{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:41:12Z","timestamp":1787838072075,"version":"build-2784847793"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000272","name":"national institute for health research","doi-asserted-by":"publisher","award":["DRF-2015-08-052"],"award-info":[{"award-number":["DRF-2015-08-052"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthod"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> To determine the extent to which the current care pathway in hypodontia promotes shared decision-making (SDM). <\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p> Exploratory cross-sectional study using qualitative methods. <\/jats:p><\/jats:sec><jats:sec><jats:title>Setting:<\/jats:title><jats:p> Orthodontic department of two NHS teaching hospitals in Yorkshire. <\/jats:p><\/jats:sec><jats:sec><jats:title>Participants:<\/jats:title><jats:p> Young people aged 12\u201316 years with hypodontia of any severity and at any stage of treatment, and their parents and guardians. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> (1) Observation and audio-recording of interdisciplinary consultation in hypodontia clinics (n = 5) without any researcher interference; (2) short, structured interviews with young people with hypodontia (n = 8) and their parent (n = 8) using a topic guide to explore themes around decision-making. Audio-recordings were transcribed and analysed using a thematic framework. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Consultations were used as an opportunity for interdisciplinary discussion, information provision and treatment planning. Evidence of good communication was observed but patient engagement was low. The decision to be made was usually stated and treatment options discussed, but time constraints limited the scope for adequate information exchange and assessment of understanding. No methods were used to establish patient and family preferences or values. Interviews suggested parents expect the dental team to make decisions and young people rely on parental advocacy. Despite little evidence of SDM, participants reported satisfaction with their treatment. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> The current care pathway for hypodontia does not support clinicians in the steps of SDM. Recommendations for improving SDM processes include support to identify preference-based decisions, greater access to comprehensive and accessible patient information to enable preparation for consultation, alternative methods for effective communication of complex information and use of preference elicitation tools to aid value-driven decision-making. <\/jats:p><\/jats:sec>","DOI":"10.1177\/1465312519842743","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T19:04:20Z","timestamp":1557255860000},"page":"126-136","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Can the current hypodontia care pathway promote shared decision-making?"],"prefix":"10.1177","volume":"46","author":[{"given":"Sophy","family":"Barber","sequence":"first","affiliation":[{"name":"Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Pavitt","sequence":"additional","affiliation":[{"name":"Department of Translational and Applied Health Research, School of Dentistry, Professorial Suite, Clarendon Way, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Meads","sequence":"additional","affiliation":[{"name":"Department of Health Economics, Leeds Institute of Health Sciences, Clarendon Way, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balvinder","family":"Khambay","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Bekker","sequence":"additional","affiliation":[{"name":"Department of Medical Decision Making, Leeds Institute of Health Sciences, Clarendon Way, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,5,7]]},"reference":[{"key":"bibr1-1465312519842743","doi-asserted-by":"publisher","DOI":"10.1177\/2380084418761340"},{"key":"bibr2-1465312519842743","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2017.10.010"},{"key":"bibr3-1465312519842743","doi-asserted-by":"publisher","DOI":"10.1038\/bdjopen.2018.1"},{"key":"bibr4-1465312519842743","doi-asserted-by":"publisher","DOI":"10.1179\/14653121043119"},{"key":"bibr5-1465312519842743","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4147"},{"key":"bibr6-1465312519842743","first-page":"26","volume":"32","author":"Borrie F","year":"2014","journal-title":"British Orthodontic Society Clinical Effectiveness Bulletin"},{"key":"bibr7-1465312519842743","first-page":"19","volume":"21","author":"Borrie F","year":"2008","journal-title":"British Orthodontic Society Clinical Effectiveness Bulletin"},{"key":"bibr8-1465312519842743","unstructured":"British Orthodontic Society (2014) Where should I refer my patient? 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