Informed Consent Comprehension and Recollection in Dentistry: A Systematic Review

Objectives: To assess available evidence on adult dental patients’ comprehension and recollection capabilities of information presented during informed consent processes related to their treatment choices.
Methods: OvidSP Medline, PubMed, Cochrane Library, Embase, LILACS and Web of Science were screened up to April 2015. A partial grey literature search was performed using Google Scholar as well as a hand search and crosschecking of reference lists.
Results: 19 studies were included: 5 randomized clinical trials, 8 cross-sectional, 3 qualitative, 2 mixed-methods and 1 case series. Some studies included additional media as adjuncts to enhance informed consent processes. Conventional informed consent processes yielded comprehension results of 27% to 85.2% and recollection of 20.19% and 85.6%, while enhanced IC processes ranged from 43.96% to 92.6% for comprehension, and from 30% to 93.6% for recollection. Patient self-reported understanding ranged positively with most patients feeling that they understood all or almost all the information presented. Qualitative data analyses indicated that patients did not always understand what was explained, although dentists had thought they did. Previous treatment makes patients feel that they already understood what was to be explained. Some of them firmly stated that they did not receive any information. Only a few patients were able to remember complications related to their treatment.
Conclusions: Overall, patients feel that they understand the information given to them; however, this is not always the case. Patients’ understanding and recall ranged widely, but seemed to increase when aiding tools were added to improve the process.