East Greenland and Svalbard polar bears (Ursus maritimus) are heavily polluted with long-range transported organochlorines such as PCBs (polychlorinated biphenyls). To investigate the negative health impacts, a time-trend study of skull pathology was conducted on 269 East Greenland and 241 Svalbard polar bears. The skulls were sampled during 1892-2002 and 1964-1992, respectively. Seven different pathological changes were found: adonti, displacement of teeth, caries, osseous proliferations, exostosis, tooth wear and periodontitis. Only tooth wear and periodontitis was in a prevalence that allowed statistical treatment. The most severe cases of tooth wear and periodontitis were accompanied by a substantial loss of alveolar bone structure. The prevalence of tooth wear and periodontitis increased significantly with age (p<0.001) with incisor wear being more severe than in canines, premolars and molars (p<0.001). No sex difference was found for tooth wear (p=0.22) while a significant difference between sexes was found for periodontitis (p=0.01) with males having higher prevalence than females (odds ratio of 2.5 for males:females). In East Greenland, the prevalence of tooth wear was significantly higher in polar bears collected in the pre pollution period (<1960) than in bears sampled during polluted periods (1960-1980 and 1981-2002) (p<0.001). Regarding periodontitis, the prevalence was not significantly different between pre-pollution and pollution periods (p=0.309). Polar bears from Svalbard had significantly higher prevalence of tooth wear (p<0.001) and periodontitis (p=0.02) than polar bears from East Greenland. The tooth wear and periodontitis odds ratios for Svalbard:East Greenland were 135 and 2.6, respectively. Hence, we found a clear age/sex link and geographical difference but no evidence for an association between skull pathology and exposure to organochlorines in East Greenland and Svalbard polar bears.