Article
Shared decision-making is an important aspect of Dentistry which is required in everyday practice. When discussing the options for replacing missing anterior teeth, dentists may give vague explanations without providing a clear overall view of the modalities available. An option grid, utilizing statistics obtained from critically appraised literature, is a useful tool in presenting this information to patients. Through a clear, user friendly document with visual representation, both dentist and patient would find the discussion easier to follow. The literature used also helps boost the patient's confidence that he/she is being treated with the latest evidence in mind.
One of the most common questions a dentist faces in everyday practice is ‘How can I replace my missing tooth?’ This may lead to either a long discussion or a short vague explanation of the treatment options available. The problem with this is that patients may be left confused or rely on dentists to decide for them. This in turn can lead to problems later down the line with patients receiving a treatment option that they have not fully understood and with which they are subsequently unhappy. With a rise in medico-legal cases and the importance placed on shared decision-making, there needs to be a shift in the way dentists present information to their patients.
The use of an option grid which utilizes both images and text in a clear and concise fashion is a useful tool for presenting such information. The option grid (Figure 1) can be easily photocopied and adapted to suit each practice. By discussing the grid with the patient in the chair, the dentist can have a standardized approach to the discussion whilst also focusing on points relevant to the individual patient. The option grid can also be given to the patient to take home and read, which allows more time to reach an informed decision.
One of the main advantages of using this method is that it already incorporates statistics obtained from critically appraised literature. The literature selected for this grid was sourced from various banks, including the Cochrane library; however, it is to be considered a representation of the literature in general.
By discussing the evidence, patients can feel more confident in their dentist as well as the practice as a whole. Incorporating literature is also good practice and is consistent with the continual shift towards Evidence-Based Dentistry.
Within the grid itself, the price list can be adapted to suit each practice, with rough guidelines provided in this template. A disclaimer is also noted regarding implant availability on the NHS. For patients who meet the eligibility criteria, this can be discussed further by the dentist.
It is important to note that, by using this grid, it does not necessarily use any additional time for the dentist. The whole process usually takes 5 minutes or less and may be tailored to the patient's individual needs. This may also save time in future visits as patients may be more prepared with the modality they have chosen, having had a better understanding of it.
Finally, though this is ideally aimed at discussions for missing anterior teeth, the grid can still be used as an overview for options with missing posterior teeth. However, extra considerations would need to be factored in and the dentist would need to explain why certain modalities would not be suitable, based on the individual's presentation.