18 August 2009
Q. I am running out of space. Where and how do I keep my records?
This is a situation that Dental Protection is regularly asked about. It can be a real problem, particularly where study models and working casts are concerned. Orthodontic practices face a particular problem in this respect, especially because of the extended length of time that records need to be kept when treating children.
It is important to be aware of the legal factors affecting the requirements for retaining records in whichever jurisdiction(s) you work, if you are to ensure that they are to be accessible if the need should ever arise
There is a view that working casts and models from routine crown and bridge work could be given to the patient for safe keeping and a note made in the dental records that this has been done. If they are presented to the patient in a protective model box, the patient is more likely to look after them and indeed bring them back the next time any crown and bridge work is planned. Having such study models available may also be useful if endodontic treatment is required after the placement of a crowns or a bridge because it allows the clinician to visualise the original angulation of the tooth and to plan the site for the access cavity.
While this approach can relieve an acute storage problem, the fact remains that the clinician loses control over what could prove to be a critically important part of the total record. In general, the best advice is to retain as much as you can for as long as you can.
Off-site storage is one solution to storage problems. This might be as simple as a lock up garage or a domestic basement or loft. The problem with these locations - apart from any cost involved - is the risk of theft, damage and attack from the elements. Retrieval may also be problematic unless the contents of the containers are accurately indexed. Where paper records are concerned, storage in sealed plastic containers will prevent damage from water and damp but not fire unless, there is a sprinkler system installed.
Commercial storage is available both for paper records and x-rays, artefacts such as working casts and study models as well as electronically stored data. These archiving facilities vary in cost depending on what is being stored and how frequently or urgently requests to access the records are likely to be made. These facilities, whilst more expensive, should be more secure than a loft or garage.