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Shared Decision-Making Theories, Conceptual Models, and Frameworks Within Oral Healthcare: A Theory Analysis
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Gothenburg University, Sweden, Region Västra Götaland, Vänersborg, Sweden.ORCID iD: 0000-0002-9739-2287
University of Ottawa, Canada. Ottawa Hospital Research Institute, Canada.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karolinska Institute,Sweden, Academic Centre for Geriatric Dentistry, Stockholm, Sweden.ORCID iD: 0000-0003-0939-802x
University of Ottawa, Canada. Ottawa Hospital Research Institute, Canada.
2026 (English)In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective To appraise the quality of theories, conceptual models, and theoretical frameworks about SDM for oral healthcare practices.Background Shared decision-making (SDM) is crucial to person-centred care. Yet little is known about how (and if) patient engagement in SDM is conceptualised in oral healthcare.Methods We conducted a theory analysis of theories, conceptual models, and frameworks. We searched Medline, Scopus, and CINAHL. Eligible theories/conceptual models/frameworks had to specifically focus on SDM in oral healthcare. Eligible papers were analysed using Walker and Avant's theory analysis steps and mapped onto the 8 core elements of SDM.Main Findings Of 195 citations, two conceptual models specific to oral healthcare were identified. The SDM System on Dental Restorations (SDMS-DR; South Korea) focuses on decisions between dentists and patients about restorative treatment. The Four + one Habits Model for dental visits (4 + 1 HB; Norway) is an approach for SDM across oral healthcare decisions, more broadly. Both conceptual models focus on the patient-professional encounter and met 4 (SDMS-DR) and 6 (4 + 1HB) of the 8 core elements of SDM. The SDMS-DR provided no reference to the patients' expertise. The 4 + 1HB presented SDM as a standardised linear process rather than a dynamic process. Neither has been empirically tested, and they do not acknowledge the broader healthcare system within which the encounters take place.Conclusion We identified two conceptual models that incorporated some elements of SDM for oral healthcare. Neither was evaluated, and both focus exclusively on the patient-oral healthcare professional encounter, without consideration of intersectional, multidisciplinary healthcare services.

Place, publisher, year, edition, pages
2026.
Keywords [en]
conceptual models, oral health, person-centred care, shared decision making, theory analysis, QUALITY-OF-LIFE, ASSOCIATION, PERIODONTITIS, PREFERENCES, DISEASES, INFORM
National Category
Oral Health
Research subject
Dental Hygiene
Identifiers
URN: urn:nbn:se:kau:diva-109884DOI: 10.1111/idh.70074ISI: 001742244600001Scopus ID: 2-s2.0-105035877285OAI: oai:DiVA.org:kau-109884DiVA, id: diva2:2055735
Available from: 2026-04-27 Created: 2026-04-27 Last updated: 2026-05-05Bibliographically approved

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Persson Kylén, JessicaWårdh, Inger

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