Prediabetes is an intermediate glycemic state defined by impaired fasting glucose, impaired glucose tolerance, or mildly elevated glycated hemoglobin (HbA1c 5.7–6.4%) and affects an estimated 374 million people worldwide. Growing evidence supports a bidirectional relationship between prediabetes and periodontitis in adults. Individuals with prediabetes face a significantly higher risk of periodontitis, with disease severity correlating with the advancing stages of clinical attachment loss. Inflamed periodontal tissues generate advanced glycation end-products (AGEs), upregulate matrix metalloproteinase-8 (MMP-8), and sustain a pro-inflammatory cytokine milieu that exacerbates insulin resistance. Non-surgical periodontal therapy reduces active MMP-8 and HbA1c levels in prediabetic patients, potentially delaying the progression to overt type 2 diabetes. Dentists are ideally positioned to identify undiagnosed prediabetes through periodontal assessment and chairside glycemic screening, enabling timely interdisciplinary referrals.