Environmental medicine in a dental perspective

Major research area: Environmental medicine in a dental perspective and oral epidemiology. Upcoming projects are related to gerodontics and the interaction between oral and general health in older people.

Principal Investigator

Project: Health economic aspects of hyposalivation-induced oral complications

Oral complications, such as rapid caries progression and oral infections in hyposalivary patients, make them life-long high-consumers of dental care. Considering the increasing aging population, the late or long-term changes in salivary glands and dentition are rapidly moving to become an important focus of interest.

The aim of this project is to survey and analyze the total and incremental resource utilization in cancer patients with medically acquired hyposalivation due to radiation therapy in the head and neck area (H&N) and due to conditioning prior to hematopoietic stem cell transplantation (HSCT).


In collaboration with Division of Clinical Epidemiology, Dept of Medicine Solna (Anders Ekbom, Scott Montgomery and Pär Karlsson) and SBU (Jan Adolfsson and Anders Norlund)


SOF 2015

Project: Fluoride exposure and osteosarcoma – additional evidence

To investigate the association between drinking water fluoride exposure and osteosarcoma in a nationwide population-based case-control study. We hypothesize that the risk of osteosarcoma is positively associated with the fluoride level in the drinking water.


Peggy Näsman, PhD-student


In collaboration with Div of Clinical Epidemiology, Dept of Medicine Solna (Mikael Fored, Anders Ekbom, Jan Ekstrand)


Stiftelsen Patentmedelsfonden för odontologisk profylaxforskning 2015-16

Project: The effect of polypharmacy on oral health in older people

The proportion of older people in the population is increasing, and more people retain their teeth into old age. In parallel, multi-morbidity and polypharmacy increases with age. A very common side effect in general is reduced salivation rates.

The overall project aim is to investigate whether drug treatment causes deteriorating oral health among older people, and to create a risk assessment tool for drug-induced hyposalivation.

Specifically we will:

  • Develop a risk score for drug-induced hyposalivation
  • Investigate the impact of the risk score on oral health (tooth loss and performed dental restorations) in a register based study
  • Apply and evaluate the risk score in a clinical setting

The project will result in a validated risk score for drug-induced hyposalivation. Implementation of the risk score will increase the awareness and knowledge. A deeper understanding in this area could add important arguments against polypharmacy in older people.


In collaboration with ARC (Kristina Johnell, Johan Fastbom, Ylva Haasum), Academic Health Care Centers (Elisabeth Rydwik, Cecilia Fridén), Folktandvården Stockholms län AB (Pia Skott), the Stockholms Sjukhem Foundation (Åke Seiger)


SOF 2016-18

Project: Dementia and oral health

Many elderly, who suffers from functional limitations of different origins and dependency, pass a period of several years until they are recognized in the system for special dental support by the Swedish counties. At that time, the oral situation often is severely decreased and sometimes hard to restore due to frailty. This situation do not only have oral implications. There are also reports about a relation between tooth loss and cognition and chewing and cognition. This scenario makes it interesting to study whether the oral health situation can be related to the onset and development of dementia.

Research questions:

  • Is dementia associated with loss of teeth?
  • Are patients with dementia characterized by fewer remaining teeth than a normal population?
  • Is dementia preceded by loss of contact with dental care?
  • How long is the break between ordinary dental care contacts and dementia diagnosis?
  • How long is the break between ordinary dental care contacts and county supported care within care?


In collaboration with Div of Clinical Geriatrics, NVS (Maria Eriksdotter, Sara Garcia-Ptacek, Seyed-Mohammad Fereshtenajad, Dorota Religa)


Alzheimerfonden 2015

Project: Knowledge and knowledge gaps in geriatric dentistry

A systematic mapping of systematic reviews will be undertaken for domains considered important in daily clinical practice. The literature search will cover questions in important domains, as determined by the expert group.

Aim: To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in dental geriatrics


In collaboration with HTA-O, Lars Gahnberg, Pia Gabre, Inger Wårdh, Katri Stålnacke, Pia Skott, Mikael Nilsson, Sofia Tranaeus, Pernilla Östlund, A-M Boström, Alfheidur Astvaldsdottir, Thomas Davidsson.

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