CONTACTS
0202 - Graham Dental Offices O-00000887 0101
020201 - Mr. David A Graham, DDS; Dentist
020203 - Executive Office O-00000887 0101
SUBJECTS
Dental Examination Tooth #2 Broke OA 060310 2nd Opinion Investigate
1403 -
1403 - ..
1404 - Summary/Objective
1405 -
140501 - Follow up ref SDS 18 0000. ref SDS 17 0000.
140502 -
140503 - Excellent second opinion consultation today. Doctor Graham was warm
140504 - and generous remembering Richard. ref SDS 0 RV65 Initially discussed
140505 - three (3) options for repairing tooth #2. ref SDS 0 IS9O Examination
140506 - indicates minimal solution is an extraction, ref SDS 0 H64F, and costs
140507 - from $200 - $400. Implant would cost about $5K, ref SDS 0 H664,
140508 - confirming proposal by Olsen's office. The doctor seemed to indicate
140509 - xrays today showing a crown reduces the risk of tooth #31 extruding
140510 - that would otherwise occur from extracting tooth #2 without an
140511 - implant, ref SDS 0 0326, and so he would choose that course for his
140512 - own treatment. ref SDS 0 H68W Got a referral for Doctor Keith in
140513 - Walnut Creek to perform the extraction. Doctor Graham will submit a
140514 - letter confirming findings for second opinion today. ref SDS 0 FC7L
140515 -
140516 - [On 090303 2053 letter to Doctor Harris in Olsen Dental Offices
140517 - confirming meeting on 090306 0830 and clarifying scope to
140518 - perform extraction of tooth #2. ref SDS 19 O13H
140520 - ..
140521 - [On 090303 2113 called Richard and advised of good results
140522 - getting 2nd opinion from Doctor Graham. ref SDS 20 J16G
140524 - ..
140525 - [On 090306 0800 Doctor Meyer did the extraction with bone
140526 - grafts to facilitate implant later if needed. ref SDS 21 J55O
140528 - ..
140529 - [On 090310 0910 called Doctor Graham; he sent the 2nd opinion
140530 - letter on 090302, but there may be a computer system problem,
140531 - because it has not been received; thanked the doctor, and
140532 - advised a letter will be submitted, ref SDS 22 JS5G, for the
140533 - meeting on 090302, and implementation of his 2nd opinion at
140534 - Olsen Dental Services on 090306. ref SDS 21 0001
140536 - ..
140537 - [On 090312 0837 letter to Doctor Graham confirms work performed
140538 - by Olsen Dental Services; requests re-submission of 2nd opinon,
140539 - and requests invoice for consultation. ref SDS 23 Y16J
140540 -
140541 -
140542 -
140544 - ..
1406 -
1407 -
1408 - Background
1409 -
140901 - Repairing tooth #2 is reported on 090220. ref SDS 15 FQ5G
140902 -
140903 - At that time on 090220, Christi advised that Russ would review the
140904 - chart, and call to discuss scope and price.
140906 - ..
140907 - On 090223 Russ called this from Steve Olsen's office, to follow up the
140908 - request for proposal on 090220. ref SDS 15 F066
140910 - ..
140911 - Russell indicated tooth #2 would require an implant, and this would
140912 - cost about $5K to accomplish. ref SDS 16 VY7W Christi called back and
140913 - scheduled an initial meeting on 080306. Russ will spend an hour to
140914 - clean the teeth, and take some xrays. The Periodonist will make an
140915 - examination for 30 minutes.
140917 - ..
140918 - For this 1.5 hours of work, and xrays, the Olsen office will charge
140919 - $500. ref SDS 16 9Z7I
140921 - ..
140922 - This cost seems higher than original pricing proposed on 050518.
140923 - ref SDS 3 ZZ4M
140925 - ..
140926 - On 090223 called Richard and he indicated that tooth #2 often does not
140927 - require implant repair. He sometimes does only an extraction.
140928 - ref SDS 17 JW9O Richard suggested calling his dentist in Danville,
140929 - David Graham. Richard went to dental school with David, and has very
140930 - high regard for his work, especially because Doctor Graham continued
140931 - to teach dentistry, while running his own practice in Danville.
140933 - ..
140934 - On 090223 1118 called and scheduled meeting with Doctor Graham this
140935 - morning for 2nd opinion on repairing tooth #2. ref SDS 18 8V9O
140936 -
140937 -
140938 -
140940 - ..
1410 -
1411 -
1412 - Progress
1413 -
141301 - Had a little difficulty finding the location on La Gonda Way. The
141302 - professional center is closer to El Cerro than expected. Had to
141303 - cross El Cerro, then double back, and found Doctor Graham's office on
141304 - the right side of the street going North from El Cerro.
141305 -
141306 -
141307 -
1414 -
SUBJECTS
Dental Professional Exceptional Skills Citizenship Contributing Pers
2703 -
270401 - ..
270402 - Richard Exceptional Dental Career Strong Citizenship
270403 -
270404 - Follow up ref SDS 14 CZ7M.
270405 -
270406 - Met with the doctor initially in the lobby.
270408 - ..
270409 - Doctor Graham asked about Richard. He remembered Richard's success in
270410 - wrestling. The doctor admired Richard's high energy for life and
270411 - passion for excellence. He seemed aware that Richard had closed his
270412 - practice due to illness about 5 years ago. Doctor Graham also
270413 - remembered that despite being the biggest man in their class at the UC
270414 - Dental School in San Francisco, even with large hands Richard was the
270415 - best in the class performing delicate and intricate procedures
270416 - required for dental work.
270418 - ..
270419 - Discussed briefly Richard's exceptional citizenship, volunteering his
270420 - time and money coaching the Cupertino High School Wrestling team for
270421 - many years, while making a living with a dental practice. Doctor
270422 - Graham nodded saying "Richard has a heart as big as a house."
270423 -
270424 -
270425 -
2705 -
SUBJECTS
Patient History Tooth #2 Failure Context Prior Work Tooth #19 Root C
4203 -
420401 - ..
420402 - Patient History Dental Work in 2005 Initial Review
420403 -
420404 - Doctor Graham reviewed the record of prior work performed by Steve
420405 - Olsen's office in July 2005. Root canal on #19, completed on 050518,
420406 - ref SDS 3 ZZ4M, Crowns on #18 and #19, completed on 020707.
420407 - ref SDS 6 QT5I
420409 - ..
420410 - Commended Doctor Olsen, and Doctor Harris for general dentistry, and
420411 - Doctor Hasse's excellent work doing the root canal on 050519.
420412 - ref SDS 4 C476 Doctor Graham is not familiar with Steve Olsen's
420413 - practice in San Francisco.
420414 -
420416 - ..
420417 - Tooth #2 Filling Failed in 2006 Eventually Portions Broke Off
420418 -
420419 - Reviewed background reporting problems with tooth #2, shown in the
420420 - record on 060317. ref SDS 8 YR4J
420422 - ..
420423 - Considered options for tooth #2...
420424 -
420425 - 1. Grind the tooth down and leave in place, similar tooth
420426 - #31.
420427 -
420428 - 2. Extract tooth #2, presents risks of erruption tooth #31.
420430 - ..
420431 - 3. Implant new tooth #2 after extraction.
420433 - ..
420434 - During examination Doctor Graham was considerate of the achalasia
420435 - problem, diagnosed on 051202, ref SDS 7 5B5K, and which makes laying
420436 - back flat normally required for dental work, difficult by causing a
420437 - drowning condition. This was solved today by sitting at a more
420438 - elevated angle.
420439 -
420440 - [On 100325 0800 as a result of Heller Myotomy surgery on
420441 - 091216 at VA Medical Center in San Francisco, was able to
420442 - fully recline to facilitate dental procedures. ref SDS 24
420443 - SV6S
420444 -
420445 -
420446 -
4205 -
SUBJECTS
Examination Tooth #2 No Pain Extraction Cost $200 - $400 Minimal Sol
6103 -
610401 - ..
610402 - Examination Indicates Extraction Minimal Solution
610403 -
610404 - Examination showed the gum has partially covered the portion of tooth
610405 - #2 that broke off. This creates a serious risk of future infection,
610406 - and so requires at a minumum extraction, and possibly an implant is
610407 - needed. Doctor Graham asked if tooth #2 is painful, and indicated
610408 - that prolonged damage since 2006 would be expected to cause continuing
610409 - discomfort.
610411 - ..
610412 - So far, there has been no pain in the past 3 years, since the problem
610413 - started with the filling coming loose.
610415 - ..
610416 - The doctor asked why repairs were delayed for 3 years?
610418 - ..
610419 - This was an economic decision.
610421 - ..
610422 - Doing an implant after extraction is the most comprehensive, and risk
610423 - averse solution.
610425 - ..
610426 - Doctor Graham explained that a standard extraction of tooth #2 would
610427 - create an open space above tooth #31 that risks erruption occurring
610428 - over several years, say 2 - 5 years. This could eventually require
610429 - extracting tooth #31, and/or doing implants for both tooth #2 and
610430 - tooth #31. This part of analysis requires clarification.
610431 -
610432 - [...below xrays show tooth #31 has a crown, and so there is
610433 - much less risk of erruption if tooth #2 is extracted and is not
610434 - restored by implant. ref SDS 0 0326
610436 - ..
610437 - Cost of extraction alone seems to be $200 - $400. During the meeting,
610438 - the doctor called a colleague at a referral practice across town and
610439 - got a ballpark estimate for extraction.
610441 - ..
610442 - Doctor Graham prefers that for this extraction project he would rather
610443 - make the referral to another specialist, Doctor Keith, who does both
610444 - extractions and implants. He explained that Doctor Keith may strongly
610445 - recommend doing the implant. Even though at this time, the plan only
610446 - rquires extraction, he feels Doctor Keith is better able to do the
610447 - work in a way that facilitates the implant step, if needed later.
610449 - ..
610450 - Sounded like Doctor Keith is a former student of Doctor Graham's at
610451 - the UC dental college in San Francisco. There was also indication
610452 - that Doctor Keith attended Harvard for undergraduate work.
610453 -
610454 -
610455 -
6105 -
610501 -
6106 -
SUBJECTS
2nd Opinion Recommends Extraction Tooth #2 with Steps Enable Implant
7903 -
790401 - ..
790402 - 2nd Opinion Recommends Extraction Implant Tooth #2 Estimate $5K - $6K
790403 - Implant Tooth #2 Estimate $5K - $6K 2nd Opinion Recommends Extraction
790404 -
790405 - The doctor estimates the cost for an implant would run $5K - $6K,
790406 - similar to the estimate by Olsen's office on 090224. ref SDS 16 KT9I
790408 - ..
790409 - Doctor Graham explained that his examination today suggests the scope
790410 - of an implant for tooth #2 requires several extra steps, including a
790411 - CT scan to find collateral structures, like the sinus system, which
790412 - must be laid out to position implant roots in the jaw bone in a way
790413 - that does not damage such other systems. This aligns with Richard's
790414 - concern about requirements to avoid damaging the sinus system with an
790415 - implant for tooth #2, during the call last week on 090223. ref SDS 17
790416 - KU4L
790418 - ..
790419 - The doctor presented a great many technical issues that drive the
790420 - decision for the level of care needed in this case. It was difficult
790421 - to grasp details of this discussion.
790422 -
790423 - [...below, the doctor will submit a letter explaining technical
790424 - terms and clarifying 2nd opinion. ref SDS 0 FC7L
790426 - ..
790427 - The doctor indicated that, if he was the patient, he would choose
790428 - extraction with additional procedures that faciliate an implant later
790429 - if experience proves this is actually needed.
790430 -
790431 - [On 090303 2053 letter to Doctor Harris in Olsen Dental Offices
790432 - confirming meeting on 090306 0830 and clarifying scope to
790433 - perform extraction of tooth #2. ref SDS 19 O13H
790435 - ..
790436 - [On 090306 0800 Doctor Meyer did the extraction with bone
790437 - grafts to facilitate implant later if needed. ref SDS 21 J55O
790439 - ..
790440 - [On 090312 0837 letter to Doctor Graham confirms work performed
790441 - by Olsen Dental Services; requests re-submission of 2nd opinon,
790442 - and requests invoice for consultation. ref SDS 23 Y16J
790443 -
790444 -
790445 -
790446 -
790447 -
7905 -
SUBJECTS
Xrays Full Set Examination Tooth #2 Extraction Viable Choice 2nd Opi
9903 -
990401 - ..
990402 - Xrays Full Set to Support 2nd Opinion Process
990403 -
990404 - The doctor took xrays to evaluate requirements, and for submission
990405 - with the referral to Doctor Keith.
990407 - ..
990408 - Carol took a full set of xrays. One of the scans failed and had to
990409 - be done again. Xrays took about 20 minutes.
990410 -
990411 - [...below xrays show tooth #31 has a crown, and so there is
990412 - much less risk of erruption if tooth #2 is extracted and is not
990413 - restored by implant. ref SDS 0 0326
990414 -
990415 -
990417 - ..
990418 - Xrays Support Extraction of Tooth #2 Because Tooth #31 Crown
990419 -
990420 - Doctor Graham showed in the xrays that tooth #31 below tooth #2 has a
990421 - crown. He seemed to indicate there is less risk than initially cited
990422 - for tooth #31 to "errupt" into the open space from extracting tooth
990423 - #2, discussed above. ref SDS 0 H646
990425 - ..
990426 - This seems to increase cost the advantage of starting with an
990427 - extraction for tooth #2, per above. ref SDS 0 H68W
990428 -
990429 - [On 090306 0800 submitted xrays taken today by Doctor Graham to
990430 - support work on tooth #2. ref SDS 21 029N
990431 -
990432 - [On 090306 0800 Doctor Harris in the Olsen Dental Offices does not
990433 - rely on the crown to prevent tooth #31 from extruding into the
990434 - space created by removing tooth #2, and cites minimal contact from
990435 - degraded tooth #2 is sufficient to account for no evidence of
990436 - movement by tooth #31 during the 2 years this condition has
990437 - existed. ref SDS 21 O13H
990439 - ..
990440 - [On 090306 0800 Doctor Meyer, oral surgeon who performed
990441 - extraction of tooth #2, does not cite concern about tooth #31
990442 - errupting into the space from removing tooth #2. ref SDS 21 IK5R
990443 -
990444 -
990445 -
9905 -
SUBJECTS
Tooth #7 or #8 Dead Xrays Examination Appears May Require Replacemen
AJ03 -
AJ0401 - ..
AJ0402 - Front Tooth #7 or #8 Appears Dead May Require Replacement Xrays
AJ0403 -
AJ0404 - The doctor showed in the xrays dark coloration in the bone surrounding
AJ0405 - the root of tooth #7 or #8, and indicated that these xray findings
AJ0406 - occur when a tooth is "dead," and so should be replaced.
AJ0407 -
AJ0408 - xx
AJ0409 - 1111111
AJ0410 - 1234567890123456
AJ0411 - R L
AJ0412 - 3332222222222111
AJ0413 - 2109876543210987
AJ0415 - ..
AJ0416 - This seems similar to discussion with Steve on 050518 showing slight
AJ0417 - coloration surrounding the roots of tooth #19 to support
AJ0418 - recommendation to perform a root canal. ref SDS 3 FB7Y
AJ0419 -
AJ0420 - [On 090306 0800 examination reviewing xrays at the Olsen
AJ0421 - Dental Offices did not identify tooth #7 or #8 requiring
AJ0422 - replacement or any form of remedial work. ref SDS 21 OE4F
AJ0424 - ..
AJ0425 - [On 140416 0800 examination indicates tooth #9 may be dead;
AJ0426 - tooth #8 seems okay. ref SDS 25 IP40
AJ0427 -
AJ0428 -
AJ0429 -
AJ0430 -
AJ0431 -
AJ05 -
SUBJECTS
Education Innovation Student Consider Dental School Observe Daily Wo
B603 -
B60401 - ..
B60402 - Student Considering Dental School Discuss Continual Learning Model
B60403 - Continual Learning Extends Traditional Practice of Continuing Education
B60404 -
B60405 - During xrays and while waiting for scans to be processed and evaluated
B60406 - by Doctor Graham, talked to Amy.
B60408 - ..
B60409 - She recently graduated from UCLA. Amy is considering dental school,
B60410 - and so is in Doctor Graham's office today under a program to observe
B60411 - daily work. Understanding first hand details of the profession as a
B60412 - career helps reduce the dropout rate in dental school. Students can
B60413 - quit before they invest money and time, and then discover later that
B60414 - commitment to dentristy is not for them.
B60416 - ..
B60417 - Discussed briefly with Amy the knowledge management dilemma of
B60418 - children working hard for 16 years learning and applying literacy in
B60419 - order to be judged fit to land a job, and then spending the next 50
B60420 - years on the job avoiding literacy due to fear of being judged
B60421 - accountabile for mistakes, as set out in the record on 991108.
B60422 - ref SDS 2 TU8S
B60424 - ..
B60425 - Explained opportunity to use technology for augmenting intelligence by
B60426 - adding time, conext, and connection to improve common literacy, i.e.,
B60427 - reading and writing, explained in POIMS. ref OF 6 8555
B60429 - ..
B60430 - Doctor Graham overheard some of this discussion while treating another
B60431 - patient in an adjacent room. He interjected comments that continuing
B60432 - education will be important in the future, echoing the Toffler's ideas
B60433 - for coping with a rapidly changing world, reviewed on 950911.
B60434 - ref SDS 1 2222 Interenst in continuing education reflects Richard's
B60435 - comment a few days ago that Doctor Graham taught and may still be
B60436 - teaching at the UC Dental College.
B60438 - ..
B60439 - POIMS supports a model of "continual learning" by investing time to
B60440 - capture the record of daily work, ref OF 3 ZC6N, and "connect the
B60441 - dots" of cause and effect that turn information into the power of
B60442 - knowledge. ref OF 3 QP4F
B60444 - ..
B60445 - This makes a distinction between "education" as a formal process of
B60446 - professors and grades, and "learning" that occurs constantly from
B60447 - experience performing daily work in meetings, calls, and documents.
B60449 - ..
B60450 - Amy will check welchco.com to review Communication Metrics for using
B60451 - technology to augment intelligence.
B60452 -
B60453 -
B60454 -
B605 -
SUBJECTS
Referral Doctor Keith Extraction Tooth #2 Oral Surgery Evaluate Impl
BT03 -
BT0401 - ..
BT0402 - Referral with Xrays for Meeting with Doctor Keith
BT0403 -
BT0404 - Doctor Graham prepared a referral notice to...
BT0405 -
BT0406 - Scott E Keith, Prosthodontist
BT0407 - Maggie T Chao, Prosthodontist
BT0408 - Dental Implant Center
BT0409 - 1111 Civic Drive Suite 320
BT0410 - Walnut Creek, CA 925 935 4040
BT0411 - office@implantcenterwc.com
BT0412 -
BT0413 - [On 090303 2053 letter to Doctor Harris in Olsen
BT0414 - Dental Offices asking to implement Doctor Graham's
BT0415 - work plan. ref SDS 19 O13H
BT0417 - ..
BT0418 - Date: 090302
BT0420 - ..
BT0421 - Professional Services Requested
BT0422 -
BT0423 - Implant surgical evaluation Teeth #2
BT0425 - ..
BT0426 - Comments:
BT0427 -
BT0428 - Please remove non-restorable #2 and evaluate for
BT0429 - possible implant replacement. Graft?
BT0430 -
BT0431 - Thank you.
BT0433 - ..
BT0434 - Areas of Special Concern
BT0435 -
BT0436 - x
BT0437 - 1111111
BT0438 - 1234567890123456
BT0439 - R L
BT0440 - 3332222222222111
BT0441 - 2109876543210987
BT0443 - ..
BT0444 - Special Instructions...
BT0445 -
BT0446 - Contact patient to arrange appointment
BT0447 - Patient will call for appointment
BT0448 - Call before patient is seen
BT0449 -
BT0450 - Xrays will be sent
BT0451 -
BT0452 - Via email to:
BT0453 -
BT0454 - office@implantcenterwc.com
BT0456 - ..
BT0457 - x Xrays will be carried by patient
BT0458 - Xrays unavailable - please take
BT0459 -
BT0461 - ..
BT0462 - Referred by Doctor David Graham
BT0463 -
BT0464 -
BT0465 -
BT05 -
SUBJECTS
Payment Deferred Pending Billing Tooth #2 Extraction Implant 2nd Opi
C903 -
C90401 - ..
C90402 - Payment Deferred Pending Billing
C90403 -
C90404 - While waiting for xrays to be processed, asked Lynn at the front desk
C90405 - for an invoice to pay for the work today, including xrays.
C90406 -
C90407 - Lynn said that the doctor will advise her later about preparing an
C90408 - invoice, and this will be submitted for payment.
C90409 -
C90410 -
C90411 -
C905 -
SUBJECTS
Case Management 2nd Opinion Email Scope Work Required Referral Extra
CZ03 -
CZ0401 - ..
CZ0402 - Case Management Based on Doctor Graham's Second Opinion
CZ0403 -
CZ0404 - Thanked Doctor Graham for support today, and looking forward to
CZ0405 - resolving dental issues.
CZ0407 - ..
CZ0408 - Requested work plan, similar to UCSF proposal for Millie on 081016.
CZ0409 - ref SDS 13 BV9J The doctor used a lot of technical terms today that
CZ0410 - were not explained, and so cannot be remembered, per above,
CZ0411 - ref SDS 0 H68S, but are needed in the record for case management,
CZ0412 - including referral consultation with Doctor Keith.
CZ0413 -
CZ0414 - [On 090303 2053 letter to Doctor Harris in Olsen
CZ0415 - Dental Offices asking to implement Doctor Graham's
CZ0416 - work plan. ref SDS 19 O13H
CZ0418 - ..
CZ0419 - This evening after work at home, Doctor Graham will submit a report
CZ0420 - via email on his examination with recommendations and cost estimates
CZ0421 - for a work plan going forward, similar to the plan submitted by Olsen
CZ0422 - Dental Care on 050518. ref SDS 3 F85G This can be used to support
CZ0423 - meeting with Doctor Keith.
CZ0424 -
CZ0425 - [On 090310 0910 called Doctor Graham; he sent the
CZ0426 - 2nd opinion letter on 090302, but there may be a
CZ0427 - computer system problem, because it has not been
CZ0428 - received; thanked the doctor, and advised a letter
CZ0429 - will be submitted, ref SDS 22 JS5G, for the meeting
CZ0430 - on 090302, and implementation of his 2nd opinion at
CZ0431 - Olsen Dental Services on 090306. ref SDS 21 0001
CZ0432 -
CZ0433 -
CZ0434 -
CZ0435 -
CZ0436 -
CZ0437 -