CONTACTS 
0201 - Steven K. Olsen, DDS.
020101 - Dr. Steven K. Olsen
020102 - Mr. Russel Harris, R.N.A.; Dentists

SUBJECTS
Cleaning
Gum Problem, Pockets
X-Rays

0605 -
0605 -    ..
0606 - Summary/Objective
0607 -
060701 - Follow up
060702 -
060703 - Follow up ref SDS 10 0000, ref SDS 9 0000.
060704 -
060705 - No cavaties or extra work needed.  Took xrays - no new findings
060706 - reported.
060707 -
060708 -
060710 -  ..
0608 -
0609 -
0610 - Progress
0611 -
061101 - X-Rays
061102 -
061103 - Russel initially took xrays.
061105 -  ..
061106 - I mentioned comments of the dentist on 941028 about a filling that may
061107 - be "fraying," ref SDS 9 6206.
061109 -  ..
061110 - Russel indicated the xrays do not show deterioration that requires
061111 - treatment at this time.
061112 -
061114 -  ..
061115 - Cleaning & Examination
061116 -
061117 - Steve did the cleaning today, assisted by Russell.  He found two
061118 - isolated instances of gum swelling:
061119 -
061120 -     •  #6 is inflamed with soft buildup which seems to have occurred
061121 -        since the last examination on 941028. ref SDS 9 LB7K
061123 -         ..
061124 -        Steve feels this most likely is due to inaequate brushing
061125 -        because I am right handed, and so this tooth which is an
061126 -        incisor on the upper right side is awkward to reach.  With
061127 -        conscious effort it can be done.
061129 -         ..
061130 -        Isolated inflamation can also be caused by biting hard material
061131 -        such as a potatoe chip, bone or hard candy.  It can cut the gum
061132 -        causing inflamation.  Steve seems to feel this case is more
061133 -        likely due to inadequate brushing because of the build up of
061134 -        material he found beneath the gum.
061136 -             ..
061137 -            My sense is that this area is being covered by brushing,
061138 -            and it fact it may reflect damage from the automatic
061139 -            brushing which is course and abrasive.  Or, it could be
061140 -            from food.
061142 -         ..
061143 -     •  Lower anterior teeth, gums are slightly inflamed but the build
061144 -        up is hard.
061146 -             ..
061147 -            This seems more problematic.  I have a sense that this
061148 -            area has been overlooked in brushing.  My main focus on
061149 -            the front lower teeth is the back area where material can
061150 -            collect because of the shape of that area.
061152 -         ..
061153 -     •  Steve showed one or several teeth that seem to have worn away
061154 -        from excessive brushing that causes abrasion.
061156 -           ..
061157 -          [See follow up at ref SDS 11 line 59.]
061158 -
061160 -      ..
061161 -     Corrections
061162 -
061163 -     Steve recommends rinsing the gums with warm salt water for a few
061164 -     days.
061165 -
061166 -     Brush with a soft brush and work the gums at the tooth line, so
061167 -     the bristles slide between the teeth and the gum to remove
061168 -     buildup.
061170 -             ..
061171 -            Think I will try going back to regular brushing with a
061172 -            soft toothbrush.  It is difficult to accomplish the kind
061173 -            of action Steve recommends with the automatic brush
061174 -            because to do so risks further abrasion.  The goal seems
061175 -            to be to work the bristles between the teeth and gum line
061176 -            to remove material that can collect there.
061177 -
061178 -               [On 950605 0915 examination periodist findings that
061179 -               teeth have improved with standard brushing methods.
061180 -               ref SDS 11 E640
061182 -  ..
061183 - Steve recommends examination by periodontist.  This was set this for
061184 - 950605 0915.
061185 -
061186 -               [On 950605 0915 follow up examination by peridonist.
061187 -               ref SDS 11 0001
061189 -  ..
061190 - Steve did not report observing a filling beginning to fray, which came
061191 - up the last time on 941028. ref SDS 9 6206  Lack of notice today,
061192 - together with the xrays, also, taken today, and reporting no findings
061193 - of any problems, noted above, ref SDS 0 2A7O, indicates resolution of
061194 - the prior matter on 951028.
061195 -
061196 -     [On 951128 1000 examination found no further evidence of problems
061197 -     with frayed tooth. ref SDS 12 W27J
061199 -      ..
061200 -     [On 960604 1000 follow up examination continues to report no
061201 -     further problems with frayed tooth. ref SDS 13 TI7J
061202 -
061203 -
061204 -
061206 -  ..
0613 -
0614 -
0615 - Analysis
0616 -
061601 - Gum swelling reported today, ref SDS 0 0065, seems to be new, since
061602 - there was none reported at the last examination on 941028. ref SDS 9
061603 - 0001  Actually, at that time on 941028, the dentist seems to have
061604 - reported that tooth #6 showed evidence of loss of gum material,
061605 - ref SDS 9 LB7K  Maybe the inflamation discussed today on tooth #6,
061606 - ref SDS 0 0065 contributes to gum swelling.  This indicates a pattern
061607 - of conduct is emerging that is more difficult to modify than expected.
061609 -  ..
061610 - It appears now that the soft toothbrush could be a better solution
061611 - than the electric tool.  The latter causes tooth abrasion.  It may not
061612 - be pliant enough to be worked between the tooth and gum, which is
061613 - needed.
061614 -
061615 -
061616 -
061617 -
0617 -