title: The influence of patients' decisions on treatment planning in restorative dentistry.
abstract: As part of treatment planning, options are presented to patients by dentists. An informal discussion takes place involving a cost-benefit analysis and a treatment plan is agreed. Evidence-based dentistry takes into account the best available literature, clinical experience and patient factors to guide the dentist. Dentists exert considerable influence on which treatment modality is selected. This paper focuses on the importance of patient factors which lead to less than ideal, clinically acceptable, treatment plans that nevertheless give patient satisfaction over the long term. Though no universally accepted healthcare model exists for restorative dentistry, patients' decisions are most influenced by their relationship with their dentist over factors such as time, access and cost. Letters should be sent to patients clarifying the nature of all proposed options, including advantages and disadvantages, complications, success rates, biological and financial costs and what happens if no treatment is carried out.
  
  
  CONCLUSIONS
  Many psychological and social determinants influence patients'values and decision-making when planning for restorative dentistry. These lead to a treatment plan agreed between the patient and the dentist. Often an element of compromise is considered acceptable to both parties when the evidence would suggest an alternative treatment to be preferable.
authors.affiliation: Restorative Dentistry, Eastman Dental Hospital, London, UK.
authors.forename: Jagdip S
authors.initials: JS
authors.lastname: Kalsi
authors.affiliation: Restorative Dentistry, Eastman Dental Hospital, London, UK.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hemmings
mesh_terms: D000328:Adult; D000848:Anodontia / Q000534:rehabilitation; D001294:Attitude to Health; D055113:Chronic Periodontitis / Q000628:therapy; D003142:Communication; D003362:Cost-Benefit Analysis; D003442:Crowns; D003657:Decision Making; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D003793:Dental Restoration, Permanent; D003812:Dentist-Patient Relations; D003814:Dentistry, Operative / Q000191:economics; D055094:Evidence-Based Dentistry; D005260:Female; D006801:Humans; D007180:Incisor / Q000002:abnormalities; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010358:Patient Participation; D017060:Patient Satisfaction; D011176:Post and Core Technique; D064890:Social Determinants of Health; D013997:Time Factors; D014082:Tooth Fractures / Q000628:therapy; D019553:Tooth, Nonvital / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015921:Dental Implants