Abstract For an evidence-based dental practice, shared decision making is made possible using an intuitive or analytic approach in reconciling best evidence and patient characteristics and preferences. Decision trees assist the dentist when presenting conditions and patient values are less certain in recommending treatment modalities whose benefits and harms are variable or unknown. Using clinical practice guidelines (or protocols organized within a decision tree), best evidence, based on the “average patient”, is integrated into the decision tree. Probability, utility, and economic data are calculated and analyzed in providing the patient with informed and individualized choices of care. Evidence-based decision making results in a process in which an individual patient is informed of the best available evidence and all relevant options. The outcome of the process is that patient utilities and cost concerns are fully addressed in optimizing the clinical decision.