Organizing population-based oral health promotion for children and adolescents in Sweden: perspectives of regional coordinators responsible for these efforts

Introduction Population-based interventions delivered through preschools, schools, and public dental services are often intended to support equitable access to oral health and preventive care. However, how such interventions are organized and experienced across Swedish regions remains insufficiently described. The aim of this study was to explore how coordinators responsible for regional oral health promotion describe population-based work for children and adolescents, including organization, implementation, and perceived opportunities and challenges.Method A qualitative design with an inductive approach was employed. Semi-structured, open-ended interviews were conducted with 17 coordinators responsible for health promotion interventions in the Public Dental Service across Sweden. Data were examined using reflexive thematic analysis.Results Participants described balancing universal approaches with targeted interventions to address differing needs among children and adolescents. Oral health promotion was shaped through collaboration and negotiation between regional priorities and local partners, including schools, preschools, child health services, and community organizations. Participants described the importance of adapting interventions to local contexts and how preventive activities were organized and evaluated across regional contexts. Sustaining preventive and oral health promotion activities was perceived as challenging because limited resources, competing priorities, and population mobility, while supportive leadership, organizational clarity, political commitment, and opportunities for early intervention were perceived as important conditions.Conclusions Population-based oral health work involves universal and targeted preventive approaches, with implementation shaped by regional mandates, organizational conditions, and intersectoral collaboration. These conditions are perceived as important for sustaining preventive work, while further research is needed to assess implementation, population coverage, effectiveness, and equity outcomes.