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To investigate and compare the extent of shared decision making (SDM) in orthodontics from the perspective of patients, clinicians and independent observers. A cross-sectional, observational study. NHS teaching hospital. A total of 31 adult patients and their treating clinicians were included in the study. The extent of SDM in new patient orthodontic consultations was measured using three versions of a validated instrument the self-administered patient dyadic-OPTION scale; the self-administered clinician dyadic-OPTION scale; and an inde