What is it about?
Dentists aim to involve patients in treatment choices, but too many options can confuse rather than help. Patients bring their wishes and goals, while dentists bring training and judgment. The challenge is greatest in cosmetic dentistry, where people often arrive with strong preconceptions but little awareness of the permanent impact or lifelong maintenance involved. True shared decision-making means guiding patients toward realistic, safe options - even if that sometimes means saying no.
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Why is it important?
This opinion piece explores the tension between shared decision-making and clinical responsibility in dentistry, with a particular focus on cosmetic practice. While patient-centred care is rightly emphasised, offering every conceivable option- many of them unsuitable - can confuse patients and undermine trust. The essay argues for a model of guided partnership, where clinicians filter out unreasonable options and recommend those that are clinically and ethically sound. It is especially timely given the rise of cosmetic demand shaped by social media and unrealistic expectations, highlighting the importance of managing consent and long-term commitment. The piece offers a practical and reassuring perspective: dentists can respect autonomy without abdicating judgement, ultimately protecting both patients and practitioners.
Perspectives
Shared decision-making is supposed to be the pinnacle of patient centred care. Writing this article was somewhat cathartic as whilst I am of course all in favour of including the patient in the decision-making process - it can be frustrating when a clinician with years of experience is discussing options with a patient to has none. In this opinion piece, I try to make some sense of the conundrum.
Andrew Dawood
university College London Hospital
Read the Original
This page is a summary of: Shared decision-making or professional guidance? a practical dilemma, Aesthetic Update, September 2025, Mark Allen Group,
DOI: 10.12968/aedu.2025.2.3.120.
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