Asthma therapies, including inhaled corticosteroids and beta-2 agonists, may worsen periodontal health by inducing xerostomia and microbial shifts. Systemic factors such as obesity, GORD, and vitamin D deficiency further amplify inflammation in both disorders. Understanding their molecular and immunological crosstalk highlights the need for integrated management to control systemic inflammation and improve oral and respiratory outcomes through collaborative clinical care and targeted interventions.