Dental before-and-after images: a permission register
Track dental image purposes, permission evidence and published versions. Keep clinical records, consultation examples and marketing uses distinct.
Published by Dr Sim Raiyat
Clinical Director, Dentorb — Private General Dentist
A dental image register should tell an authorised person which image may be used, for what purpose and where that decision is recorded. Permission for a clinical record, a consultation example and a public advert should not be treated as one automatic approval.
The GDC's patient-information standards cover photographs and other recordings, including copies and images on phones. They require explanation, patient permission and appropriate records for image use. Agree the actual process with your clinical and information-governance leads before building the register.
Separate the purpose from the file
| Intended use | Question to resolve before use |
|---|---|
| Clinical documentation | How is the image kept with the appropriate patient record? |
| Restricted consultation library | What use was explained and permitted, and who may see it? |
| Staff learning | Does the proposed audience and purpose match the permission and safeguards? |
| Website, social post or advert | Is this exact public use and presentation approved? |
This table is a review aid. It does not provide a consent form or select a data-protection lawful basis for your practice.
Identifiable images showing someone's treatment or health can involve health data. The ICO's special-category guidance explains the extra protection for health information. A signed permission form does not remove the need to assess the applicable data-protection requirements.
Record the decision and the approved version
| Field | What to record |
|---|---|
| Image or case ID | Stable internal reference with an appropriately restricted link to the patient |
| Proposed purpose and audience | Exact intended use, not just “marketing” |
| Permission evidence | Location of the relevant patient information and recorded decision |
| Approved version | File or export reference, including crop and caption where relevant |
| Restrictions and review | Any limits, unresolved questions or change triggers |
| Release record | Actual date, destination and supplier where shared |
| Action owner | Who investigates changes or stops an unclear release |
Keep patient names and other unnecessary identifiers out of public filenames. Restrict the link between the internal case ID and the patient. Keep original clinical images under the appropriate clinical-record arrangements; an edited marketing export is a different version serving another purpose.
Worked example: a consultation image becomes a social post
Illustrative case: a practice has permission to use an image in a restricted consultation library. An agency later chooses it for a public social post.
The proposed post waits while the practice checks whether that use was explained and agreed. The reviewer checks the image, caption, audience and relevant record. If approved through the appropriate process, the register identifies the exact export and destination. If the evidence is unclear, the calendar slot remains unfilled.
Removing a name does not prove anonymity
A case number, mouth crop or stripped metadata can reduce identifying detail without making identification impossible. Context, other images or information held separately may still connect the file to a person.
The ICO distinguishes anonymous information from pseudonymous personal data: replacing a direct identifier with a reference can leave the information identifiable through other information. Read its anonymisation explanation. Avoid describing a whole library as anonymous without an appropriate assessment.
Check the presentation as well as permission
Ask the clinical reviewer whether the selected before-and-after pair, framing and caption give a fair impression. Avoid edits that misrepresent the outcome or wording that suggests every patient will achieve it. The GDC's advertising guidance requires accurate information that does not mislead patients.
Keep a record of changed permissions and published copies
When a patient raises a concern or withdraws permission, route it promptly to the appropriate lead. Find where the image was used, review the required action and record what was done. Do not promise that deleting one local file removes every copy already shared online.
If an agency has the export, include it in the follow-up. Permission checked, approved for release, actually published and removed are separate states.
Dentorb's image-library page describes tagged cases, consent records and consultation views. Ask to see purpose restrictions, version history and changed permissions in a demonstration. Connect an approved release to the social workflow only after those checks; a shared library is not an automatic licence to publish.
For the wider file structure, use the practice folder guide. Clear storage helps retrieval, but the purpose and permission decision must remain visible wherever the image goes.
