{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:30:19Z","timestamp":1790361019251,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"NCI","doi-asserted-by":"publisher","award":["R03CA113157"],"award-info":[{"award-number":["R03CA113157"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"NIDCR","doi-asserted-by":"publisher","award":["R03DE016611"],"award-info":[{"award-number":["R03DE016611"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01CA061188"],"award-info":[{"award-number":["R01CA061188"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["P30ES010126"],"award-info":[{"award-number":["P30ES010126"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Central Europe study: World Cancer Research Fund"},{"name":"European Commission INCO-COPERNICUS Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Poor oral health has been identified as a prognostic factor potentially affecting the survival of patients with head and neck squamous cell carcinoma. However, evidence to date supporting this association has emanated from studies based on single cohorts with small-to-modest sample sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pooled analysis of 2449 head and neck squamous cell carcinoma participants from 4 studies of the International Head and Neck Cancer Epidemiology Consortium included data on periodontal disease, tooth brushing frequency, mouthwash use, numbers of natural teeth, and dental visits over the 10\u2009years prior to diagnosis. Multivariable generalized linear regression models were used and adjusted for age, sex, race, geographic region, tumor site, tumor-node-metastasis stage, treatment modality, education, and smoking to estimate risk ratios (RR) of associations between measures of oral health and overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Remaining natural teeth (10-19 teeth: RR\u2009=\u20090.81, 95% confidence interval [CI]\u2009=\u20090.69 to 0.95; \u226520 teeth: RR\u2009=\u20090.88, 95% CI\u2009=\u20090.78 to 0.99) and frequent dental visits (&amp;gt;5 visits: RR\u2009=\u20090.77, 95% CI\u2009=\u20090.66 to 0.91) were associated with better overall survival. The inverse association with natural teeth was most pronounced among patients with hypopharyngeal and\/or laryngeal, and not otherwise specified head and neck squamous cell carcinoma. The association with dental visits was most pronounced among patients with oropharyngeal head and neck squamous cell carcinoma. Patient-reported gingival bleeding, tooth brushing, and report of ever use of mouthwash were not associated with overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Good oral health as defined by maintenance of the natural dentition and frequent dental visits appears to be associated with improved overall survival among head and neck squamous cell carcinoma patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djad156","type":"journal-article","created":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T16:19:04Z","timestamp":1691252344000},"page":"105-114","source":"Crossref","is-referenced-by-count":38,"title":["Poor oral health influences head and neck cancer patient survival: an International Head and Neck Cancer Epidemiology Consortium pooled analysis"],"prefix":"10.1093","volume":"116","author":[{"given":"Jason","family":"Tasoulas","sequence":"first","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"},{"name":"Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"},{"name":"Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas R","family":"Farquhar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Sheth","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, The University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Hackman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendell G","family":"Yarbrough","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"},{"name":"Department of Otolaryngology\/Head and Neck Surgery, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"},{"name":"Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris B","family":"Agala","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alzina","family":"Koric","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine , Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Giraldi","sequence":"additional","affiliation":[{"name":"Section of Hygiene, University Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore , Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Fabianova","sequence":"additional","affiliation":[{"name":"Regional Authority of Public Health , Banska Bystrica, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Lissowska","sequence":"additional","affiliation":[{"name":"Department of Cancer Epidemiology and Prevention, M. 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Roffo, University of Buenos Aires , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"W\u00fcnsch-Filho","sequence":"additional","affiliation":[{"name":"Epidemiology Department, School of Public Health, University of S\u00e3o Paulo , S\u00e3o Paulo, Brazil"},{"name":"Oncocentro Foundation of S\u00e3o Paulo , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Brasilino","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Department of Head and Neck, Heliopolis Hospital , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana Ver\u00f3nica Mendoza","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Cancer Institute of the State of S\u00e3o Paulo (ICESP) , S\u00e3o Paulo, 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Richiardi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, University of Turin , Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose P","family":"Zevallos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery, University of Pittsburgh , PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Ness","sequence":"additional","affiliation":[{"name":"Bristol Dental School, University of Bristol , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miranda","family":"Pring","sequence":"additional","affiliation":[{"name":"Bristol Dental School, University of Bristol , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve J","family":"Thomas","sequence":"additional","affiliation":[{"name":"Bristol Dental School, University of Bristol , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Dudding","sequence":"additional","affiliation":[{"name":"Bristol Dental School, University of Bristol , Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Chin Amy","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine , Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Hashibe","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Family and Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine , Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Boffetta","sequence":"additional","affiliation":[{"name":"Stony Brook 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