Practitioners are able to base clinical decisions on their professional knowledge, scientific evidence and experience. However, in order to preserve the trust and to serve patients well, dental professionals must take time to understand their expectations and limitations before any treatment begins.
Patients favour a personally active approach to dental treatment. A collaborative decision, with patient and dentist equally sharing responsibility for decision-making, is increasingly popular. As well as examination, diagnosis, determining aetiology and formulating appropriate treatment options, individual preferences and requirements should be tailored into the treatment plan. Additionally, well-informed, engaged patients are placed in a stronger position when deciding between treatment options and are more likely to take ownership of the final treatment decision and outcome.
Patient expectations should be considered carefully and practitioners need to recognise that the focus of the general population has shifted from ensuring teeth are healthy and pain free to an ever-stronger desire that they should also be aesthetically pleasing. As a result, the demand for higher standards of treatment and cosmetic procedures are on the increase, but when both the practitioner and patient bring value and information to the treatment plan they can build an agreement together, which is more likely to result in patient satisfaction.
There will, of course, always be occasions when things happen that are beyond our control but by covering every eventuality, both patients and professionals can be aware of any factors or risks that could compromise the treatment outcome. When shared decision-making takes place, patient acceptance of any less desirable consequences increases and the likelihood of complaints and claims arising from clinical decision-making are also reduced.
Planning well is an attribute that all professionals aspire to achieve. It is particularly important in the dental practice because a detailed treatment plan is beneficial not only for the patient and practitioner but the dental team and laboratory. With forward thinking, realistic scheduling and organisation, the skills, services, materials and time can be communicated and allocated efficiently to ensure the most effective results.
At times, cases present that are beyond the technological parameters or skill set of the practice. This could be due to the complexity of the treatment or due to the patient needs and enhanced imaging, sedation or specialist clinical skills may be required. Whatever the circumstances, dental professionals need to recognise any limitations and make a decision to refer.
Calling upon the additional assistance will ensure the success and accuracy of treatment. Furthermore, it extends the professionalism of the referring dentist and practice. However, these professionals must be able to trust the people and services they chose to work with and have confidence in their expertise.
London Smile Clinic is able to provide a referral service that can be integrated into any treatment plan. Referring dentists can rest assured that they will remain informed throughout the treatment and feel confident that their patients will receive first class treatment to achieve the most successful results possible.
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 H Chapple, S Shah, A-L Caress & E J Kay. Exploring dental patients' preferred roles in treatment decision-making – a novel approach. British Dental Journal 194, 321 – 327. Published online: 22 March 2003 | doi:10.1038/sj.bdj.4809946. http://www.nature.com/bdj/journal/v194/n6/abs/4809946a.html
 House of Commons Health Committee Dental Services Fifth report of Session 2007-08 HC 289-I 2 July 2008.