CONTACTS 

SUBJECTS
Dental Examination Cleaning Gum Bleeding Report Conflicts Patient Hi                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2203 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2203 -    ..
2204 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2205 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
220501 - Follow up ref SDS 20 0000. ref SDS 16 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
220502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220503 - Tanya did excellent work cleaning teeth and taking xrays, including                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
220504 - use of manual dental pick to avoid painful effects of ultrasonic                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
220505 - scaler. ref SDS 0 004T  Examination found moderate gum bleeding, which                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220506 - conflicts with record brushing teeth past 20 years. ref SDS 0 8659                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
220507 - There was concern to avoid using modern toothpaste with whitening                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
220508 - agent, and recommendation to floss. ref SDS 0 AW4O  Doctor Graham did                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220509 - final examination and said dental condition appears healthy.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
220510 - ref SDS 0 O764  Set action item to check on condition of a particular                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220511 - tooth in 6 months. ref SDS 0 SZ55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
220512 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220513 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220514 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220515 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220517 -  ..
2206 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2207 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2208 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2209 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
220901 - On 101108, Lynn scheduled examination and cleaning for today, 110202,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220902 - confirmed in letter. ref SDS 20 HG6P, and following up prior cleaning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
220903 - on 100325 0800. ref SDS 16 TL9F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220905 -  ..
220906 - Background on prior work is listed on 100514 0730. ref SDS 18 VH5N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
220907 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220908 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220910 -  ..
2210 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2211 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2212 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2213 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
221301 - Meeting today scheduled by Doctor Mark Graham's letter received on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221302 - 101112 0727. ref SDS 21 VH5N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221304 -  ..
221305 - Tanya was dental hygienist who did the cleaning work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221307 -  ..
221308 - Xrays were taken to supplement prior work on 090302 0815. ref SDS 8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
221309 - RQ9N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221311 -  ..
221312 - Upon request, Tanya was considerate and used a hand dentist pick,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221313 - instead of the ultrasonic scaler.  This change avoided severe pain,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221314 - experienced previously on 050518 1100, ref SDS 3 FB6L, and following                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
221315 - Doctor Mark Graham's practice in this case on 100325 0800. ref SDS 16                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
221316 - SW86                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221317 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221318 -            [On 110225 1644 received and paid invoice $170. ref SDS 22                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221319 -            004T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221321 -  ..
221322 - The Ultasonic scaler was used to remove severe plaque on the inside of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221323 - the front lower teeth, following prior practice Russ used at Olsen                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221324 - Dental offices, reported on 090306 0800. ref SDS 9 V38I  This narrow                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
221325 - application was well tolerated without numbing agent.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221327 -  ..
221328 - Prior experience using a numbing agent, like novicane injection, or a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221329 - topical agent, has made using the ultrasonic scaler tolerable,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
221330 - reported on 050518 1100. ref SDS 3 F77O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
221332 -  ..
221333 - Tanya reported finding...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
221334 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221335 -    1.  Moderate to severe gum bleeding from back teeth.  Exact                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
221336 -        location was not clear during the meeting.  Tanya indicated the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221337 -        medical chart for the meeting on 100325, also, reports finding                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221338 -        moderate to severe gum bleeding.  There is nothing in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221339 -        record on 100325 indicating Mark reported finding bleeding                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221340 -        gums. ref SDS 16 SW86                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221342 -         ..
221343 -    2.  Tissue fraying from the inside the mouth, which Tana attributed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221344 -        to tooth paste with ingredients harmful to some people.  Tanya                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221345 -        seemed to say this is not injurious to health, but also                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
221346 -        recommended changing tooth paste.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
221348 -  ..
221349 - Tanya recommends flossing to avoid bleeding from gums found today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221350 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221351 -            [...below, oral hygiene is fair based on findings of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221352 -            moderate to severe gum bleeding, ref SDS 0 4Q6N, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221353 -            patient report of using a dental instrument to supplment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221354 -            brushing rather than floss. ref SDS 0 GE38                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221356 -  ..
221357 - Previously, bleeding gums was attributed to age and aggressive                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
221358 - brushing, reported on 950518 1100. ref SDS 2 0110   Periodontal deep                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
221359 - cleaning was performed in 1986 and 1987.  At that time 25 years ago,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221360 - the gums were bleeding, based on taste and blood evident on tooth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221361 - brush.  Following periodontal work, examination by Doctor Taggart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221362 - found this problem was improved, reported on 880419 0930. ref SDS 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
221363 - 0001  Since that time, daily procedures with dental pick further                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221364 - improved dental health eliminating evidence of gum bleeding by taste                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221365 - and brushing.  Pockets have reduced to only a few readings of 4,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221366 - reported by Mark on 100325 0800. ref SDS 16 SW66                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221368 -  ..
221369 - Today, Doctor David Graham did a final inspection.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221371 -  ..
221372 - The doctor seemed to say the teeth look very good.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221373 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221374 -            [...Medical Chart finding fair oral hygiene and heavy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221375 -            bleeding gums seems conflicting with "teeth look very                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221376 -            good." ref SDS 0 4Q6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221378 -  ..
221379 - Asked for clarification, based on Tanya's report of bleeding gums, per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221380 - above. ref SDS 0 8659                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221382 -  ..
221383 - David checked the medical chart for patient history on periodontal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221384 - pocket depth, which his son, Mark, measured during examination on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221385 - 100325 0800. ref SDS 16 SW66  As shown at that time, prior periodontal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
221386 - examination less than a year ago found 4 or 5 readings of maximum 4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221387 - pockets, out of a total of 64 readings, which seems to be inside and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221388 - outside of 32 teeth.  The doctor explained that pockets of 4 can                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221389 - signifiy beginning of potential problems.  He said, however, people                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221390 - vary.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221392 -  ..
221393 - David advised that he has had a pocket of 6 for several years and had                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221394 - no problems.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
221396 -  ..
221397 - David explained his practice to perform periodontal examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221398 - (sounded like) every 2 years, so he indicated the next examination for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221399 - pocket depth will be due in 6 months.  Nominally, since gum pockets                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221400 - were checked during examination on 100325, this might be deferred                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221401 - until next February.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221403 -  ..
221404 - Doctor Graham offered a complex, extended explanation of oral hygiene                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221405 - that balances level of effort for daily care based on patient history                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221406 - of dental disease.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221408 -  ..
221409 - David reviewed xrays taken earlier today (received in the record with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221410 - Mark's letter later this afternoon, per below. ref SDS 0 534L).  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221411 - noticed a potential problem in the 2nd scan explained during the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221412 - meeting only as on the 2nd lower tooth from the left.  David                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
221413 - recognized the number relative to the chart received from Mark on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221414 - 100325 0800, ref SDS 16 SW54  Seeing this slight blemish penetrating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
221415 - the enamel requires enlarging the image several times...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
221417 -                ..
221418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221420 -  ..
221421 - The doctor asked Tanya to enter in the medical chart an action item to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221422 - review this location again during the next examination in 6 months.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221424 -  ..
221425 - Requested a letter transmitting xrays, and explaining findings from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
221426 - examination today as set out in the medical chart, including the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221427 - potential problem the doctor identified from xrays today, with follow                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221428 - up work plan.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
221429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221430 -            [...below, on 110202 0800 at 1926 the medical chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221431 -            received from Mark does not mention this action item, nor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
221432 -            the tooth number identified for following up. ref SDS 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221433 -            534L and ref SDS 0 GE46                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
221435 -             ..
221436 -            [On 110928 0800 Doctor Mark Graham discussed finding cavity                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
221437 -            beginning to form between teeth on lower right side between                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221438 -            back and front teeth.  Mark planned to note the tooth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
221439 -            number in the medical chart, ref SDS 23 DQ90; medical chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
221440 -            merely states "continue to monitor #29 D" and does not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221441 -            indicate location nor cavity activity. ref SDS 23 5L5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
221443 -             ..
221444 -            [On 120404 0800 Doctor Mark Graham explained finding cavity                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
221445 -            beginning to form on tooth #13; there is no mention of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
221446 -            tooth 29D, ref SDS 24 8E8J, cited in medical chart for work                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
221447 -            110928 for monitoring, ref SDS 23 5L5I, and which was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221448 -            described during the meeting as a lower right side between                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
221449 -            front and back teeth. ref SDS 23 DQ90                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
221450 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221451 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221452 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2215 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2303 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2304 - 1926                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
230501 -  ..
230502 - Medical Chart Received from Graham Dental Offices                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230503 - 
230505 -  ..
230506 - Received from Mark the following letter requested during the meeting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230507 - earlier today, per above, ref SDS 0 8765, and saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
230508 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230509 -    1.  Subject: x-rays & notes from your visit                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230510 -        Date: Wed, 2 Feb 2011 16:54:27 -0800 (PST)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230517 -         ..
230518 -    2.  Notes from hygienist regarding your cleaning appointment on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230519 -        2-2-2011:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
230521 -             ..
230522 -        1.  Health history reviewed-no change. patient completed new                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
230523 -            health history.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
230525 -             ..
230526 -        2.  Examination findings...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230527 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230528 -            a.  oral hygiene is fair.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230529 -            b.  general moderate plaque and calculus.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230530 -            c.  moderate to heavy bleeding.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
230532 -  ..
230533 - Finding oral hygiene "fair" appears conflicting with Doctor Graham's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230534 - review, per above. ref SDS 0 O764                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230536 -  ..
230537 - Finding "moderate to heavy bleeding" may be an odd occurrance.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
230538 - Periodontal examination on 880419 reported prior bleeding problem                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230539 - resovled. ref SDS 1 0001  Since that time there has been no evidence                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
230540 - of bleeding.  Prior to "deep cleaning" periodontal work, there was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230541 - routinely evidence of gum bleeding after brushing teeth.  Since that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230542 - time on 880419, there has been only rare occassions when blood                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
230543 - appears on tooth brush after eating somthing very stiff, like potato                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230544 - chips, maybe bacon -- again very rare.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
230546 -  ..
230547 - Graham Dental Office Medical Chart continues...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
230548 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230549 -        3.  Cleaning...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
230550 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230551 -            a.  cavitron (ultrasonic scaler) lower anterior only.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
230552 -            b.  hand scale,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
230553 -            c.  polish and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
230554 -            d.  floss.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
230556 -             ..
230557 -        4.  Recommendations and Guidance...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
230558 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230559 -            Explained etiology of periodontal disease.  advised patient                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
230560 -            of moderate+ bleeding and the need to start flossing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
230561 -            patient currently doesn't floss - "uses instrument."                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230563 -         ..
230564 -    3.  Exam Dr David Graham...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
230565 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230566 -        1.  Explained gum disease.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230567 -        2.  Oral cancer screening was within normal limits.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
230568 -        3.  Full mouth probing at next 6 month cleaning.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
230570 -  ..
230571 - We need a written explanation of David's remarks, because the detail                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230572 - was too complex to remember long enough for entering in the record and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
230573 - following up.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
230575 -  ..
230576 - Graham Dental Office Medical Chart continues...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
230577 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230578 -    4.  Your 6 month cleaning is scheduled on Wednesday August 10 at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
230579 -        8a.m. see you in 6 months                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
230580 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230581 -            [On 110928 0800 Lynn scheduled next meeting in April 2012,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
230582 -            and advised the date would be entered in the medical chart                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
230583 -            again, and submitted by the dental team with email.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
230584 -            ref SDS 23 DP59                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
230585 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230586 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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