{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:59:27Z","timestamp":1781240367763,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore how Dutch adults with rheumatoid arthritis (RA) perceive their oral health around the diagnostic process and the early disease course. The primary objective was to describe these perceptions in depth, and a secondary objective was to identify areas for future patient\u2010centred research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A phenomenological qualitative study was conducted at Reade, a specialized rheumatology clinic in Amsterdam, The Netherlands. Adults (\u2265\u200918\u2009years) diagnosed with RA within 5\u2009years prior to the start of recruitment, without multimorbidity and irrespective of oral complaints, were eligible. After completing brief sociodemographic\/RA and oral\u2010care questionnaires, semi\u2010structured interviews in Dutch (face\u2010to\u2010face or virtual) were conducted with a trained interviewer with lived RA experience. Data were coded inductively in ATLAS.ti using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven adults (7\u2009women, 4\u2009men; median\u2009age\u200968\u2009years) were interviewed. Five themes were identified: (1) fluctuating symptoms demanded continual lifestyle adjustments and, for some, financial losses from reduced work hours; (2) the diagnosis carried a wide emotional burden\u2014humour and symptom\u2010downplaying helped, yet most still camped with accepting the disease, its medication and side\u2010effects; (3) relationships with healthcare professionals varied\u2014participants adhered to rheumatologists' recommendations but followed dental advice less consistently, and they viewed dentists and hygienists as having distinct roles; (4) oral hygiene ability varied\u2014hand\u2010 or wrist\u2010flare ups briefly hindered routines for some, and awareness of RA\u2010related oral health risks (e.g., temporomandibular\u2010joint involvement) was low; and (5) tailored information linking RA and oral health was scarce, and participants preferred clear guidance from clinicians while firmly rejecting oral hygiene guidance from friends and family.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This exploratory study of Dutch adults with RA showed that perceptions of oral health, particularly around the diagnostic process and early disease course, highlighted five patient\u2010centred research areas: determining the optimal timing and provider of RA\u2010oral health information, mapping educational gaps among dental and rheumatology professionals and students, refining ergonomic toothbrush design, addressing socioeconomic barriers to dental care and validating routine TMJ screening tools. These findings may also serve as a foundation for the development of dental guidelines that reflect the patient perspective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cdoe.70082","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:48:24Z","timestamp":1781239704000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Rheumatoid Arthritis\u2010Oral Health Perceptions Around Diagnosis and the Early Disease Course: A Phenomenological Approach"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1074-4045","authenticated-orcid":false,"given":"Nadine Isabel","family":"Bhagwandas","sequence":"first","affiliation":[{"name":"Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3065-9549","authenticated-orcid":false,"given":"Lotte Arwen","family":"van de Stadt","sequence":"additional","affiliation":[{"name":"Amsterdam Rheumatology and Immunology Center, Reade  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2288-6450","authenticated-orcid":false,"given":"Johanna Margaretha","family":"Kroese","sequence":"additional","affiliation":[{"name":"Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Reumato\u00efde Artritis (RA)","author":"VZinfo (RIVM)","year":"2024"},{"key":"e_1_2_13_3_1","volume-title":"Trendscenario\u2014Ziekten en Aandoeningen","author":"Volksgezondheid Toekomst Verkenning (VTV)","year":"2024"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2019.101476"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.25122\/jml\u20102022\u20100081"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.11607\/ofph.2718"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41405\u2010020\u20100034\u20108"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41780"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102020\u2010001485"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067\u2010019\u201004555\u20109"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010021\u201004034\u2010z"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102023\u2010003099"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/23800844211012678"},{"key":"e_1_2_13_14_1","volume-title":"When Doctors Become Patients","author":"Klitzman R.","year":"2008"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11017\u2010010\u20109161\u2010x"},{"key":"e_1_2_13_16_1","unstructured":"S.Lester \u201cAn Introduction to Phenomenological Research [Internet] \u201d Stan Lester Developments (1999) https:\/\/devmts.org.uk\/resmethy.pdf."},{"key":"e_1_2_13_17_1","volume-title":"Research Design: Qualitative, Quantitative, and Mixed Methods Approaches","author":"Creswell J. 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