Why Your Dental Records Should Follow You

Access to your records can be key to getting the best oral health care

Let's say you're happy at your local dental office, and don't anticipate things will change… but one day your dentist announces that she is going to retire. Or maybe a job transfer takes you to a new city where you don't know anyone. Under these circumstances, you will need to begin seeing a new dentist. Will your past dental records follow you to the new dental practice?

Good question. In fact, many people wonder why those old records are needed — isn't a new chart created for every new patient? Of course, it is a dentist's professional and legal obligation to maintain a record of your visits to the dental office — and if you don't transfer your records, the dentist must start from scratch. But if you want to receive the best care possible, you should make sure your new dentist has your complete health history, which must include your past dental records.

A Unique "History"

Your dental record, or patient chart, is the official document in the dentist's office that maintains a history of all office visits, diagnoses, treatment plans, procedures and communications between you and your dentist. It contains your past x-rays and information about all treatments you have received, such as fillings, crowns and bridges, along with the type of material used. If your new dentist doesn't have your chart from your previous dentist, he or she must depend on what can be deduced by looking at your mouth and talking to you. And that may not be the best way to get detailed information.

Without written records, your newly created patient chart will rely on your memory; you'll need to recall names and dates of present and past symptoms, procedures, medications and recommendations. And let's face it, how many people can describe exactly when they first noticed a certain symptom, how it progressed, when they saw the dentist about it, and how it was treated — especially when they don't have a background in the science of dentistry?

Accurate records can save you time and money, and spare you discomfort; for example, you may be able to avoid retaking x-rays or undergoing diagnostic procedures for a problem that has already been evaluated at a different dental practice.

These details are important because factors that affect treatment decisions often go beyond a dentist's observation of your oral cavity at the moment. To best manage your treatment, it's important for your dentist to know your history going back several years. A record of past fillings and crowns, for instance, can give a clue to future treatments you might need. Likewise, a record of your past x-rays will let a new dentist know of existing concerns and allow him or her to monitor changes over time. While having x-rays taken every three years may be fine for some dental patients, others need new x-rays more frequently because of their individual history and risk of cavities or periodontal disease. Accurate records can save you time and money, and spare you discomfort; for example, you may be able to avoid retaking x-rays or undergoing diagnostic procedures for a problem that has already been evaluated at a different dental practice.

Dental Records Aren't Just About Your Mouth

Keeping a written record of your oral health is only part of the issue. When you go to a new dentist, you will likely be asked to fill out a full medical history, including the medications you take. That's because, as more and more research shows, your entire body — including your mouth — is an interrelated system. Hundreds of medications have side effects that appear in the mouth. Moreover, some medications preclude the use of certain types of anesthetics to numb your teeth before treatment. Dentists have long known that the health of your whole body is reflected in your oral health; that's why we may be the first to detect conditions like diabetes, anemia and cardiovascular disease. In all, the World Health Organization lists more than 120 diseases that show signs in the oral cavity, including cancers, eating disorders and autoimmune diseases.

The treatments your dentist recommends may also depend on your specific health condition. For example, dental work that causes the mouth to bleed may pose a risk for heart patients, since bacteria from inside the mouth can travel through the bloodstream to the heart. If your dentist is aware of a heart condition, antibiotics may be prescribed prior to dental treatment. When it comes to finding specific information about your health, medical and dental records are the best sources.

Case Studies

If you're still not convinced about the importance of dental records, here are two scenarios that show how they can help your dentist make an optimal treatment recommendation.

Imagine that a new patient comes in with severe periodontal disease, an advanced form of gum disease. This may have happened because early gum disease (gingivitis) was not treated. With advanced periodontal disease, the bone that supports the teeth can begin to deteriorate. In our scenario, x-rays reveal that the patient has 50 percent loss of the periodontal bone. There are different ways to treat periodontal bone loss — but in order to choose the best course of action, the dentist must know a patient's history.

When bone loss is this severe, it makes a difference whether it occurred quickly or gradually, and whether the bone loss is recent, and still progressing — or whether it happened long ago and is now stable. By consulting your detailed dental records, your dentist will know whether to treat the condition conservatively, or to consider a more aggressive approach. When appropriate (and with your permission), more information can be gathered via a phone conversation or letter sent to your prior dentist. If the bone loss has been stable for 20 years, your dentist will make a very different treatment recommendation than if it was a recent and more dramatic occurrence.

In addition, a variety of underlying conditions may have an effect on periodontal bone loss. These include smoking, drug or alcohol use, stress and diet. In this case, a complete, updated medical history can be critical to a diagnosis and treatment. Since periodontal disease has some genetic risk factors, a family health history can also help your dentist diagnose and treat your periodontal disease.

In another scenario, a patient may come in with a failing dental implant. Although dental implants have a very high success rate, there are occasional problems. Some failures are due to an infection of the gums called peri-implantitis. In rare cases, old implants may fracture or, more commonly, require replacement of the tiny screw that attaches the parts together.

All the details about your specific dental implant — including its size, model and manufacturer — should be included in your dental chart. With this information, your dentist has the best chance to find a solution to your problem.

Getting Your Records Transferred

Who controls your dental records? Federal HIPAA (Health Insurance Portability and Accountability Act) regulations and individual state laws ensure that you have a right to your own medical records, including dental records. Here are answers to some common questions about transferring your dental records to a new practice:

• Do my dental records belong to me?
  Your dental records are actually the property of your dentist, but you are entitled to look at them and get a copy of them.
• Do I have to pay to get my records transferred?
  Your dentist may charge a fee to cover the cost of copying and sending your records to a different office. According to HIPAA regulations, the fee should be limited to the cost of labor (employee time for printing out or copying the records), supplies and postage.
• Can I have records sent directly from my old dentist to my new dentist?
  Yes! It will most likely be faster and even less expensive to have your chart directly transferred from your old dentist to your new dentist. And with many dental offices moving to electronic records, it is becoming easier to transfer records.
• What if I feel awkward about telling my old dentist that I want to change dentists?
  Your new dentist can request your dental records provided that you sign a release. This is generally a faster and more efficient way to transfer records anyway.
• What if I owe money at my old dentist's office? Can I still get my records?
  Your old dentist's office cannot refuse to transfer your records because of an unpaid balance. But remember, the office may charge a fee for copying and sending your records.
• How long do I have to get my records?
  HIPAA regulations require that dental offices keep patient records for six years — longer for minors. However, it's a good idea to have your records transferred as soon as possible to give your new dentist access to information that can help with diagnosis and treatment.

Now It's Up To You

Your dental records can be the key to an accurate diagnosis and treatment plan. You can help your dentist deliver the highest level of care by providing access to the important information contained in those records. It's your responsibility to request that your previous dental records be transferred to a new dentist. Do your part to ensure you receive the best care possible by making sure your dental records follow you wherever you go.