Orthodontic Records UK: What Treatment Records Include and Your Rights

What are orthodontic records?

Orthodontic records are the diagnostic documentation an orthodontist collects before starting treatment planning. They provide a complete baseline picture of your teeth, jaws, facial profile, and bone structure at a single point in time — information that cannot be obtained from an examination alone.

Records serve several purposes: they allow the orthodontist to plan treatment precisely, calculate tooth movements, assess risks (such as roots near nerves or thin bone), monitor progress during treatment, and provide a legal and clinical baseline.

Types of orthodontic records

Are X-rays safe?

Orthodontic X-rays use very low doses of radiation. An OPG exposes the patient to approximately 0.01–0.025 mSv — comparable to a day or two of natural background radiation. A lateral cephalogram is similar. Modern digital X-ray systems use even lower doses than older film-based machines.

The GDC and NHS require that X-rays are only taken when clinically justified — your orthodontist will not take X-rays unless they are necessary for diagnosis or treatment planning. If you are pregnant, inform your orthodontist before any X-rays are taken.

Can you start orthodontics without X-rays?

No — starting orthodontic treatment without appropriate X-rays is a significant clinical risk and falls below the expected standard of care. X-rays reveal root lengths, unerupted teeth, bone levels, and other factors that are essential to safe treatment planning. Any provider who offers to start treatment without radiographs should be treated with caution.

Can you get copies of your records?

Yes. Under UK GDPR, you have the right to request copies of your dental records, including X-rays and photographs. This is useful if you are changing orthodontist mid-treatment, seeking a second opinion, or moving abroad. A Subject Access Request is normally free and must be answered within one month; a fee is only allowed if a request is manifestly unfounded or excessive. Write to the practice manager, say you are making a Subject Access Request under UK GDPR, give the approximate treatment dates and list what you want, such as clinical notes, radiographs, photographs and scan files. You do not need to give a reason, though the practice may ask for proof of identity. If it refuses or misses the deadline, you can complain to the Information Commissioner's Office (ICO).

Why records matter beyond diagnosis

Records also include periodontal charting and contemporaneous clinical notes covering your concerns, the diagnosis, the treatment plan, consent discussions and progress at each visit. Sequential records let the orthodontist compare tooth movement against the plan and spot problems such as root resorption early. They are also the medico-legal record: GDC standards require accurate contemporaneous notes, and in a complaint they show that you were assessed properly and gave informed consent.

Records when moving practice mid-treatment

If you move orthodontist partway through treatment, your records are the handover document. The new practice needs clinical photographs, the current OPG and any other radiographs, the original treatment plan, progress notes and ideally a recent scan. The original practice cannot withhold records because fees are outstanding. The new orthodontist may still retake photographs and a scan, but will usually accept a good-quality OPG taken in the last twelve to eighteen months rather than repeat the radiation dose.

How long are orthodontic records kept?

There is no single statutory retention period for dental records in the UK. Guidance from the British Dental Association and dental defence organisations recommends keeping them for at least eleven years after the last entry for adults, and until the patient's 25th birthday (or eleven years, if longer) for those treated as children, which reflects the time limit for negligence claims. Many practices now keep digital records indefinitely, which matters because relapse or root changes can appear years after braces come off.

Photos versus a full set of records

Guided photos are useful for an initial remote assessment and a rough idea of likely options and cost, but they cannot show roots, bone levels, unerupted teeth or gum health. A photo-based quote is an early indication; the confirmed plan and price come after X-rays, a scan and a clinical examination, and they can change once those records are reviewed, for example if extractions are needed or aligners are ruled out.

Questions to ask about records

Before booking, ask which records are included in the consultation fee, whether each X-ray is clinically necessary, whether you will receive copies, how long records are kept, whether scans can be shared digitally with another clinician, and whether the quote may change once the records have been reviewed.