Table 5

Quotations for theme 3: oral health perceptions and experiences

Subtheme: making oral health changes with the aim of preventing RA
PQ22“So I have [extracted] about three myself … I didn’t have the money, you know. I possibly didn’t have the dentist at the time.” - Participant 13
PQ23“I think I probably am better with my teeth. I never forget to do them now. You know, I always do them at night and in the morning.” – Participant 10.
PQ24“I definitely drink less fizzy drinks and I have cut down on smoking and I have started eating less badly.” – Participant 14
PQ25“If a dentist recommended it, I definitely would. But if they didn’t, I probably wouldn’t, because at the moment, I’ve not, as far as I know, I’ve not got rheumatoid arthritis.” – Participant 11
PQ26“I’ve always been doing these practices before that, but now my mouth’s gonna be like priority again.” – Participant 15
HPQ20“I think that people generally don’t see cleaning their teeth as being oral health. I think it’s just something that they do. It’s just their daily hygiene routine, and I think there’s a mismatch in people’s minds.” – Healthcare professional 8
HPQ21“I think quite a lot of our patients don’t even think about it. And it’s only if they have a problem that they then think about it. But I don’t think they think about brushing their teeth two or three times a day or whatever or using mouthwashes etcetera. I don’t think they think of all that. Well not a lot of the ones I see [laughs] … And it only really comes to the forefront of their mind when they’ve actually got a problem and by then it’s too late for them to, you know, maintain their health, their mouth and their gums.” – Healthcare professional 10
HPQ22“There are some patients I think who have never bothered about their teeth. They’ve never cared for them, have had a lot of filings when they were younger. Perhaps haven’t been educated enough about managing dental hygiene.(It’s)probably harder to change their habits.” – Healthcare professional 11
Subtheme: acceptability of participation in periodontal research aiming to prevent RA
PQ27“Yeah, definitely, I’ll do whatever is required to reduce the risk.” - Participant 6
PQ28“Yeah, it won’t get mine [CCP level] down to six, but I mean, would it get it down to 200 or 250, I don’t know. Any positive step in the right direction is a motivation, innit?” – Participant 7
PQ29“Have somebody look at my teeth … Just actually see a dentist.” – Participant 16
PQ30My grandchildren down the line might be in the same position and because I haven’t stepped up, they could be in the exact same position if people don’t do this research.” – Participant 18
PQ31“He talks me along, whatever he’s doing and, you know, he’s quite, he’s obviously quite used to people who don’t like going to the dentist … My dentist knows now, you know, he literally, every little movement that he’s gonna make, he’s like, ‘I’m just gonna do this,’ so it’s not a surprise.” – Participant 14
PQ32“Yeah, I sort of shuffle [appointments] about, I have to adjust work and have a day off or whatever.” - Participant 13
HPQ23“It wouldn’t be cost effective … for a dentist to [attend a MDT] because there are so many people … with these systemic diseases.” – Healthcare professional 3
HPQ24“There’s also factors about making the best use of a highly skilled trained force. So the dentists may not be the best person to spend time doing things like making every contact count or doing blood pressure. That could be another member of the team, ‘cause the dentists will be the most expensive part of that system … it could be delegated the way it is in primary medical care to other members of the team.” – Healthcare professional 2
HPQ25“I think it’s important to understand we don’t have to use fairly expensive dentist time to do all of this. Clearly they’ll need to do some of the assessments but they don’t need to do, won’t need to do any of the introduction and the prevention pathway. That can all be done by the extended duty dental nurses.” – Healthcare professional 1
HPQ26“So the ones that make an effort to go to the dentist and are flossing their teeth and are aware of it, I think they would be very keen on that rather than taking different medication. Some people will just say, ‘oh no’.” – Healthcare professional 11
  • RA, rheumatoid arthritis.