Distinguished Research in Periodontal Medicine
Can our most common chronic diseases be detected through oral health? Which biological markers in the mouth can reveal the link between periodontitis and cardiovascular disease—and how are these markers influenced by periodontal treatment? How can biomarkers and stronger collaboration between dentistry and medicine improve early detection and care for at-risk patients?
Dr. Daniel Jönsson believes that biomarkers hold transformative potential for patients, dentists, and physicians alike—enabling earlier detection of both periodontitis and cardiovascular disease. A closer integration between dental and medical care could significantly enhance patient outcomes and public health.
Dr. Jönsson’s research journey began in cell biology, studying estrogen receptors in periodontal ligament cells at BMC, Lund University. In 2009–2010, he completed a postdoctoral fellowship at Columbia University in New York, where he investigated the connection between periodontal disease and cardiovascular conditions. Upon returning to Sweden in 2011, his focus shifted to the body’s own antibiotics — antimicrobial peptides—before a collaboration with epidemiologists and geneticists at Lund University led him to initiate and conduct the Malmö Offspring Dental Study, a sub-study of the large-scale Malmö Offspring Study.
Today, Dr. Jönsson leads a research team at the Faculty of Medicine at Lund University. He also leads investigations into oral health and the oral microbiome within the SCAPIS study and its follow-up, SCAPIS 2— Sweden’s most comprehensive population health study.
His work is currently supported by a three-year research grant from the Swedish Heart-Lung Foundation, a three-year grant from local Region Skåne County Council (ALF) and he receives ongoing funding from Oral Health Related Related Research of Skåne (OFRS).
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Advanced Dental Cleaning is Associated with Reduced Risk of COPD Exacerbations - A Randomized Controlled Trial
A randomized controlled trial (RCT) led by Dr. Jönsson demonstrates that individuals with chronic obstructive pulmonary disease (COPD) experience measurable improvements in their respiratory condition following periodontal treatment. Some COPD patients are prone to exacerbations—acute lung infections typically treated with anti-inflammatory medications and antibiotics.
In this study, the group that received dental treatment and adhered to the protocol experienced, on average, one fewer exacerbation compared to the untreated control group. The trial was conducted across clinical sites in Skåne and Örebro, with Dr. Jönsson serving as Principal Investigator (PI).
These findings underscore the potential of oral health interventions to positively influence systemic conditions such as COPD, and further support the integration of dental care into broader medical treatment strategies.
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Periodontal disease is associated with carotid plaque area: the Malmö Offspring Dental Study (MODS).
Dr. Jönsson serves as Principal Investigator (PI) for the Malmö Offspring Dental Study (MODS), the dental arm of the Malmö Offspring Study—a large-scale epidemiological project examining the adult children and grandchildren of participants in the Malmö Diet and Cancer Study.
MODS investigates the relationship between oral and systemic health across generations. One of the study’s key findings indicates that individuals with periodontitis tend to have significantly larger carotid artery plaques compared to those without periodontitis — on average, approximately 10 mm² larger in fully adjusted models. This suggests a potential link between periodontal inflammation and the development of atherosclerotic disease, reinforcing the importance of oral health in cardiovascular risk assessment.
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Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort
Dr. Jönsson is the Principal Investigator for the dental component of the SCAPIS study—one of Sweden’s largest and most comprehensive population-based health research projects.
Recent findings from this study reveal that the gut bacteria most strongly associated with extensive coronary artery plaque are, in fact, oral bacteria. The research further shows that individuals with high levels of these bacteria in the gut are also likely to have elevated levels in their saliva and, correspondingly, poorer oral health.
These results highlight a compelling link between the oral microbiome, gut microbiota, and cardiovascular disease, reinforcing the importance of oral health not only for dental outcomes but also for systemic disease prevention.
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The inverse association between a fish consumption biomarker and gingival inflammation and periodontitis: A population-based study
Another study based on data from the Malmö Offspring Dental Study (MODS) reveals a notable association between high fish consumption and improved oral health. Individuals who consume fish regularly are less likely to have periodontitis and, more specifically, tend to exhibit lower levels of gingival inflammation.
These findings suggest that dietary habits — particularly the intake of omega-3-rich foods like fish — may play a protective role in maintaining periodontal health and reducing inflammation in the oral cavity.
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Peri-implantitis: Summary and consensus statements of group 3. The 6th EAO Consensus Conference 2021
Dr. Daniel Jönsson contributed to the development of a consensus document outlining clinical recommendations for the treatment of peri-implant infections — a critical area in modern implant dentistry. This work was carried out in collaboration with leading experts under the auspices of the European Association for Osseointegration (EAO), one of the world’s foremost organizations for implant research and clinical guidelines.
The consensus document provides recommendations for the diagnosis, management, and long-term care of patients with peri-implant diseases, and serves as a key reference for clinicians across Europe and beyond.
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The Human Salivary Antimicrobial Peptide Profile According to the Oral Microbiota in Health, Periodontitis and Smoking Item
Endogenous antimicrobial peptides enable humans to coexist in symbiosis with the bacteria that inhabit our bodies, including those in the oral cavity. These peptides are present wherever bacteria exist and are often referred to as the body’s own antibiotics.
This article highlights the dynamic interaction between oral bacteria and antimicrobial peptides, shedding light on how these natural molecules contribute to maintaining microbial balance and protecting against infection in the mouth.
Selection of published articles
Persson P, Bladh M, Teleka S, Milosavljevic A, Gustafsson N, Levring Jäghagen E, Klinge B, Vähäsarja N, Orho-Melander M, Melander O, Naimi-Akbar A, Jönsson D. Periodontitis variables from self-reported periodontitis and two Swedish dental registers. In Review.
Larsson A, Ericson U, Jönsson D, Miari M, Athanasiadis P, Baldanzi G, Brunkwall L, Hellstrand S, Klinge B, Melander O, Nilsson PM, Fall T, Maziarz M, Orho-Melander M. New connections of medication use and polypharmacy with the gut microbiota composition and functional potential in a large population. Scientific Reports. 2024;14(1)23723. Läs artikeln
Haworth S, Kastenbom L, Persson P, Fries N, Esberg A, Jönsson D, Johansson I. A data-driven approach identifies subtypes of caries from dental charting. Community Dental Oral Epidemiology. 2024. In Press. Läs artikeln
Bladh M, Gustafsson N, Engström G, Kennbäck C, Klinge B, Nilsson PM, Jönsson D, Levring Jäghagen E. Defined shapes of carotid artery calcifications on panoramic radiographs correlate with specific signs of cardiovascular disease at ultrasound examination. Oral Surgery oral medicine oral pathology oral radiology. 2024;137(4):408-420. Läs artikeln
Anders Røsland, Randi J. Bertelsen, Dagmar F Bunæs, Christine Drengenes, Gunnar Engström, Bjørn Klinge, Stein-Atle Lie, Peter M Nilsson, Daniel Jönsson*, Andrei Malinovschi*(*Shared last authors). Periodontitis is associated with airflow obstruction in The Malmö Offspring Dental Study. Journal of Clinical Periodontology. 2024;51(1):86-96. Läs artikeln
Sayols-Baixeras S., Dekkers K. F., Baldanzi G., Jönsson D., Hammar U., Lin Y. T., Ahmad S., Nguyen D., Varotsis G., Pita S., Nielsen N., Eklund A. C., Holm J. B., Nielsen H. B., Ericson U., Brunkwall L., Ottosson F., Larsson A., Ericson D., Klinge B., Nilsson P.M., Malinovschi A., Lind L., Bergström G., Sundström J., Ärnlöv J., Engström G., Smith J.G., Orho-Melander M., Fall, T. (2023). Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants from the SCAPIS Cohort. Circulation. 2023;148(6), 459-472. Läs artikeln
Divaris K, Haworth S, Shaffer JR, Anttonen V, Beck JD, Furuichi Y, Holtfreter B, Jönsson D, Kocher T, Levy SM, Magnusson PKE, McNeil DW, Michaëlsson K, North KE, Palotie U, Papapanou PN, Pussinen PJ, Porteous D, Reis K, Salminen A, Schaefer AS, Sudo T, Sun YQ, Suominen AL, Tamahara T, Weinberg SM, Lundberg P, Marazita ML, Johansson I. Phenotype Harmonization in the GLIDE2 Oral Health Genomics Consortium. J Dent Res 2022;101(11):1408-1416. Läs artikeln
De Silva K, Demmer RT, Jönsson D, Mousa A, Forbes A, Enticott J. A data-driven biocomputing pipeline with meta-analysis on high throughput trascriptomics to identify genome-wide miRNA markers associated with type 2 diabetes. Heliyon. 2022;2;8(2):e08886. Läs artikeln
De Silva K, Demmer RT, Jönsson D, Mousa A, Forbes A, Enticott J. Highly perturbed genes and hub genes associated with type 2 diabetes in different tissues of adult humans: a bioinformatics analytic workflow. Functional & integrative genomics. 2022;22(5):1003-1029. Läs artikeln.
Ottosson F, Hultgren L, Fernandez C, Engström G, Orho-Melander M, Kennbäck C, Persson M, Demmer RT, Melander O, Klinge B, Nilsson P, Jönsson D. The inverse association between a fish consumption biomarker and gingival inflammation and periodontitis: A population-based study. Journal of Clinical Periodontology. 2022;49(4):353-361. Läs artikeln
Sayardoust S, Johansson A, Jönsson D. Does probiotics cause a shift in the microbiota of dental implants? - A systemic review and meta-analysis. Frontiers in cellular and infection microbiology. 2022;16:12:823985. Läs artikeln
De Silva K, Demmer RT, Jönsson D, Mousa A, Teede H, Forbes A, Enticott J. Causality of anthropometric markers associated with polycystic ovarian syndrome: Findings of a Mendelian randomization study. PLoS One. 2022;17(6):e0269191. Läs artikeln
Sundh J, Tanash H, Arian R, Neves-Guimaraes A; Broberg K, Lindved G; Kern T, Zych K, Nielsen HB, Halling A, Ohlsson B; Jönsson D. Advanced dental cleaning is associated with reduced risk of COPD exacerbations - a randomised controlled trial. Journal of Chronic Obstructive Pulmonary Disease. 2021;25(16):3203-3215. Läs artikeln
De Silva K, Lim S, Mousa A, Teede H, Forbes A, Demmer RT, Jönsson D, Enticott J. Nutritional markers of undiagnosed type 2 diabetes in adults: Findings of a machine learning analysis with external validation and benchmarking. PLoS One. 2021;16(5):e0250832. Läs artikeln
Schwartz F, Alcoforado G, Guerrero A, Jönsson D, Klinge B, Lang N, Mattheos N, Mertens B, Pitta J, Ramanauskaite A, Sayardoust S, Sanz-Martin I, Stavropoulos A, Heitz-Mayfield L. Consensus Report of group 3 of the 6th EAO Consensus Conference 2021. Clinical Oral Implant Research. 2021;32 Suppl 21:245-253. Läs artikeln
De Silva K, Mathews N, Teede H, Forbes A, Jönsson D, Demmer RT, Enticott J. Clinical notes as a prognostic marker of one-year all-cause mortality associated with diabetes mellitus following critical care: a retrospective cohort analysis using machine learning and unstructured big data. Computers in Biology and Medicine. 2021;132:104305. Läs artikeln
Brunkwall L, Jönsson D, Ericson U, Hellstrand S, Östling G, Klinge B, Melander O, Engström G, Nilsson J, Ohlsson B, Orho-Melander M, Persson M, Nilsson PM. The Malmö Offspring Study (MOS) – Design and first interim results. Eur. J Epidemiology. 2021;36(1):103-116. Läs artikeln
Jönsson D, Orho-Melander M, Demmer RT, Engström G, Melander O, Klinge B, Nilsson PM. Periodontal disease and carotid plaque area associations: The Malmö Offspring Dental Study (MODS). Journal of Internal Medicine. 2020;287(3):301-309. Läs artikeln
De Silva K, Jönsson D, Demmer RT. A combined strategy of feature selection and machine learning to identify predictors of prediabetes. J Am Med Inform Assoc. 2020;27(3):396-406. Läs artikeln
Grant M, Jönsson D. Next generation sequencing discoveries of the nitrate-responsive oral microbiome and its effect on vascular response. J Clininical Medicine. 2019; 26;8(8). Läs artikeln
Grant M, Kilsgård O, Åkerman S, Klinge B, Demmer RT, Malmström J, Jönsson D. The Human Salivary Antimicrobial Peptide Profile According to the Oral Microbiota in Health, Periodontitis and Smoking. J of Innate Immunity.2019;11(5):432-444. Läs artikeln
Dommisch H, Kuzmanova D, Jönsson D, Grant M, Chapple I. The effect of micronutrient malnutrition on periodontal disease and periodontal therapy. Periodontology 2000. 2018;20(6):129-153. Läs artikeln
Svensson D, Aidoukovitch A, Anders E, Jönsson D, Nebel D, Nilsson BO. Secretory leucocyte protease inhibitor regulates human periodontal ligament cell production of pro-inflammatory cytokines. Inflammation Research. 2017; 66(9):823-831. Läs artikeln
Svensson D, Westman, J, Wickström C, Jönsson D, Herwald H, Nilsson B-O. Human endogenous peptide p33 inhibits the detrimental effects of LL-37 on osteoblast viability. J Periodontal Research. 2015;50(1):80-8. Läs artikeln
Nebel D, Svensson D, Arosenius K, Larsson E, Jönsson D, Nilsson B-O. 1,25-dihydroxyvitamin D3 promotes osteogenic activity and down-regulates pro-inflammatory cytokine/chemokine expression in human periodontal ligament cells. J Periodontal Res. 2015;50(5):666-673. Läs artikeln
Jönsson D, Spinell T, Vrettos A, Stöcklin-Wasmer C, Celenti R, Demmer RT, Papapanou PN. Circulating endothelial progenitor cells in periodontitis. J Periodontol. 2014;85(12):1739-47. Läs artikeln
Jönsson D, Aggarwal P, Nilsson B-O, Demmer RT. Beneficial effects of hormone replacement therapy on periodontitis are vitamin D associated. J Periodontol. 2013;84(8):1048-1057. Läs artikeln
Jönsson D. Tissue senescence and periodontal disease – A reciprocal association? Editorial. Archives of Oral Biology. 2013;58(7):7583-4. Läs artikeln
Säll J, Carlsson M, Grindlöf O, Holm A, Humlén J, Öhman J, Svensson D, Nilsson B-O, Jönsson D. The antimicrobial peptide LL-37 alters human osteoblast Ca2+ handling and induces Ca2+-independent apoptosis. J Innate Immunity. 2013;5(3):290-300. Läs artikeln
Bostanci N, Ramberg P, Wahlander A, Grossman J, Jönsson D, Barnes VM, Papapanou PN. Label-free quantitative proteomics reveals differentially regulated proteins in experimental gingivitis. J Proteome Research. 2013;12(2):657-78. Läs artikeln
Jönsson D and Nilsson B-O. The antimicrobial peptide LL-37 is anti-inflammatory and pro-apoptotic in human periodontal ligament cells. J Periodontal Research. 2012;47(3):330-5. Läs artikeln
Rafferty B, Jönsson D, Kalachikov S, Demmer R, Nowygrod R, Bush H, Kozarow E. Impact of monocytic cells on recovery of uncultivable bacteria from atherosclerotic lesions. J Internal Medicine. 2011;270(3):273-80. Läs artikeln
Jönsson D, Ramberg P, Dahlén G, Papapanou P. Gingival tissue transcriptomes in experimental gingivitis. J Clin Periodontol. 2011;38(7):599-611. Läs artikeln
Jönsson D, Nebel D, Bratthall G, Nilsson BO. The human periodontal ligament cell: a fibroblast-like cell acting as an immune cell. J Periodontal Research. 2011;46(2):153-157. Läs artikeln
Nebel D, Jönsson D, Norderyd O, Bratthall G, Nilsson B-O. Differential regulation of chemokine expression by estrogen in human periodontal ligament cells. J Periodontal Research. 2010;45(6):796-802. Läs artikeln
Jönsson D, Amisten S, Bratthall G, Holm A, Nilsson B-O. LPS induces GROα chemokine production via NFκB in oral fibroblasts. Inflammation Research. 2009;58(11):791-6. Läs artikeln
Jönsson D, Nebel, D, Bratthall, G, Nilsson, B-O. LPS-induced MCP-1 and IL-6 production is not reversed by estrogen in human periodontal ligament cells. Archives of Oral Biology. 2008;53(9):896-902. Läs artikeln
Jönsson D, Nillsson J, Odenlund M, Bratthall G, Broman J, Ekblad E, Lydrup M-L, Nilsson, B-O. Demonstration of mitochondrial estrogen receptor beta and estrogen induced attenuation of cytochrome c oxidase subunit I expression in human periodontal ligament cells. Archives of Oral Biology. 2007;52(7):669-676. Läs artikeln
Jönsson D, Wahlin Å, Idvall I, Johnsson I, Bratthall G, Nilsson BO. Differential effects of estrogen on DNA synthesis in human periodontal ligament and breast cancer cells. J Periodontal Research. 2005;40(5):401-6. Läs artikeln
Jönsson D, Andersson G, Ekblad E, Liang M, Bratthall G, Nilsson BO. Immunocytochemical demonstration of estrogen receptor beta in human periodontal ligament cells. Archives of Oral Biology. 2004;49(1):85-8. Läs artikeln