Table 3.
Themes regarding collaboration in the context of diabetes and periodontitis and illustrative quotes.
| Theme | Quotes |
|---|---|
| Accommodation of evidence and guidelines | Q1: I think it makes sense… I suppose they have increased risk of, almost everything… but do we know why? Do we know why they have poorer glycaemic control? Is it because of, inflammation and infection that causes worsening of it? (Medical professional, W2001: 51–56). |
| Q2: I wouldn’t know to that, sort of, depth… like things like your HbA1c, it’s not, I know the term, but I don’t know it in and out, ‘cos [because] it’s just not something that… I would have to probably look it up, just to inform myself a little bit. (Dental professional, W1008: 150–153) | |
| Q3: …in my experience… you’re not really sure how well it’s [diabetes] being managed… and neither are they (the patient) probably for that matter…’ (Dental professional, W1003: 85–88). | |
| Q4: What is their [dentist’s] awareness of the links between periodontitis and diabetes? Or what’s their ownership of it? ‘Cos you know… work[ing] in silos… where, ‘it’s a dental problem, not mine’, but obviously, it’s very joined together. (Medical professional, W2003: 671–676). | |
| Q5: I think they (general practitioners) don’t probably appreciate, they don’t appreciate this link, but I think they also don’t appreciate, the level of understanding that as a professional group, we have, of how, if you like, our world [the oral cavity] impacts on the greater systemic world [systemic health].’ (Dental Professional, W1003: 363–365). | |
| Q6: … you know, so it’s part of the, the education rather than, you know, if you’re lucky enough to have a doctor that’s going to, a dentist that’s going to take this on board, you could miss out couldn’t you? But, if it was part of the education, in general for newly diagnosed, well everybody would be aware of it. (Patient participant, W3005: 1255–1257) | |
| Experienced interaction | Q7: What about the other way around? What about dentists referring to us? I’ve never had anyone who’s been sent to me by a dentist saying, “I’ve been told I need to tighten up my diabetic control”. (Medical professional, W2003: 668–671). |
| Q8: If they’re on warfarin [anti-coagulant therapy], “what is the advice about warfarin for doing surgery”, that’s what they ask. (Medical Professionals, W6007: 740–741). | |
| Q9: We’ve had them in the last few weeks again where they’ve [the patient] had a [dental] problem, they’ve contacted the dentist and they’ve been told … “Oh, go to your doctor… he’ll give you antibiotics”. We don’t prescribe [in] that [scenario], no we won’t [give antibiotics]. We have written to all the dentists before and said, to remind them that they shouldn’t be sending dental patients to us. (Medical professional, W6009: 630–665). | |
| Q10: Based upon the times I’ve contacted GPs to ask for blood tests, you know, when it might be you have a suspicion of anaemia or other things… they’re not really ve[ry], in my opinion, not particularly receptive to that. (Dental Professional, W1003: 277–288). | |
| Q11: If we make the referral, it’s not usually very well received at all…I think there’s a perception they think we’re interfering or we’re, we’re stepping beyond our remit… (Dental Professional, W1003: 357–358) | |
| Q12: Well, I get a [diabetes] review twice a year…they’re very good…but, my doctor is…violently against, anything to do with dentistry…they [say they] haven’t got time…they don’t see the holistic, sort of, situation. (Person with diabetes, W3002: 1115–1138). | |
| Planned interaction | Q13: The best thing for [the dentist] to do would be… to encourage them just to come along, like, we don’t want loads of letters, but if they can just encourage, we’d always be happy to see them and check [HbA1c] and do their [bloods], you know. (Medical Professional, W2006: 749–754) |
| Q14: I think that’s the easiest way, we’ve got hairdressers sending us patients, chiropractors do…if the dentist said, “Go and see your doctor, ‘cos I think these two are linked”, they would come, some of them would come…we probably wouldn’t be that responsive to a letter, but if they use the patients as the vehicle, it’s their body, and then the ones that are interested would come.’ (Medical Professional, W2003: 787–802). | |
| Q15: I didn’t contact their GP, but we advised them to go and get tested and they did. I didn’t actually write a letter or anything, they, they went, I explained the risk of diabetes, had my suspicions, I’ve done it on about 3 patients that we’ve, we’ve advised to go for testing. (Dental Professional, W1007: 269–270). | |
| Q16: Well yeah, and probably, a bit of thinking, is it easier for the patient just to make that call themselves, and go and do it themselves. (Dental Professional, W1003: 265–266). |
Q1, Q2; quote 1, quote 2 etc. W#, workshop number and participant identifier, followed by the corresponding line numbers that relate to the location of the quote within the transcription.