Background: Periodontal disease (PD) is a chronic inflammatory condition that may influence systemic markers, including prostate-specific antigen (PSA), widely used in prostate cancer (PCa) screening. PSA levels can be altered by various non-malignant conditions. Investigating PD’s impact on PSA could help improve screening accuracy and reduce unnecessary biopsies. Objective: To review current evidence on whether PD affects PSA levels and if periodontal treatment alters PSA dynamics. Methods: A scoping review was conducted via PubMed (up to February 2025), including human peer-reviewed studies. Exclusions were nonhuman studies, case reports, editorials, and abstracts. A narrative synthesis was used. Results: The review highlights conflicting evidence on the relationship between PD and PSA levels among 5 studies included. Some studies suggest that periodontitis contributes to elevated PSA levels, possibly through systemic inflammatory pathways, while others found no significant correlation. Similarly, the impact of periodontal treatment on PSA remains unclear, with some studies reporting a reduction in PSA following therapy, whereas others indicate no significant effect. Variability in study design, population characteristics, and confounding factors may explain these discrepancies. Conclusions: While there is some evidence linking periodontal disease to PSA levels, the relationship remains inconclusive. Further longitudinal studies and randomized controlled trials are needed to clarify whether periodontal disease should be considered a confounding factor in PSA-based prostate cancer screening and to determine whether periodontal therapy has a measurable impact on PSA dynamics.