What a dental practice can and cannot refuse comes down to two different rule sets: the Code of conduct that Ahpra and the Dental Board apply to practitioners, and privacy law as explained by the OAIC. A practice can decline some things and end some relationships. It cannot make those decisions arbitrarily, and it cannot simply go quiet. This page covers refusing to treat, refusing to keep treating, and refusing to hand over records, in that order.
Key takeaways
- A practice can decline treatment it does not consider clinically justified, but it has to explain why and support your right to a second opinion.
- A practice can end a patient relationship, and the Code of conduct requires it to tell you and to pass on relevant clinical information.
- Decisions about access to care must be free from bias and discrimination under the Code of conduct.
- You are entitled to access health information a practice holds, regardless of who authored it or who owns the physical record.
- Radiographs are health information, so "we own the x-rays" does not defeat your right to a copy, although originals are usually retained.
- A refusal of access has to come with reasons in writing and information about how to complain, according to OAIC guidance.
Which rules actually apply
Two documents do most of the work here. The first is the shared Code of conduct that applies across regulated health professions, which the Dental Board of Australia applies to dental practitioners. The Board retired its separate guidelines on dental records and now states that the Code of conduct is the crucial document for setting standards and regulatory guidance for dental practitioners, including about dental records.
The second is the Privacy Act, and in practice the OAIC's Guide to health privacy, which explains how access to health information works in the private sector. Between them they cover almost every "can they do that?" question patients ask.
Neither is a contract between you and the practice. They are professional and legal standards. That distinction matters when you want to know what to do about a refusal, and it is why the pathways at the end of this article differ depending on what the dispute is actually about.
What a dental practice can refuse
Treatment the dentist does not consider clinically justified
This is the refusal patients find hardest to accept and the one the Code of conduct supports most clearly. Practitioners are required to investigate and treat based on clinical need and the effectiveness of the proposed investigations or treatment. The same section says not to provide unnecessary services or encourage the indiscriminate or unnecessary use of health services.
Read together, declining a requested treatment that is not clinically justified is not a practice being difficult. It is the practitioner doing what the Code requires. What the Code also requires is that practitioners support your right to seek a second opinion, so a decline should come with an explanation and no resistance to you asking someone else. If you want to do that, our guide on when to get a second opinion as an adult covers how to make it useful rather than just another opinion.
Care where the practitioner cannot safely provide it
The Code addresses this carefully. Where a patient poses a risk to health or safety, the guidance is that the patient should not be denied care if reasonable steps can be taken to keep the practitioner and others safe. That is a conditional protection in both directions. It does not licence a practice to refuse anyone it finds difficult, and it does not require a practitioner to accept a genuinely unsafe situation where no reasonable step would fix it.
Providing care the practitioner conscientiously objects to
The Code says a practitioner must not allow moral or religious views, or a conscientious objection, to deny patients access to healthcare, while recognising that the practitioner is free to decline to provide or participate in that care personally. Where that happens, the practitioner must respectfully inform the patient and ensure the patient has alternative care options. The objection attaches to the individual, not to your access.
Continuing an ongoing relationship
The Code accepts that a practitioner and patient relationship may become ineffective or compromised and may need to end. Good practice involves ensuring the patient is adequately informed of the decision to end the relationship, and facilitating arrangements for the continuing care of the patient, including passing on relevant clinical information.
So a practice can end the relationship. What it cannot do is stop answering the phone, leave you mid-treatment with no explanation, or refuse to pass on the clinical information the next practitioner needs.
Access to records, but only on limited grounds
Access can be refused, and the Privacy Act sets out the grounds. The two most likely to come up in healthcare are a reasonable belief that giving access would pose a serious threat to the life, health or safety of any individual or to public health or safety, and access that would have an unreasonable impact on another individual's privacy. Others include requests that are frivolous or vexatious, and information relating to existing or anticipated legal proceedings between the provider and the patient.
The list is short and specific. The OAIC also states plainly that feeling embarrassed or apprehensive about the patient reading the notes is not a legitimate ground for refusing access.
What a dental practice cannot do
The Code states that decisions about access to care must be free from bias and discrimination. Good practice includes not prejudicing a patient's care because of a belief that the patient's behaviour, mental health status or other attributes contributed to their condition, and not engaging in any form of discrimination.
The Code footnotes that discrimination can be against the law where it is based on attributes such as race, and points readers to the Australian Human Rights Commission. I am not going to summarise what is or is not unlawful under discrimination legislation, because that is a legal question and the Commission is the right body to explain it.
A practice also cannot treat confidentiality as optional in one direction and absolute in the other. Information is held in confidence unless release is required or authorised by law, or is required to facilitate emergency care. And under the Code, practitioners must recognise the right of patients to access information contained in their health records, facilitate that access, and promptly facilitate the transfer or management of health information when requested by patients or when closing or relocating a practice.
One more thing that is easy to overlook: financial consent. The Code requires practitioners to get financial consent by discussing fees, addressing the costs of all required services and getting general agreement about the level of treatment to be provided, preferably before the service is provided. Being asked to agree to treatment without that conversation is not consistent with the Code, and we go through what a proper conversation looks like in informed financial consent and getting a written quote.
Refusals, and what the rules actually allow
| Situation | Can the practice refuse? | What the practice must still do | Where the rule comes from |
|---|---|---|---|
| Refusing to see a new patient | There is no obligation to accept every new patient, for example where books are closed | Keep the decision free from bias and discrimination | Code of conduct, decisions about access to care |
| Refusing care to a patient who has been abusive | Only where reasonable steps cannot keep the practitioner and others safe | Consider what reasonable steps would allow care to continue | Code of conduct, decisions about access to care |
| Ending an ongoing patient relationship | Yes, where the relationship has become ineffective or compromised | Adequately inform the patient and facilitate continuing care, including passing on relevant clinical information | Code of conduct, ending a professional relationship |
| Declining treatment the dentist thinks is not clinically justified | Yes, and the Code discourages unnecessary services | Explain the reasoning and support the right to a second opinion | Code of conduct, decisions about access to care |
| Declining on conscientious objection grounds | The individual practitioner may decline to provide or participate personally | Respectfully inform the patient and ensure alternative care options exist | Code of conduct, conscientious objection |
| Emergency presentation | The duty is qualified, not absolute | Offer assistance taking account of safety, skills, other options and the impact on other patients, and continue until services are no longer needed | Code of conduct, treatment in emergencies |
| Request for a copy of your notes | Only on one of the specific grounds in the Privacy Act | Respond within a reasonable period, try to give access another way, and give written reasons if refusing | Privacy Act, as explained in OAIC guidance |
| Request for radiographs | Not on the basis that the practice owns them | Provide access to the images it holds, usually as copies rather than originals | Privacy Act, as explained in OAIC guidance |
The one that matters most: originals versus copies of your radiographs
This is where most disputes actually happen, and where most of the advice floating around is wrong in one direction or the other.
The wrong version practices sometimes give is: we took the x-rays, we own them, so we do not have to give them to you. The wrong version patients sometimes give is: they are my x-rays, hand over the originals.
The OAIC's framing resolves both. Patients are entitled to access health information the provider holds, regardless of who authored particular documents or who owns the record. Radiographs are health information the practice holds. Ownership of the film, the file or the sensor does not defeat the access right, and it is not one of the grounds on which access can be refused.
What the access right delivers, though, is access, not possession. The OAIC describes access being given in a range of ways, including an electronic copy or a hard copy, viewing the information and taking notes, or an accurate summary. Practices are required to retain records, which is precisely why the original stays and a copy travels. So the accurate position is that you can expect a copy of your radiographs, and you should not expect the originals to be handed over.
In practice this is almost never a problem, because copies are what the next dentist actually wants. A digital file emailed or transferred to a new practice is more useful than a physical original, and it arrives faster. If you are moving practices, our guide to changing dentists and transferring records and x-rays sets out how to make the request cleanly.
What a refusal has to look like
A refusal is not a shrug. Under OAIC guidance, a provider should generally respond within a reasonable period, which in most cases will not exceed 30 calendar days. Access should be given in the manner requested unless that is unreasonable or impracticable. If access is refused, the provider must take reasonable steps to give access in another way, which could be a summary, a redacted version, or access through an agreed intermediary. And the provider must give written notice setting out the reasons for the refusal and how to complain.
If you receive a flat verbal no with no reasons and no alternative offered, that is not what the guidance describes.
Charging for access
A provider may charge for giving access, provided the charge is not excessive. The OAIC says a provider must not charge for making the request, that flat fees are generally not appropriate, that clerical work should be charged at a clerical rate, and that financial hardship should be taken into account. I am not going to publish a figure or a range, because there is no set amount and the test is whether the charge is excessive in the circumstances.
Can records be withheld over an unpaid account?
This comes up often enough to deserve a careful answer rather than a confident one.
Unpaid fees are not one of the grounds for refusing access set out by the OAIC. The list of refusal grounds is specific, and a debt is not on it. Professional associations and practitioner support services take the position that an outstanding account does not remove the access right, and that position sits comfortably with the way the grounds are drafted.
What I could not do is confirm that proposition on an OAIC, Ahpra or Dental Board page, so I am not going to state it as settled. The accurate framing is that a debt is not one of the listed grounds, and that a practice refusing access on that basis should be asked to identify which ground it is relying on and to put its reasons in writing. Fee disputes and access disputes are two different problems, and they have different complaint pathways.
Emergencies
The Code says practitioners should offer assistance in an emergency, taking account of factors such as their own safety, their skills, the availability of other options and the impact on any other patients under their care, and continue to help until their services are no longer needed.
Every one of those qualifiers is doing work. It is not an unconditional duty to treat any emergency at any time. A practice with no available appointment, or without the equipment or scope for what you need, may direct you elsewhere and that is consistent with the Code. What is not consistent is being left with nothing at all. If you are in pain right now, our guide on what to do in a dental emergency covers first steps, and Lumi Dental's emergency dental page explains how urgent appointments work.
If you have been refused something
Start with the practice, in writing, and be specific about what you are asking for. A written request creates a date, and it makes a written response much more likely.
If the dispute is about money, consumer protection is the relevant pathway. If it is about conduct or care, the Health Care Complaints Commission in New South Wales and Ahpra handle those. If it is about access to health information, the OAIC handles privacy complaints in the private sector. We set out the routes in how to make a complaint about dental treatment in NSW. I am not going to predict how any complaint body would decide a particular matter, because that depends entirely on the facts.
One practical note. If language is part of why a conversation went badly, you can ask for an interpreter, and practices should support that. Our page on interpreters and language support at the dentist explains how to arrange it.
Frequently asked questions
Can a dentist refuse to treat you in Australia?
In some circumstances, yes. The Code of conduct requires decisions about access to care to be free from bias and discrimination, and says that where a patient poses a risk to health or safety they should not be denied care if reasonable steps can be taken to keep everyone safe. A practice can also decline a treatment it does not consider clinically justified.
Can my dentist refuse to give me my x-rays?
Not on the basis of who owns them. Under OAIC guidance you are entitled to access health information the practice holds regardless of who authored it or who owns the record, and radiographs are health information. Access is normally given as copies rather than originals.
Can a dental practice refuse to release records if I owe money?
Unpaid fees are not one of the refusal grounds the OAIC sets out. If a practice refuses on that basis, ask which ground it is relying on and ask for the reasons in writing, and treat the fee dispute as a separate matter with its own pathway.
How do I get my dental records from a previous dentist?
Ask in writing, say clearly whether you want the records sent to you or to a new practice, and specify that you want radiographs included. The Code requires practitioners to recognise the access right and to promptly facilitate transfer when requested.
How long does a dentist have to respond to a records request?
The OAIC's guidance is that a provider should respond within a reasonable period, and that in most cases a reasonable period will not exceed 30 calendar days. That is guidance about what is reasonable rather than a fixed deadline for every situation.
Can a dentist stop treating you halfway through treatment?
The Code accepts that a relationship may need to end, but it requires the patient to be adequately informed and requires the practitioner to facilitate arrangements for continuing care, including passing on relevant clinical information. Silence is not an option the Code contemplates.
Can a dentist refuse to do a treatment I ask for?
Yes, where the practitioner does not consider it clinically justified. The Code requires treatment based on clinical need and effectiveness and discourages unnecessary services, and it also requires practitioners to support your right to seek a second opinion.
If you have been told no somewhere and you are not sure whether that was reasonable, a fresh examination and a clear written plan usually answers the question faster than an argument does. The team at Lumi Dental in Melrose Park is open Monday to Saturday. You can see what is currently available on our current offers page, or book a visit when it suits.
This article is general information only and is not legal advice. It is also not personalised dental advice, because that requires an examination. Codes, guidance and legislation change, so check the current versions and get advice about your own situation before acting on anything here.
