Table 1.

Themes and supporting qualitative quotes.

Theme	Quote (Q) reference	Quote
NHS policy and dental care services	Q1	The processes of how you get people to take their dental health seriously are very difficult. The ones that pay for dentistry are likely to be the ones with good teeth, the others who get free treatment just don’t access it. (GP3)13
	Q2	The area I am in is very deprived and actually, I would say that the majority don’t ever visit the dentist, I think they just don’t see it as important and loads of them just don’t have the money, and fear, loads of people hate seeing a dentist unless it’s absolutely necessary. (Pharmacist 5)16
Education of patients and preconceptions	Q3	I think it [oral health education] would be from my mum and dad and then the dentist. I don’t think anyone else has ever talked about oral health with me, maybe the school nurse a long time ago. (Patient 5)16
	Q4	I think it’s just the way society has brought us up in that the, there are two defining people, dentists and doctors. Anything to do with dentists, you go to the dentist. Anything about your health you go to the doctors. They have always been seen as separate. (Patient 6)16
Isolation	Q5	I think with a lot of things with dentists really, that we are out of the loop, I just don’t seem to have had much interaction with any other healthcare professionals. (Dentist 6)15
Communication and collaboration	Q6	I’m directly contactable face-to-face by prescribers, GPs, nurse practitioners, nurses, admin team, everything. They can just come directly into my office and ask me for information. So, I’m probably more likely to be utilised clinically. (Pharmacist 1)16
Local population needs	Q7	In that 2 min that you have got to hand something out to somebody, you concentrate on the important things, such as how to take it, to get their concordance and compliance. (Pharmacist 2)13
Education of healthcare professionals	Q8	I personally don’t really feel that I’ve got a good enough understanding of what an actual pharmacist’s job entails. (Dentist 2)15
	Q9	No not really… [we had] a little bit [of shared education] in lectures maybe at university but not with dentists. We have worked quite closely with the doctors but not with dentists. (Pharmacist 1)13
Practitioner’s competence and capability	Q10	I’m in quite an advanced clinical role now. So I do a lot of diagnostics and treating myself. I’m a prolific prescriber. (Pharmacist 7)16
Professional hierarchies	Q11	My clinics could easily be timetabled for 20 min instead of 10, and as I don’t really see acute patients or have the same time pressures as some of the GPs or practice nurses. I can talk longer and to go into more detail about things, there is scope to take more time and really reinforce the key messages. (Pharmacist 2)16
Individual clinical competencies	Q12	I think most of us know the basics, but not really much depth, especially around how oral health and just general health and wellbeing are related. (Pharmacist 3)16
	Q13	It’s the sort of thing that once you see it, you then remember it [MRONJ]. They were both very complex patients, but the amount of morbidity involved with the osteonecrosis of the jaw in both of those patients was considerable. (GP 1)13
Professional relationships	Q14	I feel as though the pharmacist that I go to, I could ask her anything and she would tell us. I have had a review with her, she’s very, very helpful and knowledgeable about medication. (Patient 5)15
	Q15	If you have to wait to get an appointment with the pharmacist at the doctor’s surgery, you may as well just see the doctor or whatever else. The point of a pharmacist to me it that it’s, like, around the corner and it’s easy. (Patient 6)16
Isolated working patterns	Q16	We don’t seem to engage with dentists. In fact, the only time that I ever had a proper conversation with a dentist was when I worked in community pharmacy and that would have been over an incorrect prescription or an out of stock item. And I just think, you know, there is a lot of cross-conversations that we could have. (Pharmacist 10)16
	Q17	I make sure I take medication histories for patients, but they don’t always know exactly what they take. It’s sometimes hard to be sure the list they give you is accurate. (Dentist 15)15
Individual patient needs	Q18	I think counselling about medication is far better done by the pharmacists. I think the other reason is perhaps, when a patient sees a doctor they expect to be able to discuss all aspects of their lives and their care. (GP 1)13
	Q19	This is difficult, but mentally, it gives you some kind of anxiety because you- you- you know your bone is [visible] there- a little piece of [exposed] bone on your left-hand side is there. (MRONJ Patient 5)14
	Q20	Psychological and mental, yeah. If you’re going out to a restaurant, then you have to be very careful. You don’t want people to see that you are eating awkwardly. (MRONJ Patient 5)14
Disconnection with general health	Q21	I haven’t really heard of links between the two. I see lots of patients with diabetes and it is definitely not something that I would tell patients about. (Pharmacist 5)16
Lack of shared clinical records	Q22	It would be brilliant, if we could just see, even just an element of their records, even just what drugs they were taking. That’s the main thing for us, it takes so long to get the drug history out of a patient. (Dentist 13)15
	Q23	We would never know if the dentists had prescribed any antibiotics or anything for a patient. Yet, if anyone else in the primary healthcare team prescribes anything for our patients, we know. (Pharmacist 7)16
Sub-optimal referral pathways	Q24	I would say there is anonymity really [between dental and medical service providers]. If you compare it with, for example, local opticians where we have frequent interactions, albeit by paper, we don’t really get any, sort of, direct contact. Not that I can recall. (GP3)16