Patient-reported outcome measures and shared decision-making in contemporary dentistry: a narrative review

Patient-reported outcome measures have moved dental evaluation beyond clinician-assessed endpoints toward outcomes that patients themselves experience, and shared decision-making has extended consent beyond the signature toward genuine deliberation. This narrative review synthesizes the current evidence on how patient-reported outcomes support shared decision-making in contemporary dentistry, the instruments available, and the barriers that condition their routine use. A transparent search of PubMed, OpenAlex and Crossref, restricted for the core literature to the years 2019 to 2026, was organized into five thematic axes: conceptual and measurement foundations, patient-reported instruments across dental disciplines, shared decision-making models and decision aids, integration of patient-reported data into shared decisions and its association with outcomes, and barriers, enablers and digital delivery. The synthesis shows that oral health-related quality of life instruments, led by the Oral Health Impact Profile family, are mature and widely validated, and that condition-specific measures and core outcome sets are consolidating in implant, periodontal, endodontic and orthodontic care. Shared decision-making is advocated across specialties, but patients and clinicians report divergent expectations and decision aids remain scarce. Evidence linking routine patient-reported measurement to better decision quality or clinical outcomes is still limited, although implant and prosthodontic studies report substantial quality-of-life gains. Time, training and interpretability remain the main barriers, while electronic capture and implementation-science frameworks are the main enablers. Dentistry has the instruments but not yet the routine infrastructure to connect them to shared decisions.