Retention periods for patient records: How long do you as a dentist need to keep specific documents?

The essentials at a glance

• As a general rule, you must retain dental treatment records for ten years; X-rays of minors must be kept until they reach the age of 28.
• If multiple periods apply to a single document, the longest one always takes precedence – and in cases where liability risks are apparent, you should retain documents for up to 30 years.
• Digital archiving is permitted, provided your records remain legible, complete, and protected against unauthorised alteration throughout the entire retention period.

Nine years after an implant procedure, a letter from a solicitor lands on your desk. The former patient is accusing you of a failure to provide proper informed consent. You know for a fact that you provided detailed information at the time. But where is the signed consent form? Medically, you did everything right. Whether you can prove it depends on your archive.

A quick note on terminology: what you know as a "patient record" has been legally referred to as a "treatment record" since 6 February 2026. There has been no change in substance. The legislator primarily intended to avoid confusion with the electronic patient record (ePA). The ePA does not replace your own documentation, and your retention obligations remain unchanged.

Which regulations govern retention periods in a dental practice?

The periods are derived from several legal sources that apply concurrently. The basic ten-year rule is set out in the BGB, the professional code of conduct, and the Federal Mantle Agreement. Special rules apply to X-rays and certain other documents.

• Section 630f (3) BGB: You must retain treatment records for ten years after the conclusion of treatment for all patients, whether they are privately or state-insured. This period applies in the event of liability claims and requests for access.
• Professional code of conduct of your regional dental chamber: also at least ten years, as a minimum professional requirement
• Section 8 (3) BMV-Z: As a contracted dentist, you must also retain records for ten years for the benefit of the Association of Statutory Health Insurance Dentists (KZV) and health insurance funds, for instance for billing and efficiency audits or expert assessment procedures.
• Section 85 StrlSchG: Special periods for X-rays and associated records
• Section 147 AO: Deadlines for invoices, laboratory receipts and other tax-relevant documents

When does the retention period begin?

There is a detail here that many practices overlook. According to § 630f of the German Civil Code (BGB), the period begins when treatment is completed, whereas under the Federal Master Agreement (Bundesmantelvertrag), it only begins at the end of the calendar year in which the billing took place. If you finish a treatment in March 2026 and bill for it in the same year, the period for the KZV runs until 31 December 2036. Therefore, you should always calculate from the end of the year.

Which patient records must you keep and for how long?

For most dental treatment records, a retention period of ten years applies. There are exceptions, particularly for X-rays of minors, certificates of incapacity for work and records relating to narcotics.

What does a treatment file include?

Much more than just the file card entry: it also includes medical history forms, consent documents, declarations of consent, photos, and models for diagnostics and planning. Since the move to paperless billing, the original plans for dentures, jaw fractures and periodontal treatments also remain in your practice. This means the obligation to retain them lies entirely with you. You can read about how to structure a medical history form in a legally compliant way in our article on the medical history form for dentists.

There is, however, no obligation to retain working and duplication models from the dental technician. Before disposing of them, check whether a model was used for diagnostic purposes. If so, the ten-year period applies.

X-rays: What applies to adults and minors?

You must keep X-rays from dental examinations for ten years after the last examination; for patients under 18, this applies until they reach the age of 28 (§ 85 para. 2 StrlSchG).

You often read about 30 years. However, this period only applies to records of X-ray treatments, i.e. radiotherapy. In dental diagnostics, it remains ten years or the age of 28. Incidentally, the images remain your property: patients have the right to view them and receive a copy, but not to the originals.

Tax-relevant documents

Patient invoices and laboratory invoices are governed by the Fiscal Code (Abgabenordnung), with the retention period for accounting vouchers having been reduced from ten to eight years as of 2025. It is best to clarify with your tax advisor which specific documents fall under this category. You can read more about this in our article on the Medical invoice.

Why are ten years not always enough?

Ten years is the minimum period, not the upper limit. Claims for damages due to injury to body or health are subject to a limitation period of 30 years under Section 199 (2) of the German Civil Code (BGB). Furthermore, under Section 630h (3) BGB, it is presumed that you failed to take a necessary measure if it was not documented or if the file was not kept in accordance with regulations. Without documentation, you must prove the opposite.

You should therefore extend the retention period in the following cases:

• Complications or complaints: up to 30 years in the event of an unexpected outcome or expressed dissatisfaction
• Ongoing proceedings: Never destroy documents from legal, expert, or administrative proceedings, even after the retention period has expired
• Minor patients: analogous to the X-ray rule, at least until the age of 28
• Extensive treatments: problems with implants, major prosthetics, and orthodontics often only appear at a later stage

However, you can only retain what has been recorded in the first place. This is exactly where the Nelly AI documentation comes in: it captures medically relevant content during the patient consultation and provides you with a structured draft for you to review and approve. This ensures that informed consent discussions are fully documented in the file, rather than just being noted in bullet points between two treatments.

Find out more here: https://www.getnelly.de/ki-assistenz#ki-dokumentation 

What applies in the event of a practice sale, practice closure, or the death of a patient?

The obligation to retain records does not end with the closure of a practice or the death of a patient. You remain responsible until the period has expired – even in retirement.

When handing over a practice, you cannot simply pass patient records on to your successor, as professional confidentiality also applies to colleagues. The "two-cabinet model" has proven effective: the successor keeps the old records separate and only accesses them once the patient has given their consent. Set out the details in the handover agreement and coordinate with your professional chamber. If you close your practice without a successor, you are responsible for the storage of records yourself; for X-ray documents, the authorities may require them to be deposited elsewhere.

Are you allowed to archive patient records digitally?

Yes. Under Section 630f (1) of the German Civil Code (BGB), you may maintain treatment records in paper or electronic form; the retention periods are the same. The crucial factor is that the records remain legible, complete, and unaltered throughout the entire period.

Paper archives, on the other hand, cost space, require climate-controlled rooms, and take time to search. Every request for access ties up staff resources – and since 6 February 2026, patients have been entitled to the first copy of their treatment records free of charge.

What does "audit-proof" actually mean?

"Audit-proof" is not a legal term, but it accurately describes what is required. Section 630f BGB and Section 127 of the Radiation Protection Ordinance (StrlSchV) establish four requirements:

• Availability: Data must be retrievable and legible within a reasonable time, even after changing practice software.
• Immutability: Information must be protected against alteration and loss.
• Traceability: Subsequent changes must remain identifiable, including the time and the person who made them.
• Association: Patient data, findings, and image data must remain permanently linked.

Destroying paper records after scanning is generally permitted, but not without risk: in court, electronic copies are subject to the judge's free evaluation of evidence. The KZV Nordrhein considers the correspondence with the original to be guaranteed only with a qualified electronic signature according to eIDAS. If you are scanning to replace paper originals, follow the BSI's TR-RESISCAN technical guideline and document the scanning process. In cases of doubt, keep liability-relevant originals, such as signed consent forms, as a precaution.

It is easier if documents are not created on paper in the first place. With the digital patient intake from Nelly your patients can fill out medical history, information, and consent forms digitally before their appointment and sign them electronically. The data flows directly into your practice software. Scanning, typing, and piles of paper at the reception desk become a thing of the past.

Find out more here: https://www.getnelly.de/patientenaufnahme 

What must you do once the retention period has expired?

Once the period has expired, you must delete or destroy patient data. During the retention period, the obligation to retain data takes precedence over the right to erasure under Article 17 of the GDPR; thereafter, the legal basis for storage no longer applies. Simply keeping everything is not a secure solution, but neither is careless destruction.

• Paper records: Use a shredder with the appropriate security level according to DIN 66399 or a certified disposal company that provides a certificate of destruction.
• Analogue X-ray films: are not classified as medical waste and must be handled by specialist disposal companies.
• Digital data: must be deleted in such a way that they cannot be recovered, even from backups.
• Proof: document every destruction process, including the date, scope, and the person responsible.

How do you organise retention and deletion in your practice?

A structured process prevents two things: documents disappearing too soon and documents being kept indefinitely.

1. Take stock: Clarify which documents are stored where – paper archives, practice management systems, old servers, X-ray systems. You will often find data from previous practice software that no one is aware of anymore.
2. Create a retention schedule: Define the retention period and start date for each type of document. The table in this article is a good starting point, supplemented by the recommendations of your regional dental association (KZV) and chamber.
3. Assign responsibility: Appoint a person to coordinate storage and destruction, and document in your quality management manual who is responsible for initiating deadline extensions in liability cases.
4. Schedule an annual deletion date: Since most retention periods begin at the end of the calendar year, a fixed date in the first quarter is ideal. Use this time to check which documents have expired and ensure any exceptions are secured beforehand.

Conclusion: A clear schedule of retention periods provides your practice with double the protection

Retention periods for patient records protect you against liability risks while simultaneously preventing data protection breaches caused by keeping records for too long. With a fixed schedule, a designated person in charge, and an annual deletion date, you can keep on top of the matter. The more digital your documentation process, the less time you lose in the archives – and the more time you have for your patients.

Find out more with no obligation

Find out in a personal consultationhow Nelly can streamline your documentation from patient intake to record-keeping. 

FAQs on retention periods in dental practices

How long must a dentist keep X-rays? 

In accordance with Section 85 (2) of the Radiation Protection Act (StrlSchG), you must keep X-rays from dental examinations for ten years after the last examination. For patients under 18, the period applies until they reach the age of 28. The frequently cited 30-year period only applies to X-ray treatments, i.e., radiotherapy.

Do I have to continue keeping patient records after closing my practice? 

Yes. The obligation to retain records does not end when you close your practice and also applies to deceased patients. When handing over a practice, you cannot simply pass on the records due to patient confidentiality. The "two-cabinet model" has proven effective, where old records are stored separately and only accessed with the patient's consent.

Can I destroy paper records after scanning them? 

In principle, yes, as Section 630f of the German Civil Code (BGB) permits electronic record-keeping. The scan must be complete, permanently legible, and protected against unauthorised changes. Since electronic copies are subject to free judicial evaluation of evidence in court, you should keep the originals of any liability-relevant documents if in doubt.