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(1) Background: No association between air pollution and periodontitis has yet been shown. Thus, we merged two nationwide databases to evaluate the risk of periodontitis in Taiwanese residents with long-term exposure to air pollution. (2) Methods: We conducted a nationwide retrospective cohort study using the Longitudinal Generation Tracking Database and the Taiwan Air Quality-Monitoring Database. The daily average air pollutant concentrations were categorized into quartiles (Q1, Q2, Q3, and Q4). We carried out Cox proportional hazards models to compute the hazard ratios of periodontitis, with 95% confidence intervals, in Q2–Q4 of the daily average air pollutant concentrations, compared with Q1. (3) Results: the adjusted HR (95 CI%) for periodontitis in Q2–Q4 increased with increased exposure to SO2, CO, NO, NO2, NOX, PM2.5, and PM10 from 1.72 (1.70, 1.76) to 4.86 (4.78–4.94); from 1.89 (1.85–1.93) to 2.64 (2.59–2.70); from 1.04 (1.02–1.06) to 1.52 (1.49–1.55); from 1.61 (1.58–1.64) to 2.51 (2.47–2.56); from 1.48 (1.45–1.51) to 2.11 (2.07–2.15); from 2.02 (1.98–2.06) to 22.9 (22.4–23.4, and from 2.71 (2.66–2.77) to 17.2 (16.8–17.6), respectively, compared to Q1. (4) Conclusions: Residents in Taiwan with long-term exposure to higher levels of air pollutants had a greater risk of periodontitis. [ABSTRACT FROM AUTHOR]