Oral Health

Research group
Active research
Project owner
Institutionen för odontologi

Short description

The disciplinary area of ‘Oral Health’ identifies factors of importance for our oral health and the interplay between oral health and general health & well-being. The focus is on health promotion and disease prevention for a good oral health on equal terms, for individuals of all ages and with varying needs at individual, group and community level. The area is interdisciplinary, which means that knowledge from natural sciences (mainly dentistry and medicine) as well as social and behavioral sciences are integrated into research, education and treatment.

Behavioral aspects on oral health and periodontal infection control; a person-centered oral health education program to increase adolescents’ motivation for adequate oral hygiene behavior

Gingivitis is a reversible condition, but if left untreated gingivitis may over time progress into chronic and destructive periodontitis. The prevalence of chronic periodontitis is about 40% among Swedish adults. The key factor for the prevention of periodontitis is to establish infection control, by means of adequate oral hygiene. Hence, the main task for dental professionals is to educate and enhance patient´s motivation for such beneficial behavior.

In Sweden, all children and adolescents are offered free-of-charge dental care, and prevention of oral disease is the issue in focus for the care provided. Even so, epidemiological surveys reveal poor oral hygiene conditions, with a high degree of gingival/periodontal infection (gingivitis) among Swedish adolescents. This suggests a need for the development of more effective educational approaches.


To test a person-centered oral health education program, based on cognitive behavioral theory and principles, for the potential to increase adolescents motivation for self-performed periodontal infection control, i.e. adequate oral hygiene behavior.

Study participants and Method

The treatment study within the project includes 312 adolescents. The study participants were recruited among 16-17 years old, who in conjunction with their ordinary dental examination showed poor oral hygiene conditions, with a high degree of gingivitis. The study patients were distributed to treatment in accord with the theory-based and person-centered educational approach (test) or to conventional educational intervention (control). Treatment was performed by dental hygienists in the Public Dental Service, Region Västra Götaland. Clinical and questionnaire data were collected during the 18-months study period. 

The project also contains qualitative interviews among adolescents and dental hygienists, on their views on treatment in accordance with the theory-based and person-centered approach. 

The results will be used as a basis for forthcoming studies within the project. In the next phase, the development of a smartphone application is in progress to be used by adolescents as means for self-monitoring of oral health behaviors.  

The project is carried out in collaboration between researchers representing different disciplines (oral health/odontology, psychology, pedagogics, health-economy, applied information technology) and The Public Dental Service, Region Västra Götaland. 

Project facts

Project Manager:
Kajsa H Abrahamsson

+ Forte
+ Regional R&D funds, Region Västra Götaland
+ The Patent Revenue Fund for Research in Preventive Odontology

Periodontal health development in relation to individual and lifestyle factors in young adults

Periodontal diseases are divided into two main groups, reversible gingivitis and destructive periodontitis. The prevalence of periodontitis is about 40% in the adult Swedish population, of which about 10% show more severe forms of the disease. Severe forms of periodontitis can debut as early as the age of 20 with a marked increase in prevalence between the ages of 30 and 40. Periodontal disease is associated with a variety of individual and lifestyle-related factors. In addition, it has been shown that oral health-related attitudes and behaviors are reflected in adolescents' clinical periodontal status and in how to plan for their future dental care. Despite the oral health-promoting efforts given in the (public) dental service, many young individuals in Sweden have poor oral hygiene and high levels of gingivitis. Studying periodontal health development among young adults is therefore important.


The present 12-year longitudinal and register-based study aims to follow up the periodontal health among a group of individuals who at the age of 19 participated in an epidemiological study and to analyze potential interacting individual- and lifestyle factors.

Study participants and method

The study population consists of individuals who previously participated in an epidemiological study conducted in 2005-2006 regarding periodontal health in 19-year-olds. The original population consisted of a random sample of 506 individuals, resident in two different regions of  Västra Götaland. From the original population, 355 individuals have been identified and will be followed up after 12 years, in terms of both cariological and periodontal status and to which extent individual- and lifestyle factors that affected periodontal health at the age of 19, can predict oral/periodontal disease development. Follow-up is carried out by register-based dental health data from SKaPa (Swedish Quality Register for Caries and Periodontitis) and individual-related socio-economic data from Statistics Sweden (Statistiska Centralbyrån).

The project will add knowledge of importance for increased ability to identify young individuals who are at risk of developing periodontitis, and thus contribute to the development of targeted prevention measures. 

Project facts

Project Manager:
Jessica Skoogh Andersson

+ Regional R&D funds Region Västra Götaland.

Cancer of the head and neck region and its treatment leads to many complications both for oral and general health. Oral mucositis, inflammation in the mucosal membranes, affects about 80% of the patients and in many cases the patients need tube-feeding and/or are hospitalized. Reduced salivary secretion rate is another common side-effect of cancer treatment. Odontological care differs in the different regions/county councils in Sweden, which might lead to unequal care. In the National Care Programme updated in 2018, there are no guidelines and recommendations to be applied during cancer treatment. It is therefore important to evaluate an oral care program to improve care and treatment for these patients, especially during cancer treatment. 


The overall aim is to evaluate an oral care programme for patients with cancer of the head and neck region regarding oral mucositis. The importance of oral health-related attitudes and behaviour and general self-efficacy for oral hygiene level will be evaluated as well as the effect of the oral care programme on quality of life, and its’ cost effectiveness. We will also examine the importance of salivary secretion rate and saliva composition for oral mucositis, as well as dietary habits, pro-inflammatory markers and oral microbiome in patients with mild and severe mucositis, and epigenetic modifications. 

Patients and method

This is a national multi-center randomised controlled study. Patients are recruited by dental hygienists in five regions/county councils and are randomised to an intervention group (intensified oral care programme) or a control group (conventional oral care). 75 patients will be included in the respective group. Data are collected before treatment starts, every week during treatment and one and 3 months after completed treatment. The patient’s cancer diagnosis and treatment, other diseases and medicines are registered. Clinical data are collected and saliva saved for later analysis. Samples for analysis of the oral microbiome, pro-inflammatory markers and epigenetic modifications are collected and the patients fill in questionnaires about quality of life, oral health related attitudes and behaviours, general self-efficacy and dietary habits. 

The project involves researchers from different fields (oral health/odontology, medicine, biomedicine, health economy and statistics) and hospital dental clinics. 

Project facts

Project Manager
Annica Almståhl

+ The Swedish Cancer Society
+ FRF-stiftelsen

Epigenetic changes and diet in relation to periodontitis

Periodontitis is a chronic inflammatory disease of supporting tissues of the teeth in response to bacteria colonizing on the tooth. The constant presence of various bacteria in the oral mucosa may alter epigenetic regulation of the inflammatory response contributing to disease progression and severity of the disease. Several studies have shown that people with periodontitis have an altered epigenetic pattern in several inflammatory cytokines and enzymes. Epigenetics is affected by environment and lifestyle and could be a factor linked to disease phenotypes where nutrients and diet are important factors. However, very few studies have been performed so far to assess associations between epigenetic changes and periodontitis.


The aims of the study are to evaluate a change of percentage of global methylation in individuals with severe periodontitis compared to a healthy control and to study associations between dietary intake and a change of percentage of global methylation/altered methylation pattern of candidate genes in relation to periodontitis.

Study participants and method

The study is part of a cross-sectional epidemiological project, The Tromsø study (Tromsø 7), where the associations between genetics, general health, lifestyle, and periodontitis are studied. A random sample of adults, 40 years and older, living in Tromsø municipality in Norway, and who participated in an oral health examination and had at least two remaining teeth were included (n = 3,695). Data have been collected thru clinical examination, saliva samples, and questionnaires. DNA methylation is analyzed based on saliva samples. DNA methylation profile in periodontally healthy individuals will be compared with individuals advanced periodontitis in relation to the individuals' dietary intake / dietary patterns, dietary supplements/probiotics, and total energy intake as well as demographic, lifestyle factors, general health, and medication.

The results will generate new hypotheses for future prospective studies or randomized controlled trials to study the relationship between epigenetics and diet in individuals with periodontitis.

The study is carried out in collaboration between researchers from different fields and disciplines (oral health/dentistry, medicine, biomedicine, and nutrition).

Project facts

Project Manager:
Birgitta Jönsson

+ Helsodirektoratet, Norway
+ Troms og Finnmarks fylkeskommune, Norway