THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com
S U M M A R Y
DIARY: April 22, 2015 08:00 AM Wednesday;
Rod Welch
Dental examination and cleaning Graham Dental Offices.
1...Summary/Objective
2...Dental Care Leverages Patient History
3...Findings No Remedial Work Performed Nor Recommended
4...Graham Dental Letter Reports Summary Dental Examination
5...Periodontal Chart 3 Pockets of 6
..............
Click here to comment!
CONTACTS
SUBJECTS
Dental Examination Cleaning No New Cavities Decay Found 2 Fillings #
4703 -
4703 - ..
4704 - Summary/Objective
4705 -
470501 - Follow up ref SDS 50 0000. ref SDS 48 0000.
470502 -
470503 -
470504 -
470505 - [On 150505 1600 meeting 2nd opinion Doctor Grosso
470506 - periodontal charting, ref SDS 53 IW5I, and on status of #13
470507 - requiring cavity repair. ref SDS 53 UO8H
470509 - ..
470510 - [On 150517 1431 submitted letter requesting consultation on
470511 - variance in periodontal charting. ref SDS 54 7R61
470512 -
470513 -
470514 -
470515 -
470516 -
470518 - ..
4706 -
4707 -
4708 - Background
4709 -
470901 - On 101108, Lynn scheduled examination and cleaning for today, 110202,
470902 - confirmed in letter. ref SDS 27 HG6P, and following up prior cleaning
470903 - on 100325 0800. ref SDS 23 TL9F
470905 - ..
470906 - Background on prior work is listed on 100514 0730. ref SDS 25 VH5N
470908 - ..
470909 - On 110928 0800 dental examination, cleaning, ref SDS 33 8659, and
470910 - periodontal chart shows good oral hygeine has restored gum health.
470911 - ref SDS 33 6Z3V
470913 - ..
470914 - On 110929 2028 letter from Graham Dental received medical chart
470915 - progress notes, ref SDS 34 VT5I, for work on 110928. ref SDS 33 534L
470917 - ..
470918 - On 110930 2246 letter to Graham Dental submits questions on issues in
470919 - progress notes for work on 110928. ref SDS 35 VT5I
470921 - ..
470922 - On 111022 1923 received and paid invoice for dental services performed
470923 - today on 110928. ref SDS 36 004T
470925 - ..
470926 - On 111025 1928 letter from Lynn at Graham Dental reports medical chart
470927 - progress notes for meeting on 110928 were submitted previously on
470928 - 110929. ref SDS 37 VT5I
470930 - ..
470931 - On 111026 1022 submit letter to Lynn at Graham Dental with questions
470932 - and action items on medical chart and progress notes for meeting
470933 - performing dental examination 110928. ref SDS 38 VT5I
470935 - ..
470936 - On 120404 0800 dental examination, cleaning. ref SDS 39 004T
470938 - ..
470939 - On 120507 1015 paid invoice for dental services on 120404.
470940 - ref SDS 40 004T
470942 - ..
470943 - On 121010 0800 dental examination, cleaning and xrays showing no
470944 - evident progression of decay. ref SDS 41 O75H
470946 - ..
470947 - On 130417 0800 dental examination, cleaning, defer fillings recover
470948 - from cavity past 18 months on tooth #13, and defer treatment new
470949 - cavity reported on #9; evaluate in 6 months. ref SDS 42 DQ90
470951 - ..
470952 - On 131016 Doctor David Graham performed teeth cleaning and
470953 - examination; no new cavity issues presented. ref SDS 44 OT6G Xrays
470954 - scheduled in 6 months, along with repair slight cavity on #9 for
470955 - approximate cost $40, absent complications. ref SDS 44 ES7M
470956 - Periodontal examination found improvement with reduced pockets,
470957 - attributed to using electric toothbrush, recommended previously by
470958 - Graham Dental. ref SDS 44 MY4I Rising pockets in back teeth,
470959 - ref SDS 44 RV5N, requires resuming use of dental pick to clean gums on
470960 - back teeth. ref SDS 44 P36J Scheduled next meeting on 140416 0800.
470961 - ref SDS 44 ES7G Received Progress Notes that support doctor/patient
470962 - partnership for following up critical issues. ref SDS 44 LB6N
470964 - ..
470965 - On 140410 0910 received letter from Graham Dental requesting feedback
470966 - to confirm meeting on 140416 0800. ref SDS 47 004T Sent letter
470967 - confirming next meeting, and agenda. ref SDS 47 FX5L
470969 - ..
470970 - On 140416 0800 Doctor David Graham did examination and cleaning.
470971 - ref SDS 48 O75H David mentioned several times today, that teeth/mouth
470972 - seem very clean. ref SDS 48 LC5F Reviewed history of tooth #9 appears
470973 - "dead" from injury many years ago. ref SDS 48 1R6O Check for dental
470974 - "pockets" in the gums showed improvement. ref SDS 48 MY4I Minor
470975 - filling on #9 and an adjacent tooth (not identified in the record).
470976 - ref SDS 48 PR7K David still plans to retire at the end of the year.
470977 - ref SDS 48 HS5G
470979 - ..
470980 - On 141021 0800 Doctor David Graham did examination and cleaning.
470981 - ref SDS 50 O75H David mentioned several times today, that teeth/mouth
470982 - seem very clean. ref SDS 50 LC5F Bleeding gum issue shows improvement
470983 - compared to prior examinations. ref SDS 50 8659 Letter from David
470984 - recommends special attention upper right side between last 2 teeth
470985 - (#3 and #4) to continue improve gum bleeding problem. ref SDS 50 H271
470986 -
470987 -
470988 -
470990 - ..
4710 -
4711 -
4712 - Progress
4713 -
471301 - Dental Care Leverages Patient History
471302 -
471303 - Follow up ref SDS 50 004T, ref SDS 48 004T.
471304 -
471305 - Meeting today was scheduled by the medical chart received with Doctor
471306 - Graham's letter on 141021 0800. ref SDS 50 H267
471308 - ..
471309 - Agenda was submitted on 150418 1304. ref SDS 52 VD5J
471311 - ..
471312 - Scheduled next meeting in October 2015.
471314 - ..
471315 - Doctor Mark Graham did the cleaning today. Excellent work.
471316 -
471317 -
471319 - ..
471320 - Findings No Remedial Work Performed Nor Recommended
471321 -
471322 - Follow up ref SDS 50 8659, ref SDS 48 8659.
471323 -
471324 - Mark reported finding...
471325 -
471326 - 1. Moderate gum bleeding still occuring when cleaning teeth with
471327 - dental pick. Mark did not show evidence of bleeding using
471328 - gauze blotted with blood, and could not taste blood from the
471329 - cleaning process, as occurred during prior meeting on 140416
471330 - 0800. ref SDS 48 8659 This shows continuing improvement from
471331 - prior dental examinations on 110202 0800. ref SDS 29 8659
471333 - ..
471334 - Previously, on 141021 0800 at 1657 letter from David identified
471335 - teeth #3 and #4 require extra care to resolve moderate gum
471336 - bleeding. ref SDS 50 H271
471338 - ..
471339 - Explained finding moderate bleeding gums today during cleaning
471340 - with sharp metal dental pick aligns with patient history the
471341 - past 25 years, showing no evidence of bleeding gums (by taste
471342 - nor observation) from routine daily activity, including eating
471343 - and brushing, previously reported on 110202 0800. ref SDS 29
471344 - UD5J
471346 - ..
471347 - 2. No remedial care was performed. Mark recommended repairing
471348 - tooth #13, described as possible decay beneath an exhisting
471349 - crown.
471350 -
471351 - [...below on 150422 0800 at 1657 dental progress notes
471352 - present finding #13 recommends remove decay and seal with
471353 - composite for cost of $150, noting performance of this work
471354 - may reveal more extensive decay that requires additional
471355 - work. ref SDS 0 Z751
471357 - ..
471358 - [On 150505 1600 meeting 2nd opinion Doctor Grosso
471359 - periodontal charting, ref SDS 53 IW5I, and on status of #13
471360 - requiring cavity repair. ref SDS 53 UO8H
471362 - ..
471363 - Mark will submit medical chart to cross check understandings from
471364 - work today.
471365 -
471366 -
471367 -
471368 -
471370 - ..
4714 -
4715 -
4716 - 1657
4717 -
471701 - Graham Dental Letter Reports Summary Dental Examination
471702 -
471703 - Follow up ref SDS 50 TN5F, ref SDS 48 TN5F.
471704 -
471705 - The next day, received letter from Mark saying...
471707 - ..
471708 - Stored original letter in the file...
471709 -
471710 - F:\05\00003\SM\GG\PS\GPMG\150422-080000\dental-visit-2015-04-22-080000.eml
471711 -
471712 - 1. Subject: Your Dental Visit on 4-22-15
471713 - Date: 2015-04-23 08:42
471717 - ..
471718 - 2. 4-22-2015 : updated medical history.
471720 - ..
471721 - 3. No chief complaint.
471723 - ..
471724 - 4. Oral cancer screening: no pathology observed. TMJ-no pathology
471725 - observed.
471727 - ..
471728 - 5. PERIO-Localized moderate to advanced chronic periodontitis at
471729 - upper and lower left posteriors.
471731 - ..
471732 - 6. CARIES-Same sticky area at open margin of #13 PFM(porcelain
471733 - fused to metal crown) on buccal surface reviewed.
471734 - Recommendation to remove decay and seal with composite and how
471735 - x-rays cannot show progression of lesion due to location on
471736 - tooth and because decay is under crown. Patient reminded that
471737 - caries process could be more extensive under crown due to
471738 - bacterial invasion. Patient to reconsider filling that as
471739 - recommended on 4-4-2012. Next visit : ideally #13-B composite
471740 - for $150.00
471742 - ..
471743 - Progress Notes presentation on tooth #13 aligns with the record of
471744 - discussion with Mark during examination, per above. ref SDS 0 DY4N
471746 - ..
471747 - History of tooth #13 reported in the record on...
471748 -
471749 - Recommend filling cavity................... 150422 0800, ref SDS 0 Z751
471750 - Doctor found no evidence of decay.......... 131016 0800, ref SDS 44 ES7M
471751 - Cavity forming recommend repair............ 130417 0800, ref SDS 42 DQ90
471752 - Cavity beginning monitor................... 121010 0800, ref SDS 41 DQ90
471753 - Recommend filling cavity................... 120404 0800, ref SDS 39 WR6L
471754 -
471755 - [On 150505 1600 meeting 2nd opinion Doctor Grosso
471756 - reported no evident need for cavity repair on #13.
471757 - ref SDS 53 P36I
471758 -
471760 - ..
471761 - Dental Progress Notes continue...
471762 -
471763 - 7. Oral hygiene is fair. Generalized light plaque, moderate
471764 - tenacious calculus on lower anteriors, generalized moderate
471765 - bleeding.
471767 - ..
471768 - Reporting oral hygiene "fair," appears conflicting with prior
471769 - examination finding teeth "very clean," reported on 140416 0800.
471770 - ref SDS 48 Q867 and again on 141021 1542. ref SDS 50 LC5F
471772 - ..
471773 - Dental Progress Notes continue...
471774 -
471775 - 8. Hand scaled & flossed. Karen(Dr Graham?s assistant) polished.
471777 - ..
471778 - 9. Recommended patient get and use a Waterpik Waterflosser(like
471779 - the Ultra model) nightly. Gave patient coupon/brochure.
471781 - ..
471782 - 10. Your periodontal chart is attached per your request
471785 - ..
471786 - 11. Attachments:
471787 - WELCHPERIO.pdf 70.4 KB
471789 - ..
471790 - A few days later received another letter from Lynn saying...
471791 -
471792 - 1. Subject: Your next appointment
471793 - Date: 2015-04-29 08:20
471800 - ..
471801 - 2. Please accept my apologies for failing to include the date and
471802 - time of your next appointment here in our office. On a second
471803 - look, I did not include that. You are scheduled in our office
471804 - on Wednesday, November 4, 2015 at 8a.m.
471805 -
471806 -
471807 -
4719 -
SUBJECTS
Dental Periodontal Examination Back Teeth Reduced Pockets #3 4 #4 4
7203 -
720401 - ..
720402 - Periodontal Chart 3 Pockets of 6
720403 -
720404 - Follow up ref SDS 48 6Z3V, ref SDS 44 MY4I.
720406 - ..
720407 - History of periodontal examinations...
720408 -
720409 - 150422............. 6s = 3 ........... ref SDS 0 6Z3V
720410 - 140416 partial..... 6s = 4 ........... ref SDS 48 6Z3V
720411 - 131016............. 6s = 6 ........... ref SDS 45 MY4I
720412 - 110928............. 6s = 0 ........... ref SDS 33 6Z3V
720413 - 100325............. 6s = 0 ........... ref SDS 23 SW66
720414 - 990503............. 6s = 0 ........... ref SDS 7 3750
720415 - 980330............. 6s = 0 ........... ref SDS 6 1151
720416 - 970324............. 6s = 0 ........... ref SDS 5 0001
720417 - 950605............. 6s = 0 ........... ref SDS 4 007U
720418 - 910218............. 6s = 0 ........... ref SDS 2 0001
720419 - 880419............. 6s = some......... ref SDS 1 0001
720420 -
720426 - ..
720427 - Progress Notes continue...
720429 - ..
720430 - 3. Perio Chart
720432 - Date................................... 150423 [...report date...]
720435 - Exam Date.............................. 150422
720437 - ..
720438 - Tooth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
720439 - MOB
720440 - PD 3 2 4 4 2 3 3 2 3 3 2 3 2 2 2 2 2 2 2 2 2 2 2 2 3 2 3 3 2 4 6 2 4 5 2 5 5 2 3
720441 - ..
720442 - GM 2 1 1 2 0 1 1 1 3 1 2 3 2
720443 - ..
720444 - CAL 3 4 4 4 3 3 3 3 3 3 4 3 2 3 2 2 3 2 2 3 2 2 2 2 3 5 3 3 3 4 6 4 4 5 5 5 5 4 3
720445 - MGJ
720446 - ..
720447 - BCI 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
720448 - +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+
720449 - |\ /| |\ /| |\ /| | | | | | | | | | | | | | | | | | | | | | | | | |\ /| |\ /| |\ /|
720450 - FG | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
720451 - | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
720452 - +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+
720453 - Ling 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
720454 - ..
720455 - MOB
720456 - PD 3 2 4 4 2 3 3 2 2 2 2 2 3 2 2 2 2 3 3 2 2 2 2 3 2 2 2 2 2 3 4 2 3 3 2 5 4 2 4
720457 - ..
720458 - GM
720459 - CAL 3 2 4 4 2 3 3 2 2 2 2 2 3 2 2 2 2 3 3 2 2 2 2 3 2 2 2 2 2 3 4 2 3 3 2 5 4 2 4
720460 - MGJ
720461 - ..
720462 - Tooth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
720464 - ..
720465 - Notes.....
720466 -
720467 - 1. Tooth # 3 improved to 4 from 6 on 140416 0800.
720468 - ref SDS 48 OV62
720469 -
720470 - Tooth #3 improved to 4 from 5 on 131016 0800.
720471 - ref SDS 44 OV62
720473 - ..
720474 - 2. Tooth # 4 improved to 4 from 6 on 140416 0800.
720475 - ref SDS 48 OV62
720477 - ..
720478 - 3. Tooth #13 worsened to 6 from 4 on 140416 0800.
720479 - ref SDS 48 OV4L
720481 - ..
720482 - Tooth # 13 was 5 on 131016 0800. ref SDS 44 OV4L
720483 -
720485 - ..
720486 - 4. Tooth # 14 worsened to 5 from 4 on 131016 0800.
720487 - ref SDS 44 OV4L
720488 -
720490 - ..
720491 - Tooth 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
720492 - MOB
720493 - PD 3 2 4 4 2 3 2 2 2 2 2 3 2 2 2 2 2 2 2 2 3 2 2 3 3 2 2 2 2 2 2 2 3 3 2 3 3 2 6 6 2 3
720494 - ..
720495 - GM
720496 - ..
720497 - CAL 3 2 4 4 2 3 2 2 2 2 2 3 2 2 2 2 2 2 2 2 3 2 2 3 3 2 2 2 2 2 2 2 3 3 2 3 3 2 6 6 2 3
720498 - MGJ
720499 - ..
720500 - BCI 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
720501 - +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+
720502 - | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |\ /| |\ /| |\ /|
720503 - FG |---| |---| |---| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
720504 - | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
720505 - +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+ +---+
720506 - Ling 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000
720508 - ..
720509 - MOB
720510 - PD 4 2 3 4 2 3 3 2 2 2 2 2 2 2 2 2 2 3 3 2 2 2 2 2 2 2 3 3 2 3 3 2 3 2 2 3 3 2 5 4 2 3
720511 - ..
720512 - GM 2 2 2 1 2 2 1 1
720513 - ..
720514 - CAL 4 2 3 4 4 3 3 2 2 2 4 2 2 2 2 2 4 3 3 3 2 2 4 2 2 2 3 3 4 3 3 3 3 2 3 3 3 2 5 4 2 3
720515 - MGJ
720516 - Tooth 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17
720518 - ..
720519 - Notes.....
720520 -
720521 - 1. Tooth # 30 improved to 4 from 6 on 140416 0800.
720522 - ref SDS 48 OV62
720523 -
720524 - Tooth #30 improved to 4 from 5 on 131016 0800.
720525 - ref SDS 44 OV62
720527 - ..
720528 - 2. Tooth # 19 outside worsened to 6 from 5 on 140416 0800.
720529 - ref SDS 48 IO9G
720531 - ..
720532 - Tooth # 19 inside improved to 4 from 6 on 140416 0800.
720533 - ref SDS 48 IO9G
720535 - ..
720536 - 3. Tooth # 18 inside worsened to 6 from 5 on 140416 0800.
720537 - ref SDS 48 IO9G
720539 - ..
720540 - Tooth # 19 inside stable at 4 from 4 on 140416 0800.
720541 - ref SDS 48 IO9G
720542 -
720543 -
720545 - ..
720546 - PERIO Chart continues...
720547 -
720548 - Summary Information
720549 -
720550 - 1. Date........................................ 150422
720551 - 2. Bleeding
720552 - Teeth....................................... 0
720553 - Sites....................................... 0
720555 - ..
720556 - Periodontal examination finding both "Bleeding teeth" and "sites" = 0
720557 - aligns with report today of no bleeding gums caused by cleaning teeth
720558 - with metal dental pick, and further aligns with daily activity,
720559 - including eating and vigorous brushing for past 15 years, per above.
720560 - ref SDS 0 KU68, and perviously on 110928 0800. ref SDS 33 KU68
720562 - ..
720563 - PERIO Chart Summary continues...
720564 -
720565 - 3. Suppuration
720566 - Teeth....................................... 0
720567 - Sites....................................... 0
720569 - ..
720570 - 4. Furcation
720571 - Teeth....................................... 0
720572 - Sites....................................... 0
720574 - ..
720575 - 5. Mobility
720576 - Teeth....................................... 0
720578 - ..
720579 - 6. PD > Alert
720580 - Teeth....................................... 5
720581 - Sites....................................... 8
720583 - ..
720584 - PD alert #13, 14, 15, 19, 18 make 5 teeth with pockets over 4.
720586 - ..
720587 - Not sure how sites are calculated.
720589 - ..
720590 - Need 2nd opinion on periodontal findings... research found...
720591 -
720592 - Lisa T Grosso, DDS
720593 - 2425 East Street #16
720594 - Concord, CA 94520
720595 - 925 676 2160
720596 -
720597 - http://www.healthgrades.com/dentist/dr-lisa-grosso-2flnx
720598 -
720599 - http://www.yelp.ca/biz/grosso-lisa-t-dds-concord
720601 - ..
720602 - [On 150505 1600 meeting 2nd opinion Doctor Grosso
720603 - periodontal charting, ref SDS 53 IW5I, and on status of #13
720604 - requiring cavity repair. ref SDS 53 UO8H
720606 - ..
720607 - [On 150517 1431 submitted letter requesting consultation on
720608 - variance in periodontal charting. ref SDS 54 7R61
720610 - ..
720611 - Periodontal Examination continues...
720612 -
720613 - 7. CAL < 0
720614 - Teeth....................................... 0
720615 - Sites....................................... 0
720617 - ..
720618 - 8. CAL 1-3
720619 - Teeth...................................... 27
720620 - Sites..................................... 129
720622 - ..
720623 - 9. CAL 4-5
720624 - Teeth...................................... 16
720625 - Sites...................................... 30
720627 - ..
720628 - 10. CAL 6+
720629 - Teeth....................................... 3
720630 - Sites....................................... 3
720631 -
720632 -
720633 -
720634 -
720635 -
720636 -
720637 -
720638 -
720639 -
720640 -
720641 -
7207 -