Electronic data processing (EDP) was introduced in 1968 to rationalize billing in dental offices. Documentation was not the originally intended purpose. The technical problems were solved by an interface description, developed by the Central Research Institute of Ambulatory Health Care in Germany. The risks of IT for an orderly accounting and documentation for a possible legal dispute are obvious (German 1998). Back-up on a tamper-proof disk must be performed. Of course, a subsequent modification of documented treatments is possible without being apparent. However, a weekly or monthly documentation can be made on an only-once writeable disk. Properly performed IT documentation suggests the correctness of its content. The burden of proof is with the practitioner only if the completeness or accuracy of the stored data is doubtful (Walther 1996). Although the fundamental jurisdiction has yet been decided, it is acknowledged that dental documentation may be based on IT as well as on imaging and virtual recordings (Epple 1994).

A survey of 143 dentists in Middle Franconia, Germany (Hausmann et al. 1997) showed that, in 65 %, only a “minimal finding” was recorded; in 19.5 %, findings that also included restorations made by the respondent (“updated finding”) were recorded; and, in 15.5 %, findings in which all existing restorations, including preexisting restorations, were documented (“exemplar finding”). The study also inspected the error rate in the treatment of 61 patients, which was 21.36 % in “exemplar findings” and 55.6 % in “minimal findings.” The compared dental charts show considerable differences in the scope and quality of the recorded data. As a result, quite often, only a “minimum finding” is available for forensic examinations or assessments in legal disputes. According to this evaluation, IT is increasingly used in dental practice. Interestingly, 82 % of the practitioners with “exemplar findings” have used IT, compared with only 33 % of practitioners with “minimal findings”.

The increasing use of IT in dental offices will significantly improve the scope and quality of dental records. Another advantage inter alia is the rapid access to a large amount of data. The most important question is whether the computerized documentation includes all required data. Compared with handwritten charts, electronic charts are clearer:

All billing-relevant data must be collected in detailed form. IT systems also offer options of entering additional data and comments, which is not important for billing but is important for medical documentation. All treatment-relevant data must be recorded (Stratmann 1997).

The second question is how corrections are to be handled. Errors must be able to be corrected, otherwise a correct billing is not possible. In a handwritten chart, alterations are always visible. Contrary to IT charts, where alterations are not retraceable, information regarding what was altered, by whom, and at what time, can be documented. The original data must be stored in a write-protected file. Modern image processing programs allow alterations of stored data. These corrections must be securely stored. Subsequent retouchings on an original X-ray image cannot be returned to the original condition (Stratmann 1997).