Defining needs
Defining needs and shared decision-making
For any care plan to be successful, it must be tailored to a realistic assessment of the child’s ability to accept treatment and aim to increase the likelihood of behaviours that maintain or contribute to good oral health. In addition, the parent/carer’s support is essential in bringing their child for care and in supervising preventive interventions.
It is important that the child and their parent/carer are actively involved in decisions with respect to care, through the process of shared decision making.52 The shared decision-making approach acknowledges the importance of health and care conversations which involve both the dental professional, with their technical knowledge, skill and experience, and the child and their parent/carer, as they know the impact of their dental health on their life and future priorities. Fully discussing, explaining and supporting understanding of the treatment options before agreeing a proposed care plan also enables valid consent to be obtained.
Some children have needs which cannot be met in their usual place of care and may require referral. In such cases it is the responsibility of the clinician to follow their local referral policy and to work in partnership to provide shared care (see Referral).
The DECIDE model can be helpful in structuring good decision-making conversations and personalising care. Additionally, encouraging children and their parents/carers to feel empowered to seek further information by using the BRAN questions can be useful in supporting decision making.