Table 3

Quotations for theme 1: understanding risk

Subtheme: knowledge of shared at-risk factors
PQ1“Without this study and being informed about it, I wouldn’t have had a clue that, you know, there’s [a link] between oral health and rheumatoid arthritis.” – Participant 15
PQ2“Yeah, well yeah, I knew about a long time ago that smoking can actually destroy your teeth and your gums, I knew quite a lot of information on that.” – Participant 6
PQ3“So obviously, I’m aware that [smoking is] bad and my dentist always tells me off.” – Participant 14
PQ4“I think everyone knows by now that tobacco is not good for
people.” – Participant 6
PQ5“Not about arthritis, but, you know, when you go to doctor’s and they do say, you know, you’ve got to stop smoking.” – Participant 8
PQ6“If you ask most people whether or not they thought or were aware of any of this, then they wouldn’t have a scooby.” – Participant 7
PQ7“I don’t think even my dentist might not know that I’ve got, I’ve got those factors anyway, but I didn’t know, and I don’t think, not sure even my dentist knew.” – Participant 3
PQ8“Well, they never mentioned anything to do with arthritis … you tick a form with certain things on it, but they don’t really ask you about any things on that … they just want to get you in, have a look at your teeth, and get you out again, you know [laughs). That’s what it seems like.” – Participant 5
PQ9“I feel like it might be one of those things that a dentist, you know, they’ll have seven years of training and they’ll have an afternoon on it, and some of them will remember it, and some of them won’t.” – Participant 19
PQ10 “I think it’s more they want to know obviously your medications you take for it, rather than your condition itself.” – Participant 9
HPQ1“I think most dentists’ experience is purely on a case by case basis, liaising with the consulting physician or cardiologist or GP because of some query relating to the dental treatment rather than treating a patient more holistically.” – Healthcare professional 2
HPQ2“They, I don’t know, I think maybe it’s because we’re more thinking about the problem they’ve got that’s a rheumatology problem. And, and we’re, they’re more thinking about how their joints are, how they’re feeling, their tiredness, their pain and all that kinda thing. But you don’t generally, and I know for a fact I don’t, well certainly haven’t [thought about] their oral health and maybe we should.” – Healthcare professional 10
HPQ3“Nobody’s said, ‘oh we don’t care about dentistry’. It’s just that we’ve never talked to them before. And as soon as you start talking to them they’re extremely interested.” – Healthcare professional 9
HPQ4“They just don’t see, ‘you’re only a dentist’, is something we often hear. ‘Why do you need to know that, this is just my teeth?’” – Healthcare professional 8
HPQ5“My impression of the dental contract is that dentists do not have to carry on taking NHS patients when they are full which we’re not allowed to shut our lists … I think there’s probably some conflict between primary care and dental care over the contract that dentists do, are allowed to shut the list, they don’t have to continue taking on NHS patients. They can choose to take them privately … I wonder sometimes if that might also be an additional barrier to actually starting to get relationships working.” – Healthcare professional 6
HPQ6“Dentistry’s commissioned by NHSE … and primary medical care services [are] commissioned by the CCG, so there’s no collaboration there … I don’t think there’s always the movers for innovation. I think apart from goodwill and local networks there are no financial incentives to join up.” – Healthcare professional 2
HPQ7“In terms of collaboration, it’s very interesting, I think it depends on where you are in the country and on which country you’re in. So … where I work, the collaboration between me and my team and the physicians is fantastic. … but those collaborations tend to be research based as opposed to clinical service based and I think there’s still a long way for us to go to get clinical pathways, joint clinical pathways going.” – Healthcare professional 3
HPQ8“It does feel like medicine and dentistry are very separate, that they’re two completely different areas and that we don’t need to know anything about the mouth or the teeth and vice versa [laughs). So I think that we could improve that in terms of perhaps within our … regional teaching programmes we should have more sessions involving oral health which we have been starting to do. But I don’t know if that’s just Yorkshire because there are collaborations within the area or whether that’s something that’s happening nationwide. I suspect not.” – Healthcare professional 11
Subtheme: information and communication
PQ11“I think it varies, you know, as to different people will want it at different stages, and I think you’ve got to assess that as a clinician as, you know, as to how much information you give people or whether to get them back and take it a bit more slowly.” – Participant 1
PQ12“I mean, initially, if you’re having a consultation, it’s good to hear somebody explain and tell you why. That’s, I’m most likely to retain it that way. But having something you can refer to, back to, either in written or online, is useful as well.” – Participant 19
PQ13“I think, without someone, either a bit of encouragement, or knowing that you’re going back to someone, you’ve got to report back on how you’ve done, you know.” – Participant 2
HPQ9“Yes I, I think it, I mean if they don’t go to the dentist they’re not gonna get any information from the dentist. So really I suppose it really ought to come from us … maybe that’s something we ought to be thinking about and putting that into our sessions that we do with the patients and the education. Because I don’t think we really do think about that generally speaking.” – Healthcare professional 10
HPQ10“When you are first told about a condition, that’s probably the time that you take on board the most things because that’s where you’re trying to learn about the condition and, and, and how to manage it. So I think if you were told at that point…that it was vitally important … that your mouth was in as good a shape as possible in terms of stability of your disease.” – Healthcare professional 2