Patients provide dentists and physicians with confidential dental, medical, and psychosocial information on the understanding that this information may be necessary for effective diagnosis and treatment and that the information will remain confidential and will be not released to other individuals without the patient’s specific permission. This information may also be entered into the patient’s record and shared with other clinical personnel involved in the patient’s treatment unless the patient specifically requests otherwise. Patients are willing to share such information with their dentists and physicians only to the extent that the patient believes that this contract is being honored.
There are also specific circumstances in which the confidentiality of clinical information is protected by law and may be released to authorized individuals only after compliance with legally defined requirements for informed consent (eg, psychiatric records, and confidential HIV-related information). Conversely, some medical information that is considered to be of public health significance is a matter of public record when reported to the local health authorities (eg, clinical or laboratory confirmation of reportable infectious diseases such as syphilis, hepatitis, or acquired immunodeficiency syndrome [AIDS]). Courts also have the power to subpoena medical and dental records under defined circumstances, and records of patients participating in clinical research trials may be subject to inspection by a pharmaceutical sponsor or an appropriate drug regulatory authority. Dentists are generally authorized to obtain and record information about a patient to the extent that the information may be pertinent to the diagnosis of oral disease and its effective treatment. The copying of a patient’s record for use in clinical seminars, case presentations, and scientific presentations is a common and acceptable practice, provided that the patient is not identifiable in any way.
Conversations about patients, discussion with a colleague about a patient’s personal problems and correspondence about a patient should be limited to those occasions when information essential to the patient’s treatment has to be transmitted. Lecturers and writers who use clinical cases to illustrate a topic should avoid mention of any item by which a patient might be identified and should omit confidential information. Conversations about patients, however casual, should never be held where they could possibly be overheard by unauthorized individuals, and discussion of patients with nonclinical colleagues, friends, family, and others should always be kept to a minimum and should never include confidential patient information.