Chapter 20A: Shared Decision-Making — Including Your Child in the Process

Orthodontic treatment is unusual among pediatric healthcare decisions in that it often spans years and requires daily cooperation from the child themselves — wearing an appliance, maintaining hygiene, attending appointments. Because of this, involving your child in the decision-making process, to a degree appropriate for their age, tends to produce better outcomes than presenting treatment as something simply decided on their behalf.

For Younger Children

Full decision-making authority isn't appropriate at six or seven, but even young children benefit from feeling heard — asking "does anything feel uncomfortable right now?" or "what questions do you have for the doctor?" during appointments helps build a sense of participation without overwhelming them with adult-level decisions.

For Older Children and Teenagers

By the interceptive and especially the comprehensive stage, most children are old enough to meaningfully weigh in on decisions like appliance appearance, and are old enough to understand basic tradeoffs ("aligners are less visible, but only work if you actually wear them enough each day"). Teenagers in particular respond far better to feeling like an informed participant in their own treatment than to feeling like treatment is simply happening to them.

A teenager who helped choose their treatment approach is, in practice, far more likely to follow through with wear-time and hygiene instructions than one who feels the decision was made entirely without them.