Regular Dental Visits: Influence on Health-Related Quality of Life in 1,607 Patients with Oral Squamous Cell Carcinoma
Identifieur interne : 007050 ( Ncbi/Merge ); précédent : 007049; suivant : 007051Regular Dental Visits: Influence on Health-Related Quality of Life in 1,607 Patients with Oral Squamous Cell Carcinoma
Auteurs : Simon Spalthoff [Allemagne] ; Henrik Holtmann [Allemagne] ; Gertrud Krüskemper [Allemagne] ; Rüdiger Zimmerer [Allemagne] ; Jörg Handschel [Allemagne] ; Nils-Claudius Gellrich [Allemagne] ; Philipp Jehn [Allemagne]Source :
- International Journal of Dentistry [ 1687-8728 ] ; 2017.
Abstract
The incidence of oral squamous cell carcinoma (OSCC) is in the top 10 of all cancer entities. Regular oral examinations by dentists play an important role in oral cancer prevention.
Patients with OSCC (
Patients in group A had significantly better health-related quality of life after tumor treatment than patients in group B. Patients in group A also had a smaller tumor size and less lymph node metastasis and lost fewer teeth during the treatment. This resulted in better prosthetic rehabilitation and better psychological status after tumor treatment.
Dentists play an important role in the early recognition of oral cancer. This study should encourage dentists to take a more active role in oral cancer prevention.
Url:
DOI: 10.1155/2017/9638345
PubMed: 28638411
PubMed Central: 5468556
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Regular Dental Visits: Influence on Health-Related Quality of Life in 1,607 Patients with Oral Squamous Cell Carcinoma</title>
<author><name sortKey="Spalthoff, Simon" sort="Spalthoff, Simon" uniqKey="Spalthoff S" first="Simon" last="Spalthoff">Simon Spalthoff</name>
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<author><name sortKey="Zimmerer, Rudiger" sort="Zimmerer, Rudiger" uniqKey="Zimmerer R" first="Rüdiger" last="Zimmerer">Rüdiger Zimmerer</name>
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<author><name sortKey="Handschel, Jorg" sort="Handschel, Jorg" uniqKey="Handschel J" first="Jörg" last="Handschel">Jörg Handschel</name>
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<author><name sortKey="Gellrich, Nils Claudius" sort="Gellrich, Nils Claudius" uniqKey="Gellrich N" first="Nils-Claudius" last="Gellrich">Nils-Claudius Gellrich</name>
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<author><name sortKey="Jehn, Philipp" sort="Jehn, Philipp" uniqKey="Jehn P" first="Philipp" last="Jehn">Philipp Jehn</name>
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<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover</wicri:regionArea>
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<series><title level="j">International Journal of Dentistry</title>
<idno type="ISSN">1687-8728</idno>
<idno type="eISSN">1687-8736</idno>
<imprint><date when="2017">2017</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p> The incidence of oral squamous cell carcinoma (OSCC) is in the top 10 of all cancer entities. Regular oral examinations by dentists play an important role in oral cancer prevention.</p>
</sec>
<sec><title> Methods</title>
<p> Patients with OSCC (<italic>n</italic>
= 1,607) and physicians (<italic>n</italic>
= 1,489) completed questionnaires during the DÖSAK Rehab Study. The psychosocial and functional factors collected in these questionnaires were assessed in the present study. We compared patients who visited their dentist at least once a year (group A) with those who visited their dentist less than once a year (group B).</p>
</sec>
<sec><title> Results</title>
<p> Patients in group A had significantly better health-related quality of life after tumor treatment than patients in group B. Patients in group A also had a smaller tumor size and less lymph node metastasis and lost fewer teeth during the treatment. This resulted in better prosthetic rehabilitation and better psychological status after tumor treatment.</p>
</sec>
<sec><title> Conclusions</title>
<p> Dentists play an important role in the early recognition of oral cancer. This study should encourage dentists to take a more active role in oral cancer prevention.</p>
</sec>
</div>
</front>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id>
<journal-id journal-id-type="publisher-id">IJD</journal-id>
<journal-title-group><journal-title>International Journal of Dentistry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1687-8728</issn>
<issn pub-type="epub">1687-8736</issn>
<publisher><publisher-name>Hindawi</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28638411</article-id>
<article-id pub-id-type="pmc">5468556</article-id>
<article-id pub-id-type="doi">10.1155/2017/9638345</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Regular Dental Visits: Influence on Health-Related Quality of Life in 1,607 Patients with Oral Squamous Cell Carcinoma</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-1381-1182</contrib-id>
<name><surname>Spalthoff</surname>
<given-names>Simon</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Holtmann</surname>
<given-names>Henrik</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Krüskemper</surname>
<given-names>Gertrud</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zimmerer</surname>
<given-names>Rüdiger</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Handschel</surname>
<given-names>Jörg</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gellrich</surname>
<given-names>Nils-Claudius</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jehn</surname>
<given-names>Philipp</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany</aff>
<aff id="I2"><sup>2</sup>
Department of Cranio and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany</aff>
<aff id="I3"><sup>3</sup>
Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780 Bochum, Germany</aff>
<author-notes><corresp id="cor1">*Simon Spalthoff: <email>spalthoff.simon@mh-hannover.de</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Andreas Stavropoulos</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>30</day>
<month>5</month>
<year>2017</year>
</pub-date>
<volume>2017</volume>
<elocation-id>9638345</elocation-id>
<history><date date-type="received"><day>5</day>
<month>12</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>7</day>
<month>5</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2017 Simon Spalthoff et al.</copyright-statement>
<copyright-year>2017</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>Background</title>
<p> The incidence of oral squamous cell carcinoma (OSCC) is in the top 10 of all cancer entities. Regular oral examinations by dentists play an important role in oral cancer prevention.</p>
</sec>
<sec><title> Methods</title>
<p> Patients with OSCC (<italic>n</italic>
= 1,607) and physicians (<italic>n</italic>
= 1,489) completed questionnaires during the DÖSAK Rehab Study. The psychosocial and functional factors collected in these questionnaires were assessed in the present study. We compared patients who visited their dentist at least once a year (group A) with those who visited their dentist less than once a year (group B).</p>
</sec>
<sec><title> Results</title>
<p> Patients in group A had significantly better health-related quality of life after tumor treatment than patients in group B. Patients in group A also had a smaller tumor size and less lymph node metastasis and lost fewer teeth during the treatment. This resulted in better prosthetic rehabilitation and better psychological status after tumor treatment.</p>
</sec>
<sec><title> Conclusions</title>
<p> Dentists play an important role in the early recognition of oral cancer. This study should encourage dentists to take a more active role in oral cancer prevention.</p>
</sec>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>Frequency of dental visits for 1,607 patients with oral squamous cell carcinoma.</p>
</caption>
<graphic xlink:href="IJD2017-9638345.001"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Tumor size and lymph node status in 1,607 patients with oral squamous cell carcinoma, compared by frequency of dental visits.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Group A</th>
<th align="center" rowspan="1" colspan="1">Group B</th>
<th align="center" rowspan="1" colspan="1"><italic>p</italic>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1"><italic>Tumor size</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 949</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 502</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">T1</td>
<td align="center" rowspan="1" colspan="1">338 (32)</td>
<td align="center" rowspan="1" colspan="1">122 (24)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">T2</td>
<td align="center" rowspan="1" colspan="1">368 (35)</td>
<td align="center" rowspan="1" colspan="1">216 (43)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">T3</td>
<td align="center" rowspan="1" colspan="1">108 (10)</td>
<td align="center" rowspan="1" colspan="1">64 (13)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">T4</td>
<td align="center" rowspan="1" colspan="1">135 (13)</td>
<td align="center" rowspan="1" colspan="1">100 (20)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td colspan="4" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Lymph node status</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 937</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 491</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">N0</td>
<td align="center" rowspan="1" colspan="1">607 (65)</td>
<td align="center" rowspan="1" colspan="1">267 (55)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">N1</td>
<td align="center" rowspan="1" colspan="1">208 (22)</td>
<td align="center" rowspan="1" colspan="1">119 (24)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">N2</td>
<td align="center" rowspan="1" colspan="1">111 (12)</td>
<td align="center" rowspan="1" colspan="1">94 (19)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">N3</td>
<td align="center" rowspan="1" colspan="1">11 (1)</td>
<td align="center" rowspan="1" colspan="1">11 (2)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>Group A visited their dentist ≥1 time per year, and group B visited their dentist <1 time per year. <italic>p</italic>
values for comparison of tumor size (T1/T2 versus T3/4 between groups A and B) and lymph node status (N0 versus N1–3 between groups A and B). The counts may not always add up to the total sample size because of missing values. Values are reported as <italic>n</italic>
(%).</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Loss of teeth during treatment for oral squamous cell carcinoma in 1,607 patients, compared by frequency of dental visits.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Group A</th>
<th align="center" rowspan="1" colspan="1">Group B</th>
<th align="center" rowspan="1" colspan="1"><italic>p</italic>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1"><italic>Tooth loss during treatment</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 974</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 508</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">0</td>
<td align="center" rowspan="1" colspan="1">321 (33)</td>
<td align="center" rowspan="1" colspan="1">189 (37)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">1–5</td>
<td align="center" rowspan="1" colspan="1">252 (26)</td>
<td align="center" rowspan="1" colspan="1">84 (17)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">6–10</td>
<td align="center" rowspan="1" colspan="1">177 (18)</td>
<td align="center" rowspan="1" colspan="1">82 (16)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">>10</td>
<td align="center" rowspan="1" colspan="1">224 (23)</td>
<td align="center" rowspan="1" colspan="1">153 (30)</td>
<td align="center" rowspan="1" colspan="1"><0.05</td>
</tr>
<tr><td colspan="4" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Presence of teeth after treatment</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 1,012</td>
<td align="center" rowspan="1" colspan="1"><italic>n</italic>
= 544</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">No teeth</td>
<td align="center" rowspan="1" colspan="1">338 (33)</td>
<td align="center" rowspan="1" colspan="1">321 (59)</td>
<td align="center" rowspan="1" colspan="1"><0.05</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Teeth</td>
<td align="center" rowspan="1" colspan="1">674 (67)</td>
<td align="center" rowspan="1" colspan="1">223 (41)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p>Group A visited their dentist ≥1 time per year, and group B visited their dentist <1 time per year. <italic>p</italic>
values for comparison of tooth loss (>10) and presence of no teeth after treatment between groups A and B. The counts may not always add up to the total sample size because of missing values. Values are reported as <italic>n</italic>
(%).</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>Comparisons of the more serious impairments between edentulous patients and patients with remaining teeth after treatment for oral squamous cell carcinoma (<italic>n</italic>
= 1652).</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Impairment</th>
<th align="center" rowspan="1" colspan="1"><italic>p</italic>
value</th>
<th align="center" rowspan="1" colspan="1">Own teeth <break></break>
<italic>n</italic>
</th>
<th align="center" rowspan="1" colspan="1">Edentulous <break></break>
<italic>n</italic>
</th>
<th align="center" rowspan="1" colspan="1">Total <break></break>
<italic>n</italic>
</th>
<th align="center" rowspan="1" colspan="1">Missing <break></break>
<italic>n</italic>
</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Intelligibility of speech for strangers</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">857</td>
<td align="center" rowspan="1" colspan="1">622</td>
<td align="center" rowspan="1" colspan="1">1479</td>
<td align="center" rowspan="1" colspan="1">173</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Intelligibility of speech for family</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">866</td>
<td align="center" rowspan="1" colspan="1">627</td>
<td align="center" rowspan="1" colspan="1">1493</td>
<td align="center" rowspan="1" colspan="1">159</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Eating/swallowing</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">866</td>
<td align="center" rowspan="1" colspan="1">628</td>
<td align="center" rowspan="1" colspan="1">1494</td>
<td align="center" rowspan="1" colspan="1">158</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Mobility of tongue</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">861</td>
<td align="center" rowspan="1" colspan="1">625</td>
<td align="center" rowspan="1" colspan="1">1486</td>
<td align="center" rowspan="1" colspan="1">166</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Mouth aperture</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">861</td>
<td align="center" rowspan="1" colspan="1">629</td>
<td align="center" rowspan="1" colspan="1">1490</td>
<td align="center" rowspan="1" colspan="1">162</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Mobility of lower jaw</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">859</td>
<td align="center" rowspan="1" colspan="1">626</td>
<td align="center" rowspan="1" colspan="1">1485</td>
<td align="center" rowspan="1" colspan="1">167</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Mobility of neck</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">860</td>
<td align="center" rowspan="1" colspan="1">622</td>
<td align="center" rowspan="1" colspan="1">1482</td>
<td align="center" rowspan="1" colspan="1">170</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Shoulder and arm mobility</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">863</td>
<td align="center" rowspan="1" colspan="1">622</td>
<td align="center" rowspan="1" colspan="1">1485</td>
<td align="center" rowspan="1" colspan="1">178</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Gustatory capability</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">861</td>
<td align="center" rowspan="1" colspan="1">621</td>
<td align="center" rowspan="1" colspan="1">1482</td>
<td align="center" rowspan="1" colspan="1">164</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Olfactory capability</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">858</td>
<td align="center" rowspan="1" colspan="1">616</td>
<td align="center" rowspan="1" colspan="1">1474</td>
<td align="center" rowspan="1" colspan="1">178</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Appearance</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">861</td>
<td align="center" rowspan="1" colspan="1">627</td>
<td align="center" rowspan="1" colspan="1">1488</td>
<td align="center" rowspan="1" colspan="1">168</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Strength</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">861</td>
<td align="center" rowspan="1" colspan="1">627</td>
<td align="center" rowspan="1" colspan="1">1488</td>
<td align="center" rowspan="1" colspan="1">179</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Appetite</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">857</td>
<td align="center" rowspan="1" colspan="1">627</td>
<td align="center" rowspan="1" colspan="1">1484</td>
<td align="center" rowspan="1" colspan="1">169</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Breathing</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">857</td>
<td align="center" rowspan="1" colspan="1">616</td>
<td align="center" rowspan="1" colspan="1">1473</td>
<td align="center" rowspan="1" colspan="1">192</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Pain</td>
<td align="center" rowspan="1" colspan="1">0.040</td>
<td align="center" rowspan="1" colspan="1">856</td>
<td align="center" rowspan="1" colspan="1">627</td>
<td align="center" rowspan="1" colspan="1">1483</td>
<td align="center" rowspan="1" colspan="1">169</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Swelling</td>
<td align="center" rowspan="1" colspan="1">0.247</td>
<td align="center" rowspan="1" colspan="1">853</td>
<td align="center" rowspan="1" colspan="1">607</td>
<td align="center" rowspan="1" colspan="1">1460</td>
<td align="center" rowspan="1" colspan="1">192</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Dryness of mouth</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">854</td>
<td align="center" rowspan="1" colspan="1">629</td>
<td align="center" rowspan="1" colspan="1">1483</td>
<td align="center" rowspan="1" colspan="1">169</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Halitosis</td>
<td align="center" rowspan="1" colspan="1">0.185</td>
<td align="center" rowspan="1" colspan="1">845</td>
<td align="center" rowspan="1" colspan="1">616</td>
<td align="center" rowspan="1" colspan="1">1461</td>
<td align="center" rowspan="1" colspan="1">191</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Stomach complaints</td>
<td align="center" rowspan="1" colspan="1">0.001</td>
<td align="center" rowspan="1" colspan="1">856</td>
<td align="center" rowspan="1" colspan="1">621</td>
<td align="center" rowspan="1" colspan="1">1477</td>
<td align="center" rowspan="1" colspan="1">175</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Allemagne</li>
</country>
<region><li>Basse-Saxe</li>
<li>District de Düsseldorf</li>
<li>Rhénanie-du-Nord-Westphalie</li>
</region>
<settlement><li>Düsseldorf</li>
<li>Hanovre</li>
</settlement>
</list>
<tree><country name="Allemagne"><region name="Basse-Saxe"><name sortKey="Spalthoff, Simon" sort="Spalthoff, Simon" uniqKey="Spalthoff S" first="Simon" last="Spalthoff">Simon Spalthoff</name>
</region>
<name sortKey="Gellrich, Nils Claudius" sort="Gellrich, Nils Claudius" uniqKey="Gellrich N" first="Nils-Claudius" last="Gellrich">Nils-Claudius Gellrich</name>
<name sortKey="Handschel, Jorg" sort="Handschel, Jorg" uniqKey="Handschel J" first="Jörg" last="Handschel">Jörg Handschel</name>
<name sortKey="Holtmann, Henrik" sort="Holtmann, Henrik" uniqKey="Holtmann H" first="Henrik" last="Holtmann">Henrik Holtmann</name>
<name sortKey="Jehn, Philipp" sort="Jehn, Philipp" uniqKey="Jehn P" first="Philipp" last="Jehn">Philipp Jehn</name>
<name sortKey="Kruskemper, Gertrud" sort="Kruskemper, Gertrud" uniqKey="Kruskemper G" first="Gertrud" last="Krüskemper">Gertrud Krüskemper</name>
<name sortKey="Zimmerer, Rudiger" sort="Zimmerer, Rudiger" uniqKey="Zimmerer R" first="Rüdiger" last="Zimmerer">Rüdiger Zimmerer</name>
</country>
</tree>
</affiliations>
</record>
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