Ethical issues in dental education-A cross-sectional study with pre-clinical and clinical dental students.

INTRODUCTION: Although ethics is an indispensable part of dental education, it has not yet played a relevant role in the dental curriculum in Germany. The study aimed at assessing their prior knowledge of ethical aspects, and their expectations of and wishes for ethics course of dental students, preclinical vs. clinical, at the dental school Kiel, Germany by means of a validated questionnaire. METHODS: A descriptive cross-sectional study design was used. The study population consisted of dental students, from pre-clinical (n = 105) and clinical semesters (n = 110). In January 2019, each student completed a validated questionnaire to identify semester-specific ethical teaching content. Besides descriptive analyses, Mann-Whitney U test was used to compare pre-clinical and clinical students. RESULTS: A total of 215 dental students, with a mean age of 25.3 (SD 4.1), participated in the study, of which 150 were female (69.8%) and 65 were male students (30.2%). The results in the areas of 'previous knowledge of ethical issues' and 'expectations and desires in terms of teaching medical ethics' showed similarities and differences between pre-clinical and clinical students. Both groups stated that they need training in ethics. Moreover, especially clinical students recognize that more ethical competence is needed if the first patient contact will start. CONCLUSION: The study indicates that there is a clear need for ethics education. Student awareness of the relevance of ethical competences and the perception of ethical problems increased progressively during the course of their studies. Overall, the study provides good support for the development of specific ethics courses.

[Pilot project for the "Internship to Gain Experience in the Professional Field" in dentistry studies with a focus on acquiring communicative skills]. / Pilotprojekt zum "Praktikum der Berufsfelderkundung" im Zahnmedizinstudium mit Fokus auf den Erwerb kommunikativer Kompetenzen.

BACKGROUND: The new dental licensing regulations provide for a professional field internship to give students an initial, comprehensive insight into their later professional field. The location, implementation and assessment are not specified and can take place within university dentistry or in cooperation with dental practices. The Kiel Dental Clinic decided to develop a concept for a two-week course, including practical training in private practices, and to take greater account of aspects of medical interviewing. Based on a theoretical introduction and an e­learning module, this is to be the introduction to a longitudinal communication curriculum. In the summer semester of 2021, a pilot project was carried out with the aim of developing the necessary course infrastructure and content and linking it with teaching content on communicative competences. METHODS: A controlled intervention study (one measurement point) was conducted with 21 fourth-semester students (two groups with and without e­learning module) and 20 dental practices. The students received documents on the organisation, procedure and documentation of various interview situations before the one-week internship. Students and practices were comprehensively evaluated after the end of the internship. RESULTS: Students and practices were satisfied with the organisation, the documents provided and the process. The e­learning module was well received. The format of the internship report proved to be impractical and was adapted. DISCUSSION: The project goals were successfully achieved. The results will be incorporated into the concrete design and implementation of the new curricular course starting summer semester 2022.

Oral cancer awareness campaign in Northern Germany: successful steps to raise awareness for early detection.

PURPOSE: Oral cancer is an underestimated health problem, and its existence and the relevant prevention measures are not sufficiently known by the general population. The project thus aimed to develop, implement and evaluate an oral cancer campaign in Northern Germany, and to increase problem awareness on various levels: draw public attention to the tumour by media coverage increase awareness of early detection opportunities for the target group, and raise awareness of carrying out early detection measures by the professional groups involved. METHODS: For each level, a campaign concept was developed and documented in terms of content and timing. The identified target group was elderly educationally disadvantaged male citizens ≥ 50 years. The evaluation concept for each level included pre-, post- and process evaluations. RESULTS: The campaign was carried out from April 2012 to December 2014. The issue of awareness within the target group was significantly increased. Media coverage showed that regional media adopted the topic of oral cancer and placed it on their published agenda. Furthermore, the continuous involvement of the professional groups over the course of the campaign led to an increased awareness of oral cancer. CONCLUSION: The development of the campaign concept with a comprehensive evaluation showed that the target group was successfully reached. The campaign was adapted to the required target group and specific conditions, and was also designed to be context sensitive. It is, therefore, recommended that the development and implementation of an oral cancer campaign on a national level be discussed.

Certainty in Uncertain Times: Dental Education during the COVID-19 Pandemic-A Qualitative Study.

BACKGROUND: The restrictions concerning social contact due to the COVID-19 pandemic implied a rethinking of teaching methods at universities in general, and for practice-oriented teaching such as dental education in particular. This qualitative study aimed to assess aspects of feelings of certainty and uncertainty during this specific education process, incorporating the perspectives of teaching staff and dental students. METHODS: Qualitative methods based on interviews were used for data collection. Dental students from different academic years (second, third, fourth, and fifth) and teaching staff responsible for the content and implementation of courses within the dental curriculum were recruited. The data analysis was performed by qualitative content analysis. RESULTS: A total of 39 dental students and 19 teaching staff participated. When students and staff dealt positively with this specific situation, certainty was achieved. The availability of presentations and clear communication enhanced feelings of certainty. The participants often felt unsure about how to handle such a challenging situation and felt insecure when planning for the semester. The students missed contact with other students and argued that the information policy on their dental studies was not transparent enough. In addition, dental students and teaching staff were nervous about the risk of infection from COVID-19, especially in practical courses with patient contact. CONCLUSIONS: The COVID-19 pandemic situation leads to a rethinking of dental education. Feelings of certainty can be strengthened by clear and transparent communication as well as training in online teaching methods. To reduce uncertainty, it is crucial to establish channels for information exchange and feedback.

Covid-19: teaching and learning in practical courses under special regulations - a qualitative study of dental students and teachers.

BACKGROUND: The coronavirus pandemic led to a lockdown of public life. For universities, this meant suspensions or corresponding adaptations of practical courses. In Germany, Kiel Dental Clinic received special permission to start practical courses under appropriate hygiene conditions. The study aimed at recording the experiences and associated challenges of course implementation under the special regulations from the perspective of students and teachers. METHODS: Qualitative guided interviews were conducted with students and teachers at Kiel in the summer semester 2020. Students (4th, 6th, 8th, 10th semesters) were recruited and lecturers responsible for conducting the practical courses within the dental clinic's four departments. Evaluation was carried out by means of qualitative content analysis, whereby deductive procedures were supplemented by inductive ones. RESULTS: Thirty-nine students and 19 lecturers took part. The flow of information at the start of the course was welcomed by students and teachers across the board. The lack of or limited adjustment to the scope tended to be assessed positively by students. The majority of both groups suspected there had been no reduction in learning, and learning had been improved due to the smaller group sizes. Regarding the necessary conditions for conducting the course, positive and negative aspects became apparent. CONCLUSION: Students and teachers felt very relief to start the practical courses under special conditions although the implementation was very challenging for both groups. The structural and content-related course adaptations required a high degree of flexibility on the part of students and lecturers alike, but also meant that courses were able to be conducted without serious deficits in learning gains.

Suspension of face-to-face teaching and ad hoc transition to digital learning under Covid-19 conditions - a qualitative study among dental students and lecturers.

BACKGROUND: In mid-March 2020, the coronavirus pandemic led to a national lockdown in Germany. Face-to-face teaching was cancelled in universities for the 2020 summer semester. Teaching moved online with no prior IT testing and lecturer training. The study analyses experiences of the suspension of face-to-face teaching and the move to digitalised learning for students and lecturers of dentistry at Kiel. METHODS: In summer 2020, qualitative guided interviews were conducted with students (4th, 6th, 8th, and 10th semesters), and lecturers. Deductive and inductive qualitative content analysis of the results was carried out. RESULTS: Thirty-nine students (69% female) and 19 lecturers (32% female) were interviewed. Reactions to the changes in teaching were observed. Feelings ranged from an essentially positive attitude, through insecurity and uncertainty to a failure to fully appreciate the situation. The loss of social contact was lamented. Digitalisation was associated with technological challenges and additional work. However, it also fostered learning independent of time and place, and encouraged autonomy. Negative aspects of digitalisation included a lack of feedback and loss of interaction. CONCLUSION: The introduction of ad hoc digitalisation challenged both students and lecturers alike. Dealing with lockdown and the changes in teaching and studying required significant flexibility.

Evaluation of prevention behaviour and its influencing factors with respect to cancer screening.

PURPOSE: Every year, about 4.6 million people are diagnosed with cancer in Europe. However, based on preclinical changes and using appropriate examination procedures certain cancers can be detected in symptom-free patients at an early stage and treatment initiated. In Germany, various cancer screening examinations are currently offered to the relevant age groups and sexes free of charge. Participation rates are affected by a number of factors and barriers. The study aimed at identifying potential obstacles and barriers to uptake, taking into account demographic and socio-economic variables. MATERIALS AND METHODS: Data collection was conducted in the context of routine examination appointments at the City of Kiel Occupational Health Department from September 2013 to September 2014 using an anonymised questionnaire. In addition to recording socio-demographic data and tobacco consumption, the questionnaire also catalogued participation in statutory health insurance cancer screening examinations using the "stages of change" from the Transtheoretical Model. Eight potential barriers to participation were recorded. RESULTS: The results are based on 718 completed questionnaires. It was found that women, older age, and non-smoking status were associated with a higher probability of participating in cancer screening. It was also found that various barriers affecting (regular) participation were perceived significantly different according to the individual stages of change. This influence of the stages was moderated by gender. CONCLUSION: The results showed interesting trends in the different barriers and how they are influenced by socioeconomic factors and the stages of change. Especially the stages require different gender-specific approaches to mobilisation for cancer screening.

Early detection of oral cancer: a key role for dentists?

PURPOSE: The majority of suspected malignant changes in the oral mucosa are detected by dentists in private practice. Statements regarding the effectiveness of visual examination of the oral cavity for early detection are not necessarily transferable between different health care systems. Our clinical-epidemiological and methodological aim was thus to conduct a prospective regional study in dental practices under everyday conditions, assess the frequency and type of oral mucosal changes, and evaluate the dental examination methodology. METHODS: A prospective observational study was conducted, combining a feasibility study of early detection of oral cancer and its documentation with phase I 'modelling' to conceptualize complex interventions in health services research. Dentists in private practice continuously recruited patients over 6 months and used two different sheets for the documentation of suspicious lesions. Statistical analysis involved descriptive statistics and tests for differences (Welch test) or association (Chi-squared test). RESULTS: Twenty-five dentists (mean age: 50 years, 24% females) participated in this study. Eleven dentists achieved the overall aim of recruiting 200 patients. Around 4200 patients (mean age: 52 years, 57.5% females) participated. The prevalence of suspicious lesions was 8.5%. CONCLUSION: It became apparent that a study in cooperation with dentists in private practice to generate clinical-epidemiological data on the early detection of oral mucosal lesions under everyday conditions can be carried out successfully. Further studies with a corresponding level of evidence should be carried out to be able to draw conclusions about the effectiveness of the early detection measure under everyday practice conditions.

Identification of semester-specific teaching contents for dental ethics: development, testing and validation of a questionnaire.

BACKGROUND: Although medical ethics is an indispensable part of dental education, it has not played a relevant role in the dental curriculum thus far. This study is aimed at developing and validating a questionnaire that identifies semester-specific ethical issues, in order to develop longitudinal ethic modules. METHODS: March 2018 a workshop on item generation was coordinated, using Delphi method; followed by a cognitive testing with students (2nd, 4th, 10th semesters, n = 12). A pilot test was carried out with students from different semesters (n = 60). The distribution of response frequencies and missing values were determined. The questionnaire used for validation consisted of three dimensions: ethical knowledge, dealing with ethical issues, expectations in terms of teaching. The psychometric examination was carried out by preclinical students (n = 105) and clinical semesters (n = 110) January 2019. RESULTS: After cognitive testing and piloting, some items were reformulated, so that a questionnaire with 127 items was used for validation. The individual dimensions were assigned to various factors with excellent to acceptable internal consistency (Cronbach's α 0.72-0.96). CONCLUSION: The questionnaire has an acceptable to excellent consistency and suggests that the different dimensions are conclusive. With this questionnaire, ethical issues in dentistry can be mapped and teaching contents identified.

Oral cancer awareness campaign in Northern Germany: first positive trends in incidence and tumour stages.

PURPOSE: Oral cancer is a still underestimated public health problem. In Germany, until 2007, there was no systematic approach available for the purpose of raising the awareness of the public. From 2007 to 2011, a concept was developed for such an approach, and the campaign was launched in Northern Germany in 2012, and concluded in 2014. This report aims at presenting incidence trends of oral cancer, stratified according to sex, age, and tumour stages, before the introduction of this campaign and upon completion thereof. METHODS: The data kept by the Schleswig-Holstein Cancer Registry on incidence rates (ICD-10, C00-C14) focused on oral cancer (C00-C06) and stratified by sex, age-groups and tumour stages, from 2000 to 2006 and from 2007 to 2014. RESULTS: From 2000 to 2014, a total of 6760 cases of oral and pharyngeal cancer (C00-C14) were registered. When data on oral cancer was taken into account, stage I cancers of women in particular, increased over time. Regarding the stages, stage IV was the most frequent and stage I the second most frequent stage for both men and women. Over time, a small shift towards detection of tumours at earlier stages was observed. CONCLUSION: A slight trend towards a temporary increase in incidence rates, especially among women, was observed. From an epidemiological point of view, this might indicate the initial success of this campaign. The slight trend in favour of stage I tumours could be seen as an initial minor success in terms of the early detection of oral cancer.

Exploratory Research Focusing on Oral Cancer Prevention: Challenges of Dealing With Informational and Cognitive Barriers.

Oral cancer is a considerable public health problem, and a low level of awareness and knowledge about this tumor and its risk factors is prevalent. To gain a profound understanding of risks groups and to identify suitable communication strategies for a prevention campaign in Northern Germany, an exploratory research was realized. In semistructured face-to-face interviews, the participants of the study (n = 28) described their individual oral cancer-related perceptions and information-seeking behaviors. A computer-assisted qualitative data analysis showed a vague but also deterring picture of cancer combined with restricted attitudes toward the topic and an inactive or even avoiding information behavior. Four underlying cognitive patterns of self-distancing were identified: (a) optimistic bias, (b) fatalism, (c) hedonism, and (d) pragmatism. The main challenge of oral cancer prevention is to deal with the target groups' informational and cognitive barriers.

The influence of clinical experience on dental students' ethical awareness.

INTRODUCTION: There has been no structured integration of ethical issues into the dental curriculum and currently no data for certain ethics modules exists in Germany. The study aimed at evaluating the attitudes to ethical issues that affect students at the Dental School in Kiel during patient treatment. MATERIAL AND METHODS: In the summer of 2017, students were recruited from the 6th and 10th semesters. A qualitative study design with interviews was chosen. The dimensions included, for example, experience with ethical issues, definitions and expectations of teaching content and methods. A qualitative content analysis was performed. RESULTS: Twelve and eleven students from semesters (32% each) participated. No student was able to name an ethical question based on his own experience (private/study). The need to address ethical issues was justified solely by personal treatment experiences. DISCUSSION: The study revealed a lack of basic ethical knowledge resulting in a lack of ability to deal with ethical issues. Instead, participants described experiences of psychological pressure, feelings of helplessness. CONCLUSION: The results suggest that ethical-theoretical foundations should be taught before the beginning of patient treatment. A didactic combination with clinical facts and case vignettes is recommended.

Challenges of early detection of oral cancer: raising awareness as a first step to successful campaigning.

In Germany, ∼ 13,000 people are found to have oral and pharyngeal cancer every year. Awareness and knowledge about this cancer remain insufficient, particularly amongst elderly people. A campaign for early detection was launched in Northern Germany in April 2012. The first step of the campaign was to increase awareness about oral cancer. Prior to a pre-campaign evaluation at the campaign start, March 2012 and an intermediate-campaign evaluation, November 2012, a sample representative for the population aged 50 ≥ years (target group; N = 500) was drawn for a first process evaluation. The surveys were conducted by means of telephone interviews including questions on behaviour, knowledge and sociodemographic/socioeconomic aspects and target group-oriented questions on issue, media and campaign material awareness. The process evaluation showed an increase in issue awareness from 25 to 40% (P < 0.001) and the media awareness increased by over 10% (P < 0.001). The results suggested that particularly women, the core age group (60-79 years) and the educationally disadvantaged group might benefit from the campaign. Awareness about the issue 'oral cancer' was already significantly increased 7 months after the campaign start. The highest general and media-related increase in awareness was achieved in the target group.

Influence of dental education on esthetic perception.

AIM: One of the most challenging tasks in daily practice when it comes to defining treatment goals and how to attain them is the communication with the patient and the self-reflection of the treating dentist. Failures due to mis-communication are common, especially in esthetic dentistry. The purpose of this study was to evaluate the influence of dental education on students' and dentists' judgment of patients' dental appearance. MATERIALS AND METHODS: Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure "dental appearance" (QDA). Eleven items defined a QDA score (0 = "absolutely dissatisfied", 100 = "absolutely satisfied"). The QDA was completed by 29 patients (21 women, 8 men) before and after a complete oral rehabilitation, including restoration of the anterior teeth. Overall, 95 students (1st, 5th, and 10th Semester) and 30 dentists evaluated the patients' esthetics before and after rehabilitation on a visual analog scale (VAS; 0 = "absolutely unesthetic", 100 = "absolutely esthetic"). RESULTS: Students and dentists alike judged a significant esthetic improvement after treatment (P ≤ 0.0001). Significant differences could be found when comparing the students' and dentists' judgment and the patients' self-evaluation (P ≤ 0.05). CONCLUSION: Since it seems that students judge dental appearance differently from patients' self-assessment, teaching esthetic rules at university should incorporate the aspect of patient feedback in order to avoid misconceptions.

Baseline data of oral and pharyngeal cancer before introducing an oral cancer prevention campaign in Germany.

OBJECTIVES: Oral and pharyngeal cancer is still a serious health problem with an annual incidence of about 13,000 in Germany. This study aimed at describing trends of incidence and mortality in Germany by age, sex, and sub-site as a baseline for an oral cancer prevention campaign. METHODS: Using data from the National Association of Population-based Cancer Registries, incidence rates for oral and pharyngeal cancer (ICD-10, C00-C14) from 2003 to 2011 and mortality rates from 1990 to 2012 were analysed by age, sex, and sub-site (C00-C06, C07-C08, C09-C14). Trends were described by annual percentage changes. RESULTS: Men are 2.5-times more likely than women to be diagnosed and 3-times more likely to die from this tumour. Incidence and mortality in women increased slightly during the last decade, while incidence and mortality in men remained stable at a high level. While a decline was observed for younger age groups, an increase was seen in the elderly. For some sub-sites a deviation from this overall pattern was observed. CONCLUSIONS: The decrease in this tumour in younger age groups is pleasing and may be attributed to public efforts in non-smoker protection in recent years. Further efforts are needed to counteract the increasing burden of disease in older age groups and in men.

Unsplinted implants and teeth supporting maxillary removable partial dentures retained by telescopic crowns: a retrospective study with >6 years of follow-up.

OBJECTIVES: Data regarding tooth- and implant-supported maxillary removable partial dentures (TIRPDs) are scarce. The objective of this research was to perform a retrospective evaluation of the clinical long-term outcome of maxillary TIRPDs rigidly retained via telescopic crowns in patients undergoing supportive post-implant therapy (SIT). MATERIAL AND METHODS: The inclusion criteria were met by 26 patients restored with maxillary TIRPDs between 1997 and 2011 in a private practice. Primary crowns (Marburg double crowns, MDCs) on teeth were cemented, whereas those on implants were screw-retained. Using patient records and data from a cross-sectional clinical examination in 2013, the survival rates of the teeth, implants and prostheses, together with the biological and technical complications, were analyzed. RESULTS: After 6.12 ± 3.80 (range: 2-16) years of loading, 23 non-smoking patients with 23 dentures supported by 60 implants and 66 teeth were available for assessment. Nine teeth (survival rate: 86.36%) were lost, whereas 1 implant (survival rate: 98.36%) failed because of peri-implantitis. Although 30 implants (50%) in 16 patients (69.57%) showed bleeding on probing (BOP+), no further peri-implantitis was observed. The mean peri-implant probing depth (PPD) was 3.68 ± 0.71 mm. All dentures were functional and required technical maintenance efforts amounting to 0.128 treatments per patient per year (T/P/Y). CONCLUSIONS: Within the limitations of this study, we conclude that TIRPDs retained via MDCs may represent a viable treatment option for patients with residual maxillary teeth.

Perception of dental esthetics in different cultures.

PURPOSE: The purpose of this study was to compare patients' and dentists' perception of dental appearance. MATERIALS AND METHODS: Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure "dental appearance" (QDA). Eleven items defined a QDA score (0 = "absolutely dissatisfied" to 100 = "absolutely satisfied"). The QDA was completed by 29 patients (21 women, 8 men) before and after a complete oral rehabilitation that included restoration of the maxillary anterior teeth. Overall, 94 dentists from four countries (Germany, the United Kingdom, China, and Switzerland) evaluated the esthetics before and after rehabilitation on a visual analog scale (VAS: 0 = "absolutely unesthetic" to 100 = "absolutely esthetic"). RESULTS: Patients and dentists of all countries found a significant esthetic improvement after treatment (P ≤ .0001). Significant differences could be found when comparing the evaluation of the dentists from the various countries among one another and with the patients' self-evaluation (P ≤ .05). With the exception of the professional rating of the initial situation, no gender-related differences could be found in any of the test groups. CONCLUSIONS: In daily practice, it seems of utmost importance for dentists to incorporate the patients' feedback in order to avoid esthetic treatment failures.

Evaluation of medical research performance--position paper of the Association of the Scientific Medical Societies in Germany (AWMF).

OBJECTIVE: The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists' careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. METHODS: During the Berlin Forum of the Association of the Scientific Medical Societies in Germany (AWMF) held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here. RESULTS: The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific "impact" rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third-party funds and the promotion of junior scientists. CONCLUSIONS: With the explicit recommendations presented in the current position paper, the AWMF suggests enhancements to the practice of evaluating medical research performance by faculties, ministries and research funding organizations.

Early detection of oral cancer: dentists' opinions and practices before and after educational interventions in Northern-Germany.

INTRODUCTION: The question whether educational programmes improve dentists' knowledge of oral cancer is still an unexplored subject. The aim of this study was to assess dentists' opinions and practices concerning oral cancer using a standardised survey after educational intervention over one year. MATERIAL AND METHODS: Following a baseline survey which was mailed to every dentist in Schleswig-Holstein, Germany (n = 2280), the results were analysed to produce a multifaceted educational programme. After educational intervention, the same survey was redistributed and the results before and after intervention were compared. RESULTS: The results are based on 394 surveys. Following intervention, 62% of responders, compared to 49% at baseline, described their overall knowledge as current. The percentage of dentists routinely investigating older patients at the recall appointment increased from 28% at baseline to 37% if the responders had attended a continuing education course during the period of intervention. Similar improvements were observed at initial appointment for older patients, with results improving from 33% to 38% for responders who attended a further educational course. CONCLUSIONS: Our results showed that a 1-year educational intervention with a multifaceted approach was successful. They underline that continuing education programmes improve the competence of dentists performing examination of the oral cavity. Therefore, regular participation in continuing educational courses is recommended.

Quality of life in oral cancer patients--effects of mandible resection and socio-cultural aspects.

INTRODUCTION: The aim of this study was to assess the postoperative quality of life in oral cancer patients depending on different mandible resection types and to collect information about their socio-cultural situation. MATERIAL AND METHODS: In this cross-sectional study, patients with primary oral cancer treated with different types of mandibular resection in the Clinic of Oral and Maxillofacial Surgery at the University of Kiel between 1997 and 2007 were included. Quality of life was assessed by means of the EORTC QLQ-C30 and H&N 35 questionnaires. Furthermore, a questionnaire about the socio-cultural background of the patients was applied. To be included, at least one year had to be passed after tumour resection. RESULTS: 111 of 235 questionnaires were returned (47%). Significant differences in quality of life were found between patients with soft tissue resections and bone resections. There were significant worse values for continuity resections compared to only partial resections. Sixty-seven patients (60.4%) had a graduation of an elementary school as the highest school graduation, four patients (3%) had no school graduation. CONCLUSIONS: The postoperative quality of life in our patients was significantly influenced by the extent of bone resection. This should be considered for surgical planning. The socio-cultural data showed a rather low education level for the majority of the patients.