Background <p>Informed consent is a process by which a patient can understand all the aspects of the treatment, including procedures benefits, potential risks, advantages, disadvantages, and purpose of treatment and alternative treatments. Informed consent assists the patient to make an informed decision whether to accept or refuse treatment.</p> Methods <p>A cross-sectional, non-probability online survey study that targeted adult dental patients with previous dental experience in the Eastern province of Saudi Arabia. An online survey using Survey Monkey was sent through social media platforms including Twitter, Instagram, Facebook and WhatsApp.</p> Results <p>Seven hundred and thirteen (713) individuals responded to the survey. This was a 25% response rate. Of respondents, 585 (82%) had previous dental treatment and were included in analyses. Around 50% of responded reported they were always informed of the risks, understood the risks, were informed of the alternative treatment options and understood these alternatives. Most responded were rarely or never been informed of specific complications or risks prior to root canal treatment (possibility of instrument breakage 85% of, perforation 77%) or tooth extraction (possibility of tooth fracture 92%, temporary nerve damage 91%, or dry socket 71%). Patients treated in private clinics had 3.6‑fold higher odds of not signing consent compared to those treated in government clinics (OR = 3.58, 95% CI: 2.55–5.04). Older age (&gt; 28 years) was also a significant predictor, with 1.4–fold higher odds of rarely/never signing (OR = 1.40, 95% CI: 1.02–1.92).</p> Conclusions <p>The findings suggest that the quality and use of informed consent practices in dental settings in Saudi Arabia vary considerably. These findings suggest potential gaps requiring further evaluation, procedure-specific consent protocols to align with national and international standards.</p>