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 19, 2016 08:00 AM Tuesday; 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


..............
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CONTACTS 

SUBJECTS
Dental Examination Cleaning No New Cavities Decay Found 2 Fillings #                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
4703 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4703 -    ..
4704 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
4705 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
470501 - Follow up ref SDS 57 0000. ref SDS 53 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
470502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470507 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470509 -  ..
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
470987 -  ..
470988 - On 150422 0900 Doctor Mark Graham did examination and cleaning.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470989 - ref SDS 53 O75H  Mark reported finding continuing moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
470990 - gum bleeding.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
470991 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470992 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470993 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470994 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470995 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470996 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470997 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470998 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471000 -  ..
4711 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4712 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4713 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4714 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471401 - Dental Care Leverages Patient History                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471402 - 
471403 - Follow up ref SDS 57 004T, ref SDS 53 004T.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471404 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471405 - Meeting was scheduled on 160418 0800, during the prior meeting on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471406 - 151104 0800. ref SDS 57 ES7G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471408 -  ..
471409 - On 160204 1014, called Graham Dental and talked to June.  She said                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471410 - that Lynn has retired.  Explained a few weeks ago there was a call                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471411 - saying Mark would not be in the office on 160418, so need to change                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471412 - the date of the work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471414 -  ..
471415 - Today, met June.  She scheduled next meeting on 1610__                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471417 -  ..
471418 - Scheduled next meeting in October 2015.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471420 -  ..
471421 - Sonja did the cleaning today.  Excellent work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471422 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471425 -  ..
471426 - Findings No Remedial Work Performed Nor Recommended                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471427 - 
471428 - Follow up ref SDS 57 8659, ref SDS 53 8659.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471430 - Sonja reported finding...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
471431 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471432 -    1.  Major improvement today using ultra sonic dental pic used for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471433 -        1st time in patient history, demonstrates continuing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471434 -        improvement of gums.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471436 -         ..
471437 -    2.  Moderate gum bleeding still occuring when cleaning teeth with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471438 -        dental pick.  Sonja did not show evidence of bleeding using                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471439 -        gauze blotted with blood, and could not taste blood from the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471440 -        cleaning process, as occurred during prior meeting on 140416                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471441 -        0800. ref SDS 48 8659  This shows continuing improvement from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471442 -        prior dental examinations on 110202 0800. ref SDS 29 8659                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471444 -         ..
471445 -        Previously, on 141021 0800 at 1657 letter from David identified                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471446 -        teeth #3 and #4 require extra care to resolve moderate gum                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471447 -        bleeding. ref SDS 50 H271                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471449 -         ..
471450 -        Explained finding moderate bleeding gums today during cleaning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471451 -        with sharp metal dental pick aligns with patient history the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471452 -        past 25 years, showing no evidence of bleeding gums (by taste                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471453 -        nor observation) from routine daily activity, including eating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471454 -        and brushing, previously reported on 110202 0800. ref SDS 29                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
471455 -        UD5J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471457 -  ..
471458 - On 150519 1621 2nd opinion Doctor Grosso reports finding no bleeding                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471459 - on probing, which indicates very little inflammation of the tissue (a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471460 - very good finding). ref SDS 56 8G92                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
471462 -  ..
471463 - Dental cleaning continues...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471464 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471465 -    3.  No remedial care was performed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471467 -  ..
471468 - Sonja will submit medical chart to cross check understandings from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471469 - work today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471470 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471471 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471472 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471473 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471475 -  ..
4715 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4716 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4717 - 1657                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
4718 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471801 - Graham Dental Letter Reports Summary Dental Examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
471802 - 
471803 - Follow up ref SDS 57 TN5F, ref SDS 53 TN5F.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471804 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471805 - Several days later letter from Mark saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471806 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471807 -    1.  Subject:  [Secure Message] Progress Notes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471808 -        Date:  2016-04-21 12:11                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471812 -         ..
471813 -    2.  Pact-One Solutions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
471814 -        [Secure Message] Progress Notes 	                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
471816 -         ..
471817 -    3.  View Secure Message                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471818 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471819 -              https://connectconfidential.com/r2/ac89e10479d293810369d9b6c8c4a0bf7fd69586473fe6bd7388626c35eadca8/7872a733d75dde1e48648e25c14a30aa13c8cf7e7b20b948480744c11c5bc144/9f723fb957c63145ccf3afb2223aee7ed5a9f4fd9ea518824b181392755d3703/d94846bab9a9290dd384d06a3550d3e942561ab29836a062d6ba6e33dc96563c/3d6603ce812fcb1e55c8ce692ba485099a3da50bc19f341f0311760a3c49fe03                                                                                                                                                                                                                              
471821 -         ..
471822 -    4.  Note: If you have any concerns about the authenticity of this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471823 -        message please contact the original sender directly.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471825 -         ..
471826 -    5.  Powered by Pact-One                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471828 -         ..
471829 -    6.  Copyright © 2016 Pact-One. All rights reserved.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471830 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471832 -  ..
471833 - The link in this letter shows content...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
471834 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471835 -        Progress Notes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471836 -        From:  grahamdds@att.net                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471837 -        To:  rod@welchco.com                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471838 -        Expires:  Never                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471839 -        Created:  Apr 21st 2016                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471840 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471841 -              https://connectconfidential.com/r2/ac89e10479d293810369d9b6c8c4a0bf7fd69586473fe6bd7388626c35eadca8/7872a733d75dde1e48648e25c14a30aa13c8cf7e7b20b948480744c11c5bc144/9f723fb957c63145ccf3afb2223aee7ed5a9f4fd9ea518824b181392755d3703/d94846bab9a9290dd384d06a3550d3e942561ab29836a062d6ba6e33dc96563c/3d6603ce812fcb1e55c8ce692ba485099a3da50bc19f341f0311760a3c49fe03                                                                                                                                                                                                                              
471843 -         ..
471844 -        Dear Mr. Welch,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471846 -         ..
471847 -        Here is the summary of your appointment on Tuesday, April 19,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471848 -        2016 as documented:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471850 -         ..
471851 -        Start of Dental chart note (Sonya):                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471853 -         ..
471854 -        Prophy (cleaning), no exam (DR.  Graham out of the office                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471855 -        today), 4 Vertical BWX, 6 month recall.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471857 -         ..
471858 -        Ultrasonic used lightly.  Hand scaled and polished full mouth.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471860 -  ..
471861 - This was significant change, demonstrating continuing improvement gum                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471862 - health.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471864 -  ..
471865 - Sonja's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471866 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471867 -        Oral Cancer exam is regular.  No sensitivity today.  Light to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471868 -        moderate bleeding with scaling.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471870 -         ..
471871 -        Light to moderate calculus.  Calculus is down on the anterior?s                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471872 -        facial and lingual.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471874 -         ..
471875 -        Revisited brushing; patient using electric toothbrush in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471876 -        shower.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471878 -         ..
471879 -        Bleeding on the upper left #12-14 more on the lingual.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471881 -         ..
471882 -        Scattered open contacts and food traps especially on #30-31,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471883 -        #31 lingual has more plaque and bleeding lingual                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471885 -         ..
471886 -        End of Dental chart note (Sonya)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471888 -         ..
471889 -        Start of Dental chart note (Dr. Graham):                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471891 -         ..
471892 -        Reviewed vertical BWX?s; no obvious pathology observed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471894 -         ..
471895 -        End of Dental chart note (Dr. Graham).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471896 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471897 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471898 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471899 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471900 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471901 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471903 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
4720 -