Fears of pain, complications and social embarrassment, exacerbated by age, are important factors that help explain refusal of implants by elderly patients.

Oral diseases are highly prevalent among people on social assistance. Despite benefiting from public dental coverage in North America, these people rarely consult the dentist. One possible reason is rooted in their perception of oral health and the means to improve it. To respond to this question, largely unexplored, we conducted qualitative research through 8 focus groups and 15 individual interviews in Montreal (Canada). Thematic analysis revealed that people on social assistance: (a) define oral health in a social manner, placing tremendous value on dental appearance; (b) complain about the decline of their dental appearance and its devastating impact on self-esteem, social interaction, and employability; and (c) feel powerless to improve their oral health and therefore contemplate extractions and complete dentures. Our research demonstrates that perception of oral health strongly influences treatment preference and explains low and selective use of dental services in this disadvantaged population.

In mixed methods studies, novice researchers need to know that qualitative and quantitative data or results sometimes diverge. However, few studies focus on this aspect of mixed methods research. The present paper aims to review the literature on divergence of qualitative and quantitative evidence, and describe examples. The prior literature reveals four strategies for taking divergence into account: reconciliation, initiation, bracketing and exclusion. Nine examples derived from empirical studies were found, and they are described. Then, a detailed example is given of how divergence was identified and explored in a pilot study of the implementation of one electronic knowledge resource on handheld computer in an academic family medicine clinic. Finally, this worked example is described in the context of a teaching exercise for novice researchers.

Persons receiving public assistance have perceptions about dental health and illness that prevent them from receiving early treatment for tooth decay, which may lead to disagreements with dentists when planning dental treatments.