Dental referral letters and AI confidentiality: what a specialist referral gives away in ChatGPT or Claude.

A general dentist writes a referral letter whenever a tooth needs an endodontist, a periodontist, an oral surgeon or an orthodontist, and the letter has to be clear to a busy specialist. That is why it is often pasted into ChatGPT or Claude to be tightened or reordered. It carries the patient’s identity, the history of the tooth, the medical conditions and medications that matter, the radiographs enclosed and often a line about what the patient wants or can afford. This page marks every item in a routine referral that the Privacy Act and the Dental Board’s Code of conduct bear on, and shows how the same letter is drafted on Ermos inside the practice.

The specialist referral letter

Sent when a general dentist asks a specialist to see a patient. Section 4.2 of the Code of conduct (item 6) asks practitioners to inform patients of the benefits as well as the associated costs or risks when referring them for further investigation or treatment.

An invented referral. The practices, dentists and patient are fictional; the phone number, file names and provider number are placeholders. Hover or tap any highlighted item for the analysis; the full list is below.

What leaves the practice

1. 1
   The patient

   Name, date of birth, address and mobile, in the heading of a clinical letter. Health information under the Privacy Act, because it is collected in providing a health service. Patient data guide.

2. 2
   Examination and radiograph findings

   What is wrong with a named person’s tooth. Clinical content the Code (section 8.3) expects to be accurate and held securely. Patient data guide.

3. 3
   Medical history and medications

   Diabetes, an HbA1c result and osteoporosis medication, given to the specialist because they change the treatment. Sensitive information under the Privacy Act. Patient data guide.

4. 4
   The tooth’s history and a previous practice

   Past treatment by a named type of practice in a named suburb, and a flare-up. Clinical history, and a statement about another dentist’s earlier work. Patient data guide.

5. 5
   Enclosed images

   The names and dates of radiographs sent with the letter. A pointer to health information held elsewhere, with the patient’s initials in the file names. Privacy Act guide.

6. 6
   The patient’s circumstances and what the specialist will charge

   Unemployment, cost concerns and a note that the specialist’s fee is separate. Personal information, and the cost explanation the Code (section 4.2, item 6) asks for. Privacy Act guide.

7. 7
   The request and the instruction before extraction

   What the dentist wants done and the condition for a second conversation. The practice’s clinical judgement and part of the continuity of care the Code asks records to support.

8. 8
   The referring dentist

   A named dentist with a provider number. Bound by the Code of conduct, and the person responsible for what the letter says.

9. 9
   The specialist and the specialist practice

   A named specialist and an address. Public information about a practice, though it shows which referral pathways this practice uses.

What happens in Frontier Models (ChatGPT, Claude)

• The whole document is transmitted to the provider’s servers. On personal plans the user cannot choose where it is stored or processed, and for the major providers that has generally meant outside Australia, under that country’s legal process. Some business plans offer storage in Australia, but the provider still receives the content.
• On consumer tiers, prompts can be retained and used to train future models.
• The provider’s staff and systems can reach the content under the provider’s own policies.
• Once sent, the practice no longer controls it. Retention and deletion happen on the provider’s terms.

The same document on Ermos

Part of AI data leakage in dental practices. See how this works in practice: Referral letters on Ermos.

Common questions