Patient autonomy in dentistry: demonstrating the role for shared decision making

Area of Science:

• Healthcare Decision Making
• Patient Autonomy
• Shared Decision Making

Background:

• Evidence-based practice and patient preferences are key to shared decision-making (SDM).
• Patient autonomy preferences (AP) are crucial for quality healthcare but understudied in dentistry.
• This study compares dental patient autonomy preferences with those in other medical fields.

Purpose of the Study:

• To explore and compare patient autonomy preferences in dentistry versus other medical domains.
• To investigate patient and dentist role preferences in dental decision-making.
• To assess how autonomy preferences differ across various patient cohorts and decision types.

Main Methods:

• 100 dental patients and 16 dentists were recruited from a university prosthodontic clinic.
• Control Preference Scale (CPS) assessed role preferences in dental decision-making.
• Cross-sectional surveys with Autonomy Preference Index (API) and CPS were used for additional cohorts (general practice, multiple sclerosis clinic).

Main Results:

• Dentists were less willing to cede control than patients desired.
• Decisions on tooth loss management were seen as relevant for SDM by both patients and dentists.
• Autonomy preferences were highest in multiple sclerosis patients and lowest in dental patients (p=0.035).

Conclusions:

• Patient participation is vital in dental decision-making.
• Autonomy preferences vary significantly by decision type, condition severity, and medical domain.
• Healthcare professionals need communication skills training to address specific patient autonomy needs.