Periapical lesions were recorded by both visual and radiographic examination in an Early Iron Age population from Alvastra, Östergötland, Sweden. Only those individuals with discernible bone destruction were included in the study. The study comprised 37 adult individuals from both sexes of a total of 90 adult individuals among the population, thus the prevalence of visual periapical lesions in the population was 41.1%. Out of 819 tooth sockets, 83 (10.1%) showed signs of periapical lesions, mainly caused by chronic inflammations. Cyst-like lesions were recorded in five cases of which four were in a possible acute phase. Around thirty-two percent of the periapical lesions were associated with severe carious. The corresponding rate for severe attrition was 14.4%. No significant difference in frequency of lesions was observed between sexes and age groups. The most affected tooth was the first maxillary molar followed by the first molar in the mandible. Radiographic examination proved useful in detecting additional pathological processes, other than those observed by visual examination.