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A register\u2010based cohort study linked individual\u2010level information on dental services received, age, gender, municipality\/region, highest completed education, socioeconomic position, income, and immigrant\/descendant status for each calendar year in the period 1990\u20132021. Also included were data reported by dentists since 2001 on number of teeth present, number of teeth with decay, and number of teeth with fillings for 25\u2010, 40\u2010, and 65\u2010year\u2010old patients. About 58% of all adults had used the dental health care system in 2021, less than that seen in previous decades. Non\u2010users were younger, male, had lower income, lower education, lower socioeconomic position, and were immigrants or descendants. Dental attendance has substantially reduced over time among age groups younger than 70 years but increased among the older age groups. Considerable improvements in dental health were noted, with greater tooth retention, fewer caries, and fewer filled teeth in the indicator age groups since 2001. 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