Sir, since the global pandemic started teledentistry has been encouraged by many hospital trusts and dental practices. In the standard operating procedures for urgent dental care systems, it is encouraged to risk assess, triage and manage remotely via telephone or video link. It has also been hugely beneficial for patients and clinicians shielding, significantly reducing the number of people coming into care settings lessening the risk of COVID-19 transmission.

However, with many clinicians working from home and on personal devices it raises the question: how does our duty of confidentiality extend to protecting patient data when carrying out remote teledentistry and triaging? Undoubtedly clinicians will be aware of their duty both ethically and legally to make sure that clinical data are kept safely and securely when in a dental practice or hospital setting. Despite this, many clinicians will be unaware of how this extends to the use of personal devices, potentially leaving patient data and records vulnerable.

This leads to our second question: if patient data and records are stolen what is the clinician's liability for this and to whom would they then report this? Clear guidelines are needed on how to protect patient data and what clinicians' duties and responsibilities are regarding this matter. For example, is there a minimum level of software that our devices should have installed or should we have separate and secure devices purely for work purposes? Such guidelines are of great importance to help maintain the trust between the public and the profession, much of which stems from the duty of patient confidentiality.

Dr Len D'Cruz, Head of BDA Indemnity responds: Thank you to Drs Menhadji and Oberai for raising these important questions. The GDC together with other healthcare regulators have recently published High level principles for good practice in remote consultations and prescribing.1

This document makes it clear that patients can expect to have effective safeguards in place to protect them when they receive advice and treatment remotely. Safeguards are necessary whether the consultation happens as part of a continuing treating relationship or in a one-off interaction between a patient and a healthcare professional. The same obligations apply to any notes made by the clinician that explain and justify the decisions made during the consultation, regardless of it being provided face to face or remotely. At all times, there is a need to keep the patients' information secure, whether the records are held on paper or electronically. 2 This is already a familiar requirement of the dental practice environment that is normally facilitated by the use of commercial practice management software.

Security in the practice might involve encryption or password protection for documents stored on or sent from a computer. Remote consultations conducted from a dentist's normal practice allows the clinician to securely update the patient's record at the time of the consultation. Working from a remote location might require the clinician to make written notes which are subsequently transferred to the patient's electronic record held on the practice server. Unless remote access to the practice server has been organised, any written notes will require safe storage and/or anonymisation until they can be transferred manually at a later date.

The variety of available practice management software in use and the design of surgery networks as well as choices for cloud storage, means that practice owners should take professional advice from commercial providers to review the systems employed in running their business to ensure that they meet the principles adopted by the GDC for good practice in remote consultations and prescribing.

The use of teledentistry and remote working has been accelerated by the current pandemic and is likely to have a role in the future provision of dental services. By embracing the modifications adopted to stop the spread of disease, we also help to future-proof the business of dentistry since it is unlikely that COVID-19 will be the last pandemic we will experience.