Rajagopal Sandhya, Kelly Aengus
Endodontist, Collingham Dental Care, Wetherby.
Clinical Lecturer in Dental Education, Peninsula Dental School, Plymouth University.
Prim Dent J. 2020 Dec;9(4):31-36. doi: 10.1177/2050168420963303.
Engaging patients in shared decision making (SDM) is a professional requirement since the Montgomery ruling in 2015. Endodontic treatments present a specific challenge to achieving SDM, both for the clinician and the patient. The treatments are often perceived as more challenging to complete by the clinician, and the assessment of risk and likely outcome requires a deep understanding of the (limited) evidence base. For the patient, decisions can be required at a time of acute symptoms and prolonged treatments. There are health literacy demands in comparison to some less complex dental treatments. Treatment decisions may be based more on inherent biases and prior experiences than objective probabilities. This article discusses options and supports effective shared decision making in endodontic treatment.
自2015年蒙哥马利裁决以来,让患者参与共同决策(SDM)已成为一项专业要求。牙髓治疗对临床医生和患者而言,在实现共同决策方面都面临着特殊挑战。临床医生通常认为这些治疗更具挑战性,而对风险和可能结果的评估需要对(有限的)证据基础有深入理解。对患者来说,在出现急性症状和接受长期治疗时可能需要做出决策。与一些不太复杂的牙科治疗相比,这对健康素养有要求。治疗决策可能更多地基于内在偏见和既往经验,而非客观概率。本文讨论了相关选项,并支持在牙髓治疗中进行有效的共同决策。