CONTACTS
SUBJECTS
Dental Examination Cleaning No New Cavities Decay Found 2 Fillings #
4703 -
4703 - ..
4704 - Summary/Objective
4705 -
470501 - Follow up ref SDS 61 0000. ref SDS 60 0000.
470502 -
470503 -
470504 -
470505 -
470506 -
470508 - ..
4706 -
4707 -
4708 - Background
4709 -
470901 - On 101108, Lynn scheduled examination and cleaning for today, 110202,
470902 - confirmed in letter. ref SDS 27 HG6P, and following up prior cleaning
470903 - on 100325 0800. ref SDS 23 TL9F
470905 - ..
470906 - Background on prior work is listed on 100514 0730. ref SDS 25 VH5N
470908 - ..
470909 - On 110928 0800 dental examination, cleaning, ref SDS 33 8659, and
470910 - periodontal chart shows good oral hygeine has restored gum health.
470911 - ref SDS 33 6Z3V
470913 - ..
470914 - On 110929 2028 letter from Graham Dental received medical chart
470915 - progress notes, ref SDS 34 VT5I, for work on 110928. ref SDS 33 534L
470917 - ..
470918 - On 110930 2246 letter to Graham Dental submits questions on issues in
470919 - progress notes for work on 110928. ref SDS 35 VT5I
470921 - ..
470922 - On 111022 1923 received and paid invoice for dental services performed
470923 - today on 110928. ref SDS 36 004T
470925 - ..
470926 - On 111025 1928 letter from Lynn at Graham Dental reports medical chart
470927 - progress notes for meeting on 110928 were submitted previously on
470928 - 110929. ref SDS 37 VT5I
470930 - ..
470931 - On 111026 1022 submit letter to Lynn at Graham Dental with questions
470932 - and action items on medical chart and progress notes for meeting
470933 - performing dental examination 110928. ref SDS 38 VT5I
470935 - ..
470936 - On 120404 0800 dental examination, cleaning. ref SDS 39 004T
470938 - ..
470939 - On 120507 1015 paid invoice for dental services on 120404.
470940 - ref SDS 40 004T
470942 - ..
470943 - On 121010 0800 dental examination, cleaning and xrays showing no
470944 - evident progression of decay. ref SDS 41 O75H
470946 - ..
470947 - On 130417 0800 dental examination, cleaning, defer fillings recover
470948 - from cavity past 18 months on tooth #13, and defer treatment new
470949 - cavity reported on #9; evaluate in 6 months. ref SDS 42 DQ90
470951 - ..
470952 - On 131016 Doctor David Graham performed teeth cleaning and
470953 - examination; no new cavity issues presented. ref SDS 44 OT6G Xrays
470954 - scheduled in 6 months, along with repair slight cavity on #9 for
470955 - approximate cost $40, absent complications. ref SDS 44 ES7M
470956 - Periodontal examination found improvement with reduced pockets,
470957 - attributed to using electric toothbrush, recommended previously by
470958 - Graham Dental. ref SDS 44 MY4I Rising pockets in back teeth,
470959 - ref SDS 44 RV5N, requires resuming use of dental pick to clean gums on
470960 - back teeth. ref SDS 44 P36J Scheduled next meeting on 140416 0800.
470961 - ref SDS 44 ES7G Received Progress Notes that support doctor/patient
470962 - partnership for following up critical issues. ref SDS 44 LB6N
470964 - ..
470965 - On 140410 0910 received letter from Graham Dental requesting feedback
470966 - to confirm meeting on 140416 0800. ref SDS 47 004T Sent letter
470967 - confirming next meeting, and agenda. ref SDS 47 FX5L
470969 - ..
470970 - On 140416 0800 Doctor David Graham did examination and cleaning.
470971 - ref SDS 48 O75H David mentioned several times today, that teeth/mouth
470972 - seem very clean. ref SDS 48 LC5F Reviewed history of tooth #9 appears
470973 - "dead" from injury many years ago. ref SDS 48 1R6O Check for dental
470974 - "pockets" in the gums showed improvement. ref SDS 48 MY4I Minor
470975 - filling on #9 and an adjacent tooth (not identified in the record).
470976 - ref SDS 48 PR7K David still plans to retire at the end of the year.
470977 - ref SDS 48 HS5G
470979 - ..
470980 - On 141021 0800 Doctor David Graham did examination and cleaning.
470981 - ref SDS 50 O75H David mentioned several times today, that teeth/mouth
470982 - seem very clean. ref SDS 50 LC5F Bleeding gum issue shows improvement
470983 - compared to prior examinations. ref SDS 50 8659 Letter from David
470984 - recommends special attention upper right side between last 2 teeth
470985 - (#3 and #4) to continue improve gum bleeding problem. ref SDS 50 H271
470987 - ..
470988 - On 150422 0900 Doctor Mark Graham did examination and cleaning.
470989 - ref SDS 53 O75H Mark reported finding continuing moderate
470990 - gum bleeding.
470992 - ..
470993 - On 160419 0800 Sonja did examination and cleaning using ultrasonci
470994 - dental pick. ref SDS 58 8659 No remedial care was found to be needed.
470995 - ref SDS 58 DY4N
470997 - ..
470998 - On 161106 Doctor Lisa Grosso did periodontal examination, and found
470999 - improvements. ref SDS 61 004T
471000 -
471001 -
471002 -
471003 -
471005 - ..
4711 -
4712 -
4713 - Background
4714 -
471401 - Doctor Grosso provided dental examination and periodontal depth
471402 - measurements on 161116 1500. ref SDS 61 004T
471404 - ..
471405 - Previously, Doctor Grosso provided periodontal 2nd opinon work on
471406 - 150505 1600. ref SDS 54 IW5I
471408 - ..
471409 - Most recent xrays were taken by Graham Dental on 140416 0800.
471410 - ref SDS 48 6H7K Xray scan files are listed at the bottom of the same
471411 - record. ref SDS 48 TF5N
471413 - ..
471414 - Prior xrays were taken on 110202 0800. ref SDS 29 SZ55
471416 - ..
471417 - Last examination by dentist was Graham Dental on 160419 0800.
471418 - ref SDS 58 8659
471420 - ..
471421 - On 170417 1000, called and talked to Deann. Explained cannot make the
471422 - meeting on 170418 0800. Re- scheduled meeting for 170424 0800.
471423 - reported on 170417 1000, ref SDS 62 004T
471424 -
471425 -
471426 -
471428 - ..
4715 -
4716 -
4717 - Progress
4718 -
471801 - Dental Radiology and Cleaning
471802 -
471803 - Follow up ref SDS 61 IU5I, ref SDS 58 004T.
471804 -
471805 - Today, meeting...
471806 -
471807 - Alexander Ham, DDS
471808 - 2951 Salvio Street
471809 - Concord, CA 94519
471810 - 925 682 2000
471811 -
471812 - http://www.contracostadentistry.com
471814 - ..
471815 - Julia Dominguez, RDH, did cleaning today. Excellent work.
471817 - ..
471818 - Radiology - Julia took full set xrays to compare with prior radiology
471819 - studies on 140416 0800, ref SDS 48 TF5N, and previously on 110202
471820 - 0800. ref SDS 29 SZ55
471840 -
471842 - ..
471843 - Julia was careful and thorough. Julia explained each step when she
471844 - changed a procedure, so the patient was warned something different
471845 - would be done.
471847 - ..
471848 - Julia initially used a standard dental pick. On discussion she tried
471849 - ultrasonic scaler pick. This worked well, but the amount of water
471850 - produced caused concern about swallowing. Julia was kind to switch
471851 - back to the conventional pick. Would like to try ultrasonic pick
471852 - again next time, and elevate head slightly for better control of
471853 - swallowing. Hopefully, this will not impede Julia's work.
471855 - ..
471856 - During dental cleaning, Julia commented on patient having small mouth,
471857 - which makes doing dental work slow and difficult, especially flossing.
471859 - ..
471860 - Julie noted moderate plaque buildup. She used her finger to somehow
471861 - illustrate plaque that grows between teeth and gum line.
471862 -
471863 - [...below on 170424 1400 Progress Notes report moderate
471864 - plaque and calculus buildup, and futher found "especially
471865 - lower anterior-tenacious tartar". ref SDS 0 JW3M
471866 -
471867 -
471869 - ..
471870 - Doctor Ham Consultation and Review Xrays
471871 -
471872 - The doctor reviewed xrays taken by Julia, per above. ref SDS 0 VF6M
471873 - He used computer c23 to compare current xrays taken by Julia today,
471874 - with prior xrays done 3 years ago on 140416 0800. ref SDS 48 6H7K
471875 - Doctor Ham noted there is stable to improved gum bone conditions. He
471876 - feels that despite plaque buildup found by Julia, there is no evident
471877 - negative effect on dental health. Patient dental hygeine methods
471878 - appear to be adequate to prevent dental disease over the past 12
471879 - months, since prior cleaning on 160419 0800. ref SDS 58 8659
471881 - ..
471882 - Doctor Ham reviewed latest periodontal examination by Doctor Grosso
471883 - showing improved conditions from a year earlier, reported on 161116
471884 - 1500. ref SDS 61 Z64N
471886 - ..
471887 - Doctor Ham will discuss with Julia findings today, of plaque and
471888 - calculus buildup over the past year since prior cleaning, as discussed
471889 - with Julia, per above. ref SDS 0 3W4J He will enter into progress
471890 - notes an opinion on annual or 6-month dental checkups in order to
471891 - balance risk management relative to saving money on dental care.
471892 -
471893 - [...below on 170424 1400 Progress Notes cite discussions
471894 - with Julia from performing cleaning, and recommend 6 month
471895 - dental meetings. ref SDS 0 7T5Q
471897 - ..
471898 - The doctor further granted 10% discount for age.
471900 - ..
471901 - Talked to Deanne. Paid bill with credit card. She will submit
471902 - invoice and Progress Notes with xrays via email.
471903 -
471904 -
471905 -
4720 -
SUBJECTS
Default Null Subject Account for Blank Record
4803 -
480401 - ..
480402 - Medical Chart Received from Graham Dental Offices
480403 -
480404 - Follow up ref SDS 61 XE3N, ref SDS 58 TN5F.
480405 -
480406 - Progress Notes for meeting on 170424 1400, are stored at...
480407 -
480408 - F:\05\00003\SM\GG\PS\GPMG\170424-140000\progress_notes_doctor_ham_170424.pdf
480410 - ..
480411 - 1. Contra Costa Dentistry
480413 - ..
480414 - 2. Date................................... 2017 04 24 1720
480416 - ..
480417 - 3. Patient Notes Master for
480420 -
480421 - 1. Date Entered............................ 2017 04 24 1422
480422 - Format.................................. Text
480423 - Type.................................... General
480424 - Tooth
480425 - Status.................................. Verified
480427 - ..
480428 - 2. User.................................... Julia Dominguez, RDH
480429 -
480430 -
480432 - ..
480433 - 4. Updated Patient Medical History
480434 -
480435 - 1. Date Entered............................ 2017 04 24 1545
480436 - Format.................................. Text
480437 - Type.................................... Chart
480438 - Tooth
480439 - Status.................................. Verified
480441 - ..
480442 - 2. User.................................... Daniela Vega
480443 -
480444 -
480446 - ..
480447 - 5. Comprehensive Exam, FMX
480448 -
480450 - ..
480451 - 6. Medical history reviewed
480453 - ..
480454 - 7. CC: Referred by Doctor Grosso for comprehensive dental exam
480455 - and cleaning. No pain.
480457 - ..
480458 - 8. EO: WNL
480460 - ..
480461 - 9. Radiographic findings:
480463 - ..
480464 - 1. Generalized horizontal bone loss. Patient had 4BWs from 2014.
480466 - ..
480467 - 2. No significant changes with posterior bone level when
480468 - radiographs were compared.
480470 - ..
480471 - 3. Radiolucent resin restorations #7-ML, 9-DL, 10-ML. Watch.
480472 -
480474 - ..
480475 - 10. Clinical findings:
480476 -
480477 - 1. #7 (ML) composite DOES NOT SHOW UP IN RADIOGRAPHS-watch,
480478 -
480479 - 2. #9-DL and #10 (ML) COMPOSITE DOES NOT SHOW UP IN
480480 - RADIOGRAPHS with staining around margins-watch,
480482 - ..
480483 - 3. #21 (B) composite STAIN -watch, #25 (IL) CHIP -watch.
480484 -
480486 - ..
480487 - 11. Discussed with Julie the amount of calculus build up and plaque
480488 - and determined 6 month recall is appropriate and can be
480489 - alternated with Dr Grosso.
480491 - ..
480492 - Doctor Grosso was consulted on 150505, for 2nd opinion review of
480493 - specific issues, including periodontal gum pockets. ref SDS 54 IW5I
480494 - She was consulted again on 161116 to evaluate response to treatment
480495 - using better daily dental home care, and reported improved conditions.
480496 - ref SDS 61 004T She does not do routine cleaning, and recommended
480497 - Ham Dental for this. If Doctor Grosso wishes to alternate with Ham
480498 - Dental, it would be a delight working with her on this basis.
480500 - ..
480501 - 12. Caries risk: low
480503 - ..
480504 - 13. PSR: 313/313
480506 - ..
480507 - 14. PN: Prior patient of Doctor Taggart and Doctor Graham.
480509 - ..
480510 - 15. NV: 6 month recall
480512 - ..
480513 - 16. AH 54950
480514 -
480515 -
480517 - ..
480518 - 17. Section 2 of Medical Chart....
480519 -
480520 - 1. Date Entered............................ 2017 04 24 1546
480521 - Format.................................. Text
480522 - Type.................................... Chart
480523 - Tooth
480524 - Status.................................. Verified
480526 - ..
480527 - 2. User.................................... Daniela Vega
480529 - ..
480530 - 18. New patient prophy, FMX
480532 - ..
480533 - 19. Full mouth scale polish
480535 - ..
480536 - 20. Oral cancer screen: WNL
480538 - ..
480539 - 21. Perio exam completed
480541 - ..
480542 - 22. Cavitron Used:
480544 - ..
480545 - Yes/ No- Used ultrasonic in the beginning for part of UR quad-
480546 - but ultrasonic had too much water and was hard to handle. Will
480547 - try again with ultrasonic at next appointment.
480549 - ..
480550 - Good report. Julia was helpful with this experiment. Might work
480551 - better if patient is sitting up slightly more, as discussed with Julia
480552 - during the work today, per above. ref SDS 0 1R36
480553 -
480554 -
480555 - 23. Recession.................................... 1 - 4 mm
480557 - ..
480558 - Doctor Ham noticed looking at c23, periodontal exam performed by
480559 - Doctor Grosso on 161116 1500. ref SDS 61 XE3N Periodontal examinaton
480560 - on 161104 shows recission 0 - 4 mm. Does this range today 1 - 4 mm
480561 - reflect updated assessment?
480562 -
480563 -
480564 - 24. Mobility...................................... none
480566 - ..
480567 - 25. Plaque........................................ moderate
480569 - ..
480570 - 26. Calculus...................................... moderate
480571 -
480572 - (especially lower anterior-tenacious tartar)
480574 - ..
480575 - Finding moderate plaque and calculus relates to Julia's report during
480576 - cleaning process, per above. ref SDS 0 3W4J
480577 -
480579 - ..
480580 - 27. Bleeding...................................... moderate
480581 -
480582 - heavier bleeding on #19 upon scaling
480584 - ..
480585 - Bleeding has been continuing issue, beginning with Doctor Taggart
480586 - hired to perform deep cleaning in 1986. At that time pockets were
480587 - from 2 - 9, and severe bleeding occurred brushing with conventional
480588 - toothbrush. The doctor completed work in 1988, reducing all pockets
480589 - below 7, with only a few measured 6 mm, reported on 880419 0930.
480590 - ref SDS 1 0001 Bleeding significantly declined, but continued for 20
480591 - years on occasion. OA 2011, switched to automatic toothbrush. Since
480592 - then there has never been a sign of blood on the brush during timed 8
480593 - - 10 minute brushing cycle, and despite more vigorous force on gums.
480594 -
480596 - ..
480597 - 28. Stains........................................ moderate
480599 - ..
480600 - 29. OHI
480601 -
480602 - given, Pt was referred to our office by Dr Grosso for
480603 - dental treatment. Per patient- periodontal health has been
480604 - improving over time and the bone loss has been an ongoing
480605 - condition. Patient had a deep cleaning performed in 1986
480606 - and has not had one since then. Patient is seen at Dr
480607 - Grosso`s office for a cleaning 1x per year. I recommend
480608 - patient come in more frequently than 1 year for dental
480609 - cleanings due to amount and the tenacity of tartar built up
480610 - on lower anterior teeth. Recommends be placed on a month
480611 - recall appointment schedule.
480613 - ..
480614 - Doctor Grosso was not seen for dental cleaning, only 2nd opinion
480615 - examination, including periodontal pockets. Initial examination
480616 - occurred on 150519 1621. ref SDS 56 IW5I Follow up examination to
480617 - compare for improvement was performed on 161116 1500. ref SDS 61 IU5I
480619 - ..
480620 - Okay will do another meeting in 6 months. This addresses request
480621 - during the meeting with Doctor Ham, for the doctor to recommend dental
480622 - checkup interval, per above. ref SDS 0 RT5N
480624 - ..
480625 - This seems to be saying that "moderate" amount of plaque and calculus
480626 - that occurred over the past year, ref SDS 0 JW3M, since prior dental
480627 - cleaning, presents significant dental health risk that requires 6
480628 - month rather than 12 month cleaning.
480630 - ..
480631 - If the patient went another 12 months and examination contined to show
480632 - "moderate" plaque and calculus, would this still indicate that 12
480633 - month dental cleaning intervals present signficant risk?
480635 - ..
480636 - Since 12 month intervals yielded moderate plaque and calculus, should
480637 - 6 month cleaning find minor, slight, minimal... buildup?
480638 -
480639 -
480640 - 30. NV........................................... 6MRC
480641 -
480642 - 31. JD 30250
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