The RCDSO has issued updated guidance on planning ahead for the succession of patient records, a legally mandated responsibility under Ontario's Personal Health Information Protection Act (PHIPA). With an estimated 15% of Ontario dentists expected to retire or transition their practices within the next five years, dental professionals in the GTA and across the province must understand exactly what happens to patient records when a practice changes hands — and the consequences of getting it wrong.
As of September 2026, patient record succession is one of the most underestimated compliance risks facing Ontario dental practices. The Royal College of Dental Surgeons of Ontario (RCDSO) has emphasized that dentists are legally and professionally responsible for their patient records — and that responsibility does not end when the dentist stops practising. Whether a dentist retires, sells a practice, becomes incapacitated, or dies, every patient record must be transferred to a successor custodian in accordance with Ontario law. There is no exemption for small practices, solo practitioners, or dentists who plan to "simply close the door."
Why Patient Record Succession Matters Now
Ontario's dental workforce is aging. According to data from the RCDSO, a significant proportion of currently registered dentists are within a decade of typical retirement age. In the Greater Toronto Area — where practices in Scarborough, North York, Etobicoke, and Mississauga serve large and diverse patient populations — the scale of record succession over the next several years will be substantial.
At the same time, the transition landscape is evolving. Dental service organizations (DSOs) are acquiring independent practices at an accelerating rate, private equity is reshaping ownership structures, and associate dentists are increasingly purchasing practices earlier in their careers. Each of these scenarios triggers specific record transfer obligations that many dentists have never confronted before.
The stakes are not theoretical. Failure to properly transfer patient records can result in:
- RCDSO disciplinary proceedings for professional misconduct
- Complaints to the Information and Privacy Commissioner of Ontario (IPC) under PHIPA
- Patient harm when treatment history, allergies, or medication records become unavailable to a new treating dentist
- Legal liability if lost records prevent a patient from pursuing or defending a claim
What PHIPA Requires: The Legal Framework
The Personal Health Information Protection Act, 2004 (PHIPA) is Ontario's health privacy statute, and it governs every dental practice in the province. Under PHIPA, a dentist is a Health Information Custodian (HIC), and patient records are personal health information (PHI) subject to the Act's requirements for collection, use, disclosure, retention, and transfer.
Key PHIPA Requirements for Practice Transitions
Notification: The selling or retiring dentist must notify patients in writing about the change in practice ownership. When the outgoing dentist cannot provide notification — due to incapacity or death — the incoming dentist assumes the notification obligation.
Consent model: PHIPA uses a "transfer and notify" model for practice sales, not an explicit consent model. This means the selling dentist may transfer patient records to the purchasing dentist without obtaining express consent from each patient, provided that patients are notified and given the opportunity to request their records be transferred to a different provider.
Confidentiality agreements: Before any patient records are disclosed to a prospective purchaser for due diligence purposes — for example, to assess practice volume and patient demographics — the prospective purchaser must enter into a confidentiality agreement restricting how they handle and protect that information.
Retention: Patient records must be retained for a minimum of 10 years from the date of the last entry (or, for minor patients, 10 years after the patient turns 18). These retention obligations follow the records through any transfer.
Pro Tip: If you are a solo practitioner with no immediate plans to sell, designate a successor custodian in your will and in a written agreement now. The RCDSO's Practice Advisory Service can guide you through the documentation. Waiting until retirement day creates unnecessary risk.
The Three Transition Scenarios Every Ontario Dentist Must Prepare For
Scenario 1: Planned Practice Sale
This is the most straightforward scenario, but it still requires careful execution. The selling dentist negotiates a purchase agreement that includes provisions for patient record transfer. Before the sale closes, both parties must address:
- The confidentiality agreement covering due diligence access to patient data
- The format of record transfer (electronic practice management system migration vs. paper chart handover)
- Written patient notification letters sent before or at the time of transition
- A plan for patients who request their records be sent elsewhere
- Ongoing retention obligations for records that the selling dentist may have retained copies of
For practices in the GTA where patient populations are large and multilingual, the notification letter should be clear, accessible, and ideally available in the languages most commonly spoken by the practice's patient base — though PHIPA does not specifically require multilingual notification.
Scenario 2: Retirement Without Sale
Some dentists, particularly those in smaller or rural practices, may choose to close their practice without selling it. In this case, the retiring dentist remains the custodian of all patient records and must either:
- Transfer records to another dentist or health information custodian who agrees to assume custody
- Arrange for secure storage and access for the full retention period
- Notify all patients in writing and provide them with a reasonable opportunity to obtain copies of their records
Destroying records before the retention period expires — or simply locking them in a storage unit and losing the key — violates both PHIPA and RCDSO professional standards.
Scenario 3: Incapacity or Death
This is the scenario most dentists prefer not to think about, but it is the one that creates the most acute compliance risk. If a dentist becomes incapacitated or dies without having made succession arrangements, the responsibility for patient records falls to the dentist's estate. The personal representative (executor or administrator) must arrange for a successor custodian.
If the incoming custodian is the purchasing dentist, they must send the written notification to patients. If no purchaser exists, the estate must engage the RCDSO and, potentially, the IPC to arrange for appropriate custodianship.
Pro Tip: Include a specific clause in your estate planning documents designating a successor custodian for patient records. Discuss this with both your estate lawyer and your dental colleagues. A handshake agreement is not sufficient — the arrangement must be documented and the designated successor must have agreed in writing.
Electronic Records: Migration Challenges
Most GTA dental practices now use electronic practice management software — platforms such as ABELDent, Dentrix, ClearDent, or Tracker. When a practice changes hands, the patient data stored in these systems must be migrated to the purchasing dentist's system. This is rarely as simple as copying a database file.
Common challenges include:
- Software incompatibility: The selling and purchasing dentists may use different practice management platforms, requiring data export, conversion, and import
- Image and radiograph migration: DICOM images, intraoral photographs, and CBCT scans may be stored in separate systems or file servers that require independent migration
- Data integrity verification: After migration, the purchasing dentist must verify that all records transferred completely and accurately — missing radiographs or corrupted treatment notes create both clinical and legal risk
- Software licensing: Some practice management vendors restrict data export or charge fees for migration assistance, which should be addressed in the purchase agreement
Pro Tip: Budget $5,000 to $15,000 CAD for professional data migration services when purchasing a dental practice. Attempting to migrate patient records without specialized assistance frequently results in data loss that only becomes apparent months later when a patient's historical radiographs cannot be located.
What About DSO Acquisitions?
Dental service organizations acquiring practices in Ontario are subject to the same PHIPA requirements as individual dentist purchasers. The DSO must enter into a confidentiality agreement during due diligence, the selling dentist must notify patients, and the DSO assumes custodianship obligations for all transferred records.
One additional complexity: DSOs typically centralize patient data across multiple practice locations. If the DSO later closes the acquired practice location and consolidates patients into another site, a second round of patient notification may be required.
For Ontario dentists considering offers from DSOs, the RCDSO recommends reviewing the practice purchase agreement carefully to ensure that record custodianship obligations are clearly assigned and that the agreement complies with PHIPA's requirements.
RCDSO Practice Advisory Service
The RCDSO operates a Practice Advisory Service that provides guidance to Ontario dentists on professional standards, practice management, and regulatory compliance — including patient record succession. The service is available to all RCDSO registrants and can help dentists develop a succession plan that satisfies both PHIPA and the College's professional standards.
Dentists in Toronto, the GTA, and across Ontario can contact the Practice Advisory Service directly through the RCDSO website at rcdso.org.
A Record Succession Checklist for Ontario Dentists
Whether you are five years from retirement or five months, the following checklist provides a starting framework:
- Identify your successor custodian — a purchasing dentist, a colleague, or a professional records custodianship service
- Document the arrangement in writing — include the agreement in your estate planning documents
- Assess your records format — electronic, paper, or hybrid — and identify any migration challenges
- Draft a patient notification letter that complies with PHIPA's requirements
- Verify retention periods for all patient records, paying special attention to records of minor patients
- Consult the RCDSO Practice Advisory Service for guidance specific to your situation
- Engage a health law lawyer to review the record transfer provisions of any practice purchase agreement
- Budget for data migration if your practice uses electronic records
EBIKO Dental will continue monitoring RCDSO guidance on practice transitions and patient record management as the regulatory landscape evolves.
Frequently Asked Questions
Q: Can a retiring Ontario dentist destroy patient records instead of transferring them?
No. Under PHIPA, patient records must be retained for a minimum of 10 years from the last entry (or 10 years after a minor patient turns 18). Destroying records before the retention period expires violates Ontario law and RCDSO professional standards. A retiring dentist must arrange for a successor custodian to maintain the records for the remaining retention period.
Q: Do patients need to consent before their dental records are transferred during a practice sale in Ontario?
PHIPA uses a "transfer and notify" model, not an explicit consent model, for practice sales. The selling dentist may transfer patient records to the purchasing dentist without obtaining individual consent, provided that patients are notified in writing and given the opportunity to request that their records be transferred to a different provider of their choice.
Q: How much does dental practice data migration typically cost in the GTA?
Professional data migration services for a dental practice in the Greater Toronto Area typically cost between $5,000 and $15,000 CAD, depending on the complexity of the migration, the software platforms involved, and the volume of imaging data (radiographs, CBCT scans, intraoral photographs) that must be transferred. This cost should be budgeted separately from the practice purchase price.