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 24, 2017 02:00 PM Monday; Rod Welch

Dental examination and cleaning Doctor Ham.

1...Summary/Objective
2...Dental Radiology and Cleaning
3...Doctor Ham Consultation and Review Xrays
4...Medical Chart Received from Graham Dental Offices


..............
Click here to comment!

CONTACTS 

SUBJECTS
Dental Examination Cleaning No New Cavities Decay Found 2 Fillings #                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
4703 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4703 -    ..
4704 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
4705 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
470501 - Follow up ref SDS 61 0000. ref SDS 60 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
470502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
470508 -  ..
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.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
470992 -  ..
470993 - On 160419 0800 Sonja did examination and cleaning using ultrasonci                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
470994 - dental pick. ref SDS 58 8659  No remedial care was found to be needed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
470995 - ref SDS 58 DY4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
470997 -  ..
470998 - On 161106 Doctor Lisa Grosso did periodontal examination, and found                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
470999 - improvements. ref SDS 61 004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471000 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471001 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471002 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471003 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471005 -  ..
4711 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4712 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4713 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
4714 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471401 - Doctor Grosso provided dental examination and periodontal depth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471402 - measurements on 161116 1500. ref SDS 61 004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471404 -  ..
471405 - Previously, Doctor Grosso provided periodontal 2nd opinon work on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471406 - 150505 1600. ref SDS 54 IW5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471408 -  ..
471409 - Most recent xrays were taken by Graham Dental on 140416 0800.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471410 - ref SDS 48 6H7K  Xray scan files are listed at the bottom of the same                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471411 - record. ref SDS 48 TF5N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471413 -  ..
471414 - Prior xrays were taken on 110202 0800. ref SDS 29 SZ55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
471416 -  ..
471417 - Last examination by dentist was Graham Dental on 160419 0800.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471418 - ref SDS 58 8659                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471420 -  ..
471421 - On 170417 1000, called and talked to Deann.  Explained cannot make the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471422 - meeting on 170418 0800.  Re- scheduled meeting for 170424 0800.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471423 - reported on 170417 1000, ref SDS 62 004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471424 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471425 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471428 -  ..
4715 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4716 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4717 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4718 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
471801 - Dental Radiology and Cleaning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471802 - 
471803 - Follow up ref SDS 61 IU5I, ref SDS 58 004T.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471804 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471805 - Today, meeting...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471806 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471807 -               Alexander Ham, DDS                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471808 -               2951 Salvio Street                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471809 -               Concord, CA  94519                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471810 -               925 682 2000                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471811 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471812 -                     http://www.contracostadentistry.com                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471814 -  ..
471815 - Julia Dominguez, RDH, did cleaning today.  Excellent work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471817 -  ..
471818 - Radiology - Julia took full set xrays to compare with prior radiology                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471819 - studies on 140416 0800, ref SDS 48 TF5N, and previously on 110202                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471820 - 0800. ref SDS 29 SZ55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471840 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471842 -  ..
471843 - Julia was careful and thorough.  Julia explained each step when she                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471844 - changed a procedure, so the patient was warned something different                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471845 - would be done.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
471847 -  ..
471848 - Julia initially used a standard dental pick.  On discussion she tried                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471849 - ultrasonic scaler pick.  This worked well, but the amount of water                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471850 - produced caused concern about swallowing.  Julia was kind to switch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471851 - back to the conventional pick.  Would like to try ultrasonic pick                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471852 - again next time, and elevate head slightly for better control of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471853 - swallowing.  Hopefully, this will not impede Julia's work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471855 -  ..
471856 - During dental cleaning, Julia commented on patient having small mouth,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471857 - which makes doing dental work slow and difficult, especially flossing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471859 -  ..
471860 - Julie noted moderate plaque buildup.  She used her finger to somehow                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471861 - illustrate plaque that grows between teeth and gum line.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
471862 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471863 -            [...below on 170424 1400 Progress Notes report moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471864 -            plaque and calculus buildup, and futher found "especially                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
471865 -            lower anterior-tenacious tartar". ref SDS 0 JW3M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471866 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471867 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471869 -  ..
471870 - Doctor Ham Consultation and Review Xrays                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
471871 - 
471872 - The doctor reviewed xrays taken by Julia, per above. ref SDS 0 VF6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471873 - He used computer c23 to compare current xrays taken by Julia today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471874 - with prior xrays done 3 years ago on 140416 0800. ref SDS 48 6H7K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471875 - Doctor Ham noted there is stable to improved gum bone conditions.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471876 - feels that despite plaque buildup found by Julia, there is no evident                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471877 - negative effect on dental health.  Patient dental hygeine methods                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471878 - appear to be adequate to prevent dental disease over the past 12                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471879 - months, since prior cleaning on 160419 0800. ref SDS 58 8659                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471881 -  ..
471882 - Doctor Ham reviewed latest periodontal examination by Doctor Grosso                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471883 - showing improved conditions from a year earlier, reported on 161116                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
471884 - 1500. ref SDS 61 Z64N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
471886 -  ..
471887 - Doctor Ham will discuss with Julia findings today, of plaque and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471888 - calculus buildup over the past year since prior cleaning, as discussed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
471889 - with Julia, per above. ref SDS 0 3W4J  He will enter into progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
471890 - notes an opinion on annual or 6-month dental checkups in order to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
471891 - balance risk management relative to saving money on dental care.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471892 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471893 -            [...below on 170424 1400 Progress Notes cite discussions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
471894 -            with Julia from performing cleaning, and recommend 6 month                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
471895 -            dental meetings. ref SDS 0 7T5Q                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
471897 -  ..
471898 - The doctor further granted 10% discount for age.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471900 -  ..
471901 - Talked to Deanne.  Paid bill with credit card.  She will submit                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471902 - invoice and Progress Notes with xrays via email.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
471903 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471904 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
471905 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
4720 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
4803 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
480401 -  ..
480402 - Medical Chart Received from Graham Dental Offices                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
480403 - 
480404 - Follow up ref SDS 61 XE3N, ref SDS 58 TN5F.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
480405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480406 - Progress Notes for meeting on 170424 1400, are stored at...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480408 -              F:\05\00003\SM\GG\PS\GPMG\170424-140000\progress_notes_doctor_ham_170424.pdf                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480410 -         ..
480411 -    1.  Contra Costa Dentistry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
480413 -         ..
480414 -    2.  Date................................... 2017 04 24 1720                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480416 -         ..
480417 -    3.  Patient Notes Master for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480421 -        1.  Date Entered............................ 2017 04 24 1422                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480422 -            Format.................................. Text                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480423 -            Type.................................... General                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480424 -            Tooth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480425 -            Status.................................. Verified                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
480427 -             ..
480428 -        2.  User.................................... Julia Dominguez, RDH                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480430 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480432 -         ..
480433 -    4.  Updated Patient Medical History                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480434 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480435 -        1.  Date Entered............................ 2017 04 24 1545                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480436 -            Format.................................. Text                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480437 -            Type.................................... Chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480438 -            Tooth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480439 -            Status.................................. Verified                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
480441 -             ..
480442 -        2.  User.................................... Daniela Vega                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480443 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480444 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480446 -         ..
480447 -    5.  Comprehensive Exam, FMX                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480448 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480450 -         ..
480451 -    6.  Medical history reviewed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480453 -         ..
480454 -    7.  CC:  Referred by Doctor Grosso for comprehensive dental exam                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480455 -             and cleaning.  No pain.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480457 -         ..
480458 -    8.  EO:  WNL                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480460 -         ..
480461 -    9.  Radiographic findings:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
480463 -             ..
480464 -        1.  Generalized horizontal bone loss. Patient had 4BWs from 2014.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480466 -             ..
480467 -        2.  No significant changes with posterior bone level when                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480468 -            radiographs were compared.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480470 -             ..
480471 -        3.  Radiolucent resin restorations #7-ML, 9-DL, 10-ML.  Watch.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480472 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480474 -         ..
480475 -   10.  Clinical findings:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480476 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480477 -        1.  #7 (ML) composite DOES NOT SHOW UP IN RADIOGRAPHS-watch,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480478 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480479 -        2.  #9-DL and #10 (ML) COMPOSITE DOES NOT SHOW UP IN                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480480 -            RADIOGRAPHS with staining around margins-watch,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
480482 -             ..
480483 -        3.  #21 (B) composite STAIN -watch, #25 (IL) CHIP -watch.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480484 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480486 -         ..
480487 -   11.  Discussed with Julie the amount of calculus build up and plaque                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480488 -        and determined 6 month recall is appropriate and can be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480489 -        alternated with Dr Grosso.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480491 -  ..
480492 - Doctor Grosso was consulted on 150505, for 2nd opinion review of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480493 - specific issues, including periodontal gum pockets. ref SDS 54 IW5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480494 - She was consulted again on 161116 to evaluate response to treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480495 - using better daily dental home care, and reported improved conditions.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480496 - ref SDS 61 004T  She does not do routine cleaning, and recommended                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480497 - Ham Dental for this.  If Doctor Grosso wishes to alternate with Ham                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480498 - Dental, it would be a delight working with her on this basis.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
480500 -         ..
480501 -   12.  Caries risk: low                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
480503 -         ..
480504 -   13.  PSR: 313/313                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480506 -         ..
480507 -   14.  PN: Prior patient of Doctor Taggart and Doctor Graham.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
480509 -         ..
480510 -   15.  NV: 6 month recall                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480512 -         ..
480513 -   16.  AH 54950                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480514 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480515 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480517 -         ..
480518 -   17.  Section 2 of Medical Chart....                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480519 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480520 -        1.  Date Entered............................ 2017 04 24 1546                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480521 -            Format.................................. Text                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480522 -            Type.................................... Chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480523 -            Tooth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480524 -            Status.................................. Verified                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
480526 -             ..
480527 -        2.  User.................................... Daniela Vega                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480529 -         ..
480530 -   18.  New patient prophy, FMX                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480532 -         ..
480533 -   19.  Full mouth scale polish                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480535 -         ..
480536 -   20.  Oral cancer screen:  WNL                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480538 -         ..
480539 -   21.  Perio exam completed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480541 -         ..
480542 -   22.  Cavitron Used:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480544 -         ..
480545 -        Yes/ No- Used ultrasonic in the beginning for part of UR quad-                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480546 -        but ultrasonic had too much water and was hard to handle.  Will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480547 -        try again with ultrasonic at next appointment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480549 -  ..
480550 - Good report.  Julia was helpful with this experiment.  Might work                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480551 - better if patient is sitting up slightly more, as discussed with Julia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480552 - during the work today, per above. ref SDS 0 1R36                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480553 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480554 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480555 -   23.  Recession.................................... 1 - 4 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
480557 -  ..
480558 - Doctor Ham noticed looking at c23, periodontal exam performed by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480559 - Doctor Grosso on 161116 1500. ref SDS 61 XE3N  Periodontal examinaton                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480560 - on 161104 shows recission 0 - 4 mm.  Does this range today 1 - 4 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480561 - reflect updated assessment?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480562 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480563 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480564 -   24.  Mobility...................................... none                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
480566 -         ..
480567 -   25.  Plaque........................................ moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480569 -         ..
480570 -   26.  Calculus...................................... moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480571 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480572 -            (especially lower anterior-tenacious tartar)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
480574 -  ..
480575 - Finding moderate plaque and calculus relates to Julia's report during                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480576 - cleaning process, per above. ref SDS 0 3W4J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480577 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480579 -         ..
480580 -   27.  Bleeding...................................... moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480581 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480582 -            heavier bleeding on #19 upon scaling                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480584 -  ..
480585 - Bleeding has been continuing issue, beginning with Doctor Taggart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480586 - hired to perform deep cleaning in 1986.  At that time pockets were                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
480587 - from 2 - 9, and severe bleeding occurred brushing with conventional                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480588 - toothbrush.  The doctor completed work in 1988, reducing all pockets                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480589 - below 7, with only a few measured 6 mm, reported on 880419 0930.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480590 - ref SDS 1 0001  Bleeding significantly declined, but continued for 20                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480591 - years on occasion.  OA 2011, switched to automatic toothbrush.  Since                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480592 - then there has never been a sign of blood on the brush during timed 8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480593 - - 10 minute brushing cycle, and despite more vigorous force on gums.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480594 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480596 -         ..
480597 -   28.  Stains........................................ moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
480599 -         ..
480600 -   29.  OHI                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
480601 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480602 -            given, Pt was referred to our office by Dr Grosso for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480603 -            dental treatment.  Per patient- periodontal health has been                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480604 -            improving over time and the bone loss has been an ongoing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480605 -            condition.  Patient had a deep cleaning performed in 1986                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480606 -            and has not had one since then.  Patient is seen at Dr                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480607 -            Grosso`s office for a cleaning 1x per year.  I recommend                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
480608 -            patient come in more frequently than 1 year for dental                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480609 -            cleanings due to amount and the tenacity of tartar built up                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480610 -            on lower anterior teeth.  Recommends be placed on a month                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480611 -            recall appointment schedule.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
480613 -  ..
480614 - Doctor Grosso was not seen for dental cleaning, only 2nd opinion                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480615 - examination, including periodontal pockets.  Initial examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
480616 - occurred on 150519 1621. ref SDS 56 IW5I  Follow up examination to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480617 - compare for improvement was performed on 161116 1500. ref SDS 61 IU5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480619 -  ..
480620 - Okay will do another meeting in 6 months.  This addresses request                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480621 - during the meeting with Doctor Ham, for the doctor to recommend dental                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480622 - checkup interval, per above. ref SDS 0 RT5N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
480624 -  ..
480625 - This seems to be saying that "moderate" amount of plaque and calculus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480626 - that occurred over the past year, ref SDS 0 JW3M, since prior dental                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480627 - cleaning, presents significant dental health risk that requires 6                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480628 - month rather than 12 month cleaning.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
480630 -  ..
480631 - If the patient went another 12 months and examination contined to show                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
480632 - "moderate" plaque and calculus, would this still indicate that 12                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
480633 - month dental cleaning intervals present signficant risk?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480635 -  ..
480636 - Since 12 month intervals yielded moderate plaque and calculus, should                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
480637 - 6 month cleaning find minor, slight, minimal... buildup?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
480638 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480639 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480640 -   30.  NV........................................... 6MRC                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
480641 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480642 -   31.  JD 30250                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480643 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480644 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480645 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480646 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480647 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480648 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480649 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480650 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480651 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480652 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480653 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480654 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480655 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480656 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480657 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480658 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480659 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480660 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
480661 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
4807 -