Involving young people and parents in decision-making for hypodontia

Involving young people and their parents in decisions about their health care is ethically and professionally the right thing to do. Good decision-making relies on informed, value-based deliberation. Providing the right treatment for people with hypodontia is complex, both technically, in terms of the range of options available, and from a communication perspective. Treatment decisions faced by young people with hypodontia can have lifelong implications and the weight of this is felt both by the patient, who may have limited experience of dental treatment and decision-making, and their parents, who act as advocates. It is important that clinicians understand how they can best share the available evidence and their expertise in a way that can be understood and applied. Clinicians also have an important role in facilitating young people to recognise and communicate their own values, expectations, and ultimately, preferences for treatment. This paper outlines the challenges of navigating information sharing and engaging in shared decision-making specific to hypodontia. A scoping review of the literature by the authors was conducted to identify evidence-based advice for discussing uncertainties, risks and increasing engagement in decision-making. This may be useful to both primary and secondary care practitioners involved in decision-making with people with hypodontia. Choosing the 'best' treatment for a young person with hypodontia is challenging due to the variation in clinical presentation and treatment options, differences in patients' understanding, goals and expectations, and variability in clinical services.Shared decision-making (SDM) is a joint process in which healthcare professionals and patients work together to make decisions about their care. The decision is reached by taking into account the clinician's clinical knowledge, expertise, the available evidence base and the patient's preferences, beliefs and values. Establishing how the decision-maker wishes to be involved, how much information they want, and how they prefer information to be delivered is essential to ensure communication is person-centred and supports deliberative decision-making.Communication of risks, benefits and consequences, particularly when using numerical information, can be challenging. Discussions may be aided by the use of plain language, summary tables to present all of the risks and benefits of each option side by side, presenting information in several formats, use of visual aids and using absolute rather than relative risks.