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Schaper K, Woelber JP, Jaehne A. Can the spirit of motivational interviewing be taught online? A comparative study in general practitioners. PATIENT EDUCATION AND COUNSELING 2024; 125:108297. [PMID: 38728998 DOI: 10.1016/j.pec.2024.108297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Motivational Interviewing (MI) is an evidence-based approach to enhance patients' motivation and is increasingly in demand in medical practice. Online teaching methods offer advantages to train health care professionals, but only very few studies examined whether MI-specific interviewing skills (""MI-skills""), and especially MIspecific attitudes (the "MI-spirit"), can be taught online and whether learning gains differ from those in face-to-face courses. This study compared the effects of 7 h of basic training for experienced general practitioners (GP) in either an online or a traditional face-to-face format with a non-trained control group. METHODS "MI-skills" and "MI-spirit" were measured in a prospective analysis in 49 experienced GPs before and one week after training RESULTS: An ANOVA on gain-scores demonstrated significant differences between groups in both MI-specific skills (VASE-R, p = 0.006) and "MIspirit" (MIKAT, p = 0.029; HRQ, p < 0.001) from pre- to posttest. Post-hoc comparisons revealed significant improvement only in the training groups (VASE-R, p < 0.001; MIKAT, p = 0.014 for online, p = 0.003 for face-to-face; HRQ, p < 0.001). CONCLUSION The results suggest similar effects of both online and face-to-face training of "MI-skills" and "MI-spirit" to GPs. PRACTICE IMPLICATION Online learning opportunities should be integrated in MIT programs for general practitioners where appropriate.
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Affiliation(s)
- Karsten Schaper
- Faculty of Medicine, Albert-Ludwigs-University, Breisacher Str. 153, 79106 Freiburg im Breisgau, Germany
| | - Johan Peter Woelber
- Policlinic of Operative Dentistry, Periodontology, and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Andreas Jaehne
- Oberberg Specialist Clinic Rhein-Jura, Schneckenhalde 13, 79713 Bad Säckingen, Germany.
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Farina R, Simonelli A, Guarnelli ME, Secchiati G, Montemezzo G, Scapoli C, Trombelli L. Efficacy of communicating periodontal risk on psychological outcomes and supragingival plaque control in patients undergoing first periodontal consultation: A parallel-arm, randomized trial. J Clin Periodontol 2024. [PMID: 38956317 DOI: 10.1111/jcpe.14032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/31/2024] [Accepted: 06/07/2024] [Indexed: 07/04/2024]
Abstract
AIM To evaluate the efficacy of the PerioRisk prognostic tool in implementing the effect of motivational interviewing (MI) on psychological outcomes and supragingival plaque control. MATERIALS AND METHODS Participants underwent MI immediately after their first periodontal visit. According to a parallel-arm, randomized study design, MI was performed with (RISK group) or without (CTR group) information on PerioRisk level and treatment goals based on PerioRisk output. Psychological outcomes were assessed using the Positive Affect Negative Affect Scale (PANAS) and Protection Motivation Theory (PMT). Plaque index (PI) was re-evaluated after 8-12 weeks. RESULTS Significant improvements in PMT overall score and PI were observed in CTR and RISK groups, without inter-group difference in PANAS and PMT overall scores and PI. A sub-analysis showed that the overall PMT scores recorded immediately after MI in both CTR and RISK groups for subjects with no tooth loss due to periodontitis were higher than those recorded before MI in subjects with tooth loss due to periodontitis. CONCLUSIONS At first periodontal visit, MI (implemented with without PerioRisk) has tangible effects on psychological outcomes and supragingival plaque control and seems to anticipate the awareness that is commonly generated by periodontitis-related tooth loss (ClinicalTrials.gov protocol registration ID: NCT05078411).
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Affiliation(s)
- Roberto Farina
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Maria Elena Guarnelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Giacomo Secchiati
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
| | - Giulia Montemezzo
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Chiara Scapoli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Section of Biology and Evolution, Department of Life Sciences and Biotechnologies, University of Ferrara, Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy
- Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
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Erschens R, Fahse B, Festl-Wietek T, Herrmann-Werner A, Keifenheim KE, Zipfel S, Fallgatter AJ, Velten-Schurian K. Training medical students in motivational interviewing using a blended learning approach: a proof-of-concept study. Front Psychol 2023; 14:1204810. [PMID: 37546454 PMCID: PMC10400288 DOI: 10.3389/fpsyg.2023.1204810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background Difficulties in implementing behavior change in patients with chronic diseases are common in clinical practice. Motivational interviewing (MI) helps clinicians to support patients in overcoming ambivalence while maintaining self-determination. The inclusion of MI in German medical training curricula is still rare. Furthermore, the effects of systematic teaching of MI, especially via blended learning, have hardly been investigated. Methods Medical students participated in three curricular events related to MI, consisting of instructional videos and theoretical and practical components in a blended learning format. The aim of the study was to investigate the effect of teaching MI in students' medical education. A controlled, non-randomized study was conducted with an intervention group and a control group. Both groups completed questionnaires on their experience and knowledge related to MI, completed a knowledge test and rated their satisfaction with the course. MI was taught in the 6th semester of medical coursework as part of a psychosomatic course, in the 8th semester during a psychiatry course and in the 9th semester during a weekly psychiatry clerkship. Results Data from the intervention group (n = 35) and control group (n = 14) were analyzed, with 65.7% of students participating in all three parts of the curriculum. Overall interest in learning MI was high, with M = 2.92 (SD = 1.00). The results indicate a greater increase in knowledge over time in the intervention group. The majority (62.86%) stated that the curriculum was relevant to their future career. Free-form text responses indicated a high level of satisfaction with practical relevance. Conclusion This study demonstrates the usefulness of an MI curriculum for medical students. The integration of MI into medical curricula is a promising curricular addition to improve doctor-patient communication. Future research should address patient perceptions of MI competencies and the persistence of acquired competencies.
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Affiliation(s)
- Rebecca Erschens
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Bettina Fahse
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
- Tübingen Institute for Medical Education (TIME), Faculty of Medicine, Tübingen, Germany
| | - Teresa Festl-Wietek
- Tübingen Institute for Medical Education (TIME), Faculty of Medicine, Tübingen, Germany
| | - Anne Herrmann-Werner
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
- Tübingen Institute for Medical Education (TIME), Faculty of Medicine, Tübingen, Germany
| | - Katharina E. Keifenheim
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Stephan Zipfel
- University Medical Hospital Tuebingen, Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
- German Center for Mental Health (DZPG), Tuebingen, Germany
| | - Andreas J. Fallgatter
- German Center for Mental Health (DZPG), Tuebingen, Germany
- Tübingen Center for Mental Health, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Kerstin Velten-Schurian
- Tübingen Center for Mental Health, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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Fuhrmann S, Kitzmann J, Isailov-Schöchlin M, Vach K, Fabry G, Schulz C, Jähne A, Ratka-Krüger P, Woelber JP. Can motivational interviewing for dental settings be taught online? Results of an uncontrolled interventional trial. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:254-262. [PMID: 34009671 DOI: 10.1111/eje.12698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Motivational interviewing (MI) is an evidence-based method of promoting oral healthcare behaviour. Conventional training of MI is a time-consuming and costly aspect in the dental curriculum. Therefore, the aim of this study was to evaluate the effectiveness and acceptance of a MI-blended learning programme for dental students. MATERIALS AND METHODS Dental students had to perform an interdisciplinary created "ecourse Motivational Interviewing in medical settings" (eMI-med). After completion, patient-student interviews were recorded and evaluated using the Motivational Interviewing Treatment Integrity Code (MITI-d). Furthermore, the students' self-efficacy regarding smoking cessation and oral hygiene motivation was examined and the acceptance of the tool was enquired. RESULTS Forty interviews with 25 different students were analysed with the MITI-d. Students showed high levels of MI-adherent behaviour (15.45 ± 6.98), open-ended questions (9.95 ± 6.90) and reflections (10.43 ± 8.85), which were comparable to previous classroom trainings. In addition, 90% of the students preferred e-learning over classroom teaching. Furthermore, the students' therapeutical self-efficacies were significantly increased by the programme. CONCLUSION Within the limitations of this study, the created e-learning programme was able to equip dental students with basic knowledge and MI skills. Furthermore, learning MI through e-learning may heighten the self-efficacy of dental students regarding smoking cessation and oral hygiene promotion. Students showed a high acceptance of e-learning, preferring it over traditional learning.
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Affiliation(s)
- Sascha Fuhrmann
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Kitzmann
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Private Practice, Hamburg, Germany
| | - Milena Isailov-Schöchlin
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kirstin Vach
- Department of Medical Biometry and Medical Informatics, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Götz Fabry
- Department of Medical Psychology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cornelia Schulz
- Cancer Prevention Team, Tumor Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Jähne
- Oberberg specialist hospital Rhein-Jura Bad Säckingen, Bad Säckingen, Germany
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johan Peter Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Woelber JP, Lessing C, Oesterreich D. [Oral health competence and its communication in "talking dentistry"]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:986-992. [PMID: 34226945 DOI: 10.1007/s00103-021-03370-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
The concept of health literacy has received much attention in recent years. Essential approaches are the provision of health information, teaching through educational programs, and transfer via communication techniques. From a dental point of view, the individual discussion between patient and dentist is of particular importance ("talking dentistry").The aim of our article is to present the current state of knowledge on the relationship between oral health literacy and talking dentistry, to present existing concepts for teaching communicative competencies, and to identify the further need for action from the point of view of the German Dental Association. Several health psychology models emphasize a positive relationship between oral health literacy, oral health behavior, and oral health. Further determinants seem to be the patient's self-efficacy beliefs and the individual interaction with the dentist. Therefore, it seems purposeful to intervene in an occasion-related manner in the sense of talking dentistry. The personal conversation between dentist and patient can cover counselling, education, motivation, and practical guidance and can lead to participatory decision-making.Offers for learning and deepening communication techniques represent important aids for the practice. Some are presented in this article as examples. However, in order to establish talking dentistry on a broad level, more far-reaching offers and incentives are needed. Through our suggestions, we would like to show ways in which talking dentistry can be further promoted and consolidated as an integral part of dental care.
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Affiliation(s)
- Johan Peter Woelber
- Klinik für Zahnerhaltungskunde und Parodontologie, Department für Zahn‑, Mund- und Kieferheilkunde, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Constanze Lessing
- Abteilung Versorgung und Qualität, Bundeszahnärztekammer, Arbeitsgemeinschaft der Deutschen Zahnärztekammern e. V., Chausseestraße 13, 10115, Berlin, Deutschland.
| | - Dietmar Oesterreich
- Abteilung Versorgung und Qualität, Bundeszahnärztekammer, Arbeitsgemeinschaft der Deutschen Zahnärztekammern e. V., Chausseestraße 13, 10115, Berlin, Deutschland
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Carra MC, Detzen L, Kitzmann J, Woelber JP, Ramseier CA, Bouchard P. Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: A systematic review. J Clin Periodontol 2021; 47 Suppl 22:72-89. [PMID: 31912530 DOI: 10.1111/jcpe.13234] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022]
Abstract
AIM This systematic review investigates the impact of specific interventions aiming at promoting behavioural changes to improve oral hygiene (OH) in patients with periodontal diseases. METHODS A literature search was performed on different databases up to March 2019. Randomized and non-randomized controlled trials evaluating the effects of behavioural interventions on plaque and bleeding scores in patients with gingivitis or periodontitis were considered. Pooled data analysis was conducted by estimating standardized mean difference between groups. RESULTS Of 288 articles screened, 14 were included as follows: 4 studies evaluated the effect of motivational interviewing (MI) associated with OH instructions, 7 the impact of oral health educational programmes based on cognitive behavioural therapies, and 3 the use of self-inspections/videotapes. Studies were heterogeneous and reported contrasting results. Meta-analyses for psychological interventions showed no significant group difference for both plaque and bleeding scores. No effect was observed in studies applying self-inspection/videotapes. CONCLUSIONS Within the limitations of the current evidence, OH may be reinforced in patients with periodontal diseases by psychological interventions based on cognitive constructs and MI principles provided by oral health professionals. However, no conclusion can be drawn on their specific clinical efficacy as measured by reduction of plaque and bleeding scores over time.
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Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France.,Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France
| | - Laurent Detzen
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France
| | - Julia Kitzmann
- Private Practice, Hamburg, Germany.,Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Philippe Bouchard
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France.,EA 2496, U.F.R. of Odontology, University of Paris, Paris, France
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Donos N, Suvan JE, Calciolari E, Nibali L, Rollnick S. The effect of a behavioural management tool in adults with mild to moderate periodontitis. A single-blind, randomized controlled trial. J Periodontal Res 2020; 56:46-57. [PMID: 32959898 DOI: 10.1111/jre.12790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare a behavioural management program (test) to a standard communication approach (control) to reduce plaque, improve clinical outcomes and patient's compliance with oral self-care. BACKGROUND Since psychological factors affect oral health-related behaviours, approaches directed at changing behaviours and improving compliance might improve the effect of oral health education. MATERIALS AND METHODS This was a randomized, single-blind, parallel-design trial involving 71 patients with mild to moderate periodontitis. During a run-in period, all participants began using a power toothbrush. Two sessions of non-surgical periodontal therapy were performed post-baseline, along with one of the two oral healthcare communication approaches. Plaque and bleeding scores, probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at the screening visit, baseline visit and at 8 and 14 weeks post-baseline. Patients were asked to fill in oral self-care diaries. Experience questionnaires were administered to both clinicians and patients to assess subjective experience of the clinician-patient interactions during the visits. RESULTS In both groups, a significant reduction in plaque and bleeding scores was observed from baseline to 8 weeks after baseline, which then remained stable at week 14, but no differences between the groups were noted. An improvement in CAL and PPD was recorded at week 8 post-baseline in the test compared to the control group. No inter-group differences in the clinician's and subject's experience questionnaires were observed. CONCLUSION Both approaches significantly promoted periodontal health. However, changing lifestyle requires repeated communication/engagement over time and a behavioural management program based upon two visits did not provide additional benefit compared to a standard approach.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jeanie E Suvan
- Unit of Periodontology, Eastman Dental Institute, University College London (UCL), London, UK
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Medicine and Surgery, School of Dental Medicine, University of Parma, Parma, Italy
| | - Luigi Nibali
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centre for Host-Microbiome Interactions, Guy's Hospital, Kings College London, London, UK
| | - Stephen Rollnick
- Cochrane School of Primary Care & Public Health, Cardiff University, Cardiff, UK
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Ramseier CA, Woelber JP, Kitzmann J, Detzen L, Carra MC, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review. J Clin Periodontol 2020; 47 Suppl 22:90-106. [DOI: 10.1111/jcpe.13240] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | - Julia Kitzmann
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
- Private Practice Hamburg Germany
| | - Laurent Detzen
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
| | - Maria Clotilde Carra
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- Population‐based Epidemiologic Cohorts Unit INSERM UMS 011 Villejuif France
| | - Philippe Bouchard
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- EA 2496 Université de Paris U.F.R. of Odontology Paris France
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