Diabetes, Aging, and Oral Health: Salivary and Oral Tissue Research at the Crossroads of Metabolic and Vascular Disease

Diabetes mellitus, cardiometabolic disease, and ageing are major global health challenges connected by shared inflammatory, metabolic, and vascular pathways. Diabetes and periodontal disease show a well-established bidirectional relationship, with each condition worsening the other through immune dysregulation and metabolic disturbance. The oral cavity is a key, clinically accessible interface where metabolic dysregulation can present through altered salivary gland function, impaired tissue repair, barrier disruption, and microbial imbalance. Conversely, oral inflammation and dysbiosis can contribute to glycaemic dysregulation and vascular risk through systemic inflammation, endothelial dysfunction, and microbe-associated mechanisms (e.g., transient bacteremia). Importantly, oral diseases are not microbiologically uniform: dental caries and periodontitis represent distinct microbial ecologies, which may translate into different systemic signatures and vascular associations.Aging - often accompanied by polypharmacy, dietary change, and cumulative inflammatory exposure - may further intensify oral-systemic interactions via immunosenescence and reduced regenerative capacity. Advances in omics and systems approaches now enable deeper insight into salivary biomarkers of metabolic status, oral microbiome features linked to cardiometabolic risk, and microbial functional pathways relevant to glucose homeostasis (including nitrate metabolism).This Research Topic aims to clarify mechanistic pathways linking diabetes, ageing, and oral health within a cardiometabolic framework, with emphasis on biomarker discovery and actionable prevention/intervention insights. This Research Topic invites studies examining the pathophysiological connections between diabetes, ageing, and oral diseases through inflammatory and microbial mechanisms, with primary focus on cardiometabolic and vascular implications (including downstream vascular outcomes). Specific themes include:• Salivary biomarkers of glycaemic control, metabolic risk, inflammation, and vascular health• Plasma/blood biomarkers reflecting oral inflammatory burden and oral–systemic crosstalk• Diabetic- and ageing-related changes in salivary glands and oral tissues (mucosa, periodontal and peri-implant tissues), including impaired healing• Oral dysbiosis and oral microbiome ecology in diabetes, ageing, and metabolic risk states• Oral microbial states and disease ecologies (caries, periodontitis, peri-implantitis) as distinct microbial niches and their potential links to differing systemic/vascular profiles• Inflammatory and immune mediators connecting oral inflammation to endothelial dysfunction and cardiometabolic risk• Microbial translocation/bacteremia-related mechanisms relevant to systemic inflammation and vascular injury• Oral nitrate metabolism and other microbial functions linked to glucose tolerance, pre-diabetes, and diabetes pathways• Dental interventions, prevention strategies, and health promotion initiatives and their effects on glycaemic and cardiometabolic parameters• Multi-omics and integrative analyses (genomic/proteomic/metabolomic and microbiome-focused) to map oral-cardiometabolic connections• Novel diagnostic/monitoring approaches using saliva or other oral-derived biofluids• Age-related modifiers (immunosenescence, polypharmacy, reduced regeneration capacity) of the oral–systemic axisWe particularly encourage multi-omics, longitudinal, and translational submissions that connect oral biology to cardiometabolic outcomes and prevention opportunities. Topic editors: Marija S Milic, Razia Abdool Gafaar Khammissa, Ljiljana Djukic Source: https://www.frontiersin.org/research-topics/76195/diabetes-aging-and-oral-health-salivary-and-oral-tissue-research-at-the-crossroads-of-metabolic-and-vascular-disease