Abstract
Record-keeping is an essential part of clinical dental practice, having a direct relationship to patient safety and patient care. This study assesses the quality of record-keeping of 134 GDPs against 14 Clinical Governance standards. GDPs using computerized record systems showed statistically significantly (
In particular, the recording of medical history, soft tissues assessment, periodontal assessment and radiograph clinical evaluation is shown to be suboptimal and this could have potentially serious adverse effects on patient safety and patient care.