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OpenNotes may improve treatment adherence and shared decision-making in dental practice based on medical analogiesOpenNotes Could Improve Patient Engagement in Dental Care

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Key Takeaway
Note that OpenNotes may improve patient engagement in dentistry, but findings are currently based on medical analogies.

This narrative review explores the potential of OpenNotes, which provides patients with access to clinical notes through electronic health records, as a strategy to improve engagement in dental practice. The scope of the review focuses on how note sharing might influence treatment adherence, shared decision-making, and patient empowerment.

The authors synthesize evidence from the medical field to suggest potential benefits for dentistry. They argue that while medical evidence suggests positive outcomes for patient empowerment, these findings are based on analogy rather than direct dental evidence. The review notes that the benefits for dental patients remain hypothetical and require empirical testing to confirm.

Several barriers to implementation are identified, including procedure-centric documentation, specialized terminology, fragmented electronic health record adoption, and privacy regulations. The authors note that successful integration would require documentation standardization, clinician training, and infrastructure improvements. Because no primary studies specifically addressing OpenNotes in dentistry were identified, the clinical certainty of these outcomes is low.

This review looks at OpenNotes, a system where patients can see their clinical notes in electronic health records. While the review focuses on the dental field, it notes that there are currently no direct studies specifically testing OpenNotes in dental practices. Instead, the authors used existing medical evidence to suggest how it might work for dental patients.

Based on these medical comparisons, sharing notes could help patients feel more empowered and involved in their care. It may also lead to better adherence to treatment plans and more shared decision-making between the patient and the dentist. These benefits are currently considered hypotheses rather than proven facts for dentistry.

There are several hurdles to making this work in dental offices. These include complex medical terminology, the need for standardized documentation, and strict privacy regulations. Because the evidence is based on analogies from other medical fields, the actual impact on dental patients is not yet confirmed. Patients should talk to their dental providers about how they share information.

What this means for you:
OpenNotes may improve patient engagement in dentistry, but more direct research is needed to confirm these benefits.

Common questions

What is OpenNotes and how does it work?

OpenNotes is a system that allows patients to access their clinical notes through electronic health records. In this review, it is discussed as a potential strategy to increase patient engagement. By seeing their notes, patients may feel more empowered and involved in their own dental treatment plans.

Can OpenNotes improve dental treatment results?

The review suggests that sharing notes may improve treatment adherence and shared decision-making. However, these benefits are based on medical evidence rather than specific dental studies. Because of this, the benefits for dental patients are currently considered hypotheses that need more testing.

What are the challenges of using OpenNotes in dental offices?

Several barriers exist, including the use of specialized terminology, the need for standardized documentation, and strict privacy regulations. Additionally, dental practices may face challenges with fragmented electronic health record adoption and the need for specific clinician training to implement the system correctly.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Patient engagement is increasingly recognized as a cornerstone of high-quality, patient-centered care. Although the OpenNotes initiative, which gives patients direct access to their clinical notes through electronic health records, has demonstrated significant benefits in medicine, its application in dentistry remains largely unexplored despite the elective and decision-intensive nature of dental care. This targeted narrative review was informed by a PubMed search conducted on March 26, 2026, using the terms (“OpenNotes” OR “shared clinical notes” OR “patient access to records”) AND (“dentistry” OR “dental”), which identified 12 articles and no studies directly addressing OpenNotes implementation in dental practice. Consequently, the anticipated benefits for dentistry are derived by analogy with medical evidence and should be regarded as hypotheses requiring empirical testing rather than established findings. We examined the potential of OpenNotes as a patient engagement strategy in dentistry, including its benefits, the structural and technical barriers unique to dental documentation, and the enabling role of emerging technologies such as artificial intelligence and teledentistry, and found that, based on evidence from medical OpenNotes programs, note sharing may improve treatment adherence, shared decision-making, and patient empowerment in dentistry as well, although important barriers remain, including procedure-centric documentation, specialized terminology, fragmented electronic health record adoption, and privacy regulations; overall, OpenNotes appears to hold substantial promise for enhancing patient engagement in dentistry, but realizing this potential will require coordinated efforts in documentation standardization, clinician training, technology infrastructure, and regulatory compliance, with pilot implementation in academic dental institutions representing a pragmatic first step toward building an evidence base for broader adoption.
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