THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: May 3, 1999 03:30 PM Monday; Rod Welch

Visit Dr. Kashini at Steve's office for dental examination.

1...Summary/Objective
2...Periodontal Gum Recession Improved
3...End Tuft Brushing Treatment for #6 and #11
4...Special Knot Flossing for #3, 13 15, 31 30
5...Two Rows Tooth Brush Home Treatment, 2 Weeks
6...Lower Front Teeth at Beginning Stage of Gengivitis
7...Doctor's Report on Examination and Confirming Instructions


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CONTACTS 
0201 - Steven K. Olsen, DDS.                                                                                                                                              
020101 - Dr. Steven K. Olsen                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               

SUBJECTS
Dental Periodontal Examination Gengivitis Periodontal Disease Lower                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2203 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2203 -    ..
2204 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2205 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
220501 - Follow up ref SDS 12 0000, ref SDS 11 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
220502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220503 - Gum recession has improved considerably.  Examination found new issues                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220504 - that resulted in recommendations for special home treatment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
220505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220507 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220509 -  ..
2206 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2207 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2208 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
220901 -  ..
220902 - Periodontal Gum Recession Improved                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
220903 - 
220904 - Follow up ref SDS 12 0824.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
220905 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220906 - On 990310 Russel reported several additional areas that should be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
220907 - examined by Dr Kashani for possible gum recession. ref SDS 12 0824                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
220909 -  ..
220910 - Today, Dr Kashani reported tooth #3 measures 3 3 4.  This seems to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
220911 - show considerable improvement from 5 reported on 980330. ref SDS 8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
220912 - 1151  Dr Kashani's work and continuing dental care by Steve and Russel                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220913 - have helped achieve this recovery, following periodonatl deep cleaning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220914 - significantly improved prior deep pocket problems, reported on 880419.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220915 - ref SDS 1 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
220916 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220917 -            [On 001212 1500 Doctor Steve Olsen making routine dental                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
220918 -            examination reported finding no evident gum nor other                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
220919 -            periodontal issues. ref SDS 14 E49K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
220921 -  ..
220922 - Dr Kashani noted that his dental records show recommendations on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
220923 - 980330 for work to be performed on tooth #11 and #14, but the dental                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
220924 - record does not show whether this work has been performed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
220926 -  ..
220927 - I mentioned it may have been done on 980827. ref SDS 11 3748                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
220929 -  ..
220930 - Dr Kashani commented after examination that #11 and #14 have received                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220931 - recommended treatment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220932 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220933 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220934 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220936 -  ..
220937 - End Tuft Brushing Treatment for #6 and #11                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
220938 - 
220939 - He suggested the following during the examination...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
220940 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220941 -     #6 and #11                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
220942 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220943 -         Use a special "end tuft" tooth brush for two weeks.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
220945 -          ..
220946 -         These are the front two incisors.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
220948 -          ..
220949 -         A special brush was provided for this home treatment effort.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
220951 -          ..
220952 -         The idea seems to be to give these two teeth directed but                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
220953 -         delicate brushing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
220954 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220956 -  ..
220957 - Special Knot Flossing for #3, 13 15, 31 30                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
220958 - 
220959 - Dr. Kashini suggested...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
220960 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220961 -         Use special flossing technique on these teeth, where a knot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
220962 -         is tied in the floss, so it presents a larger mass moving                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
220963 -         between the teech.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
220965 -  ..
220966 - A diagram provided by the dental assistant, Wenda, shows the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
220967 - following...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
220968 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220969 -         #3 is the upper right molar 2nd from the end.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220970 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220971 -         #13 is the Upper left, 3rd from the end                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220972 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220973 -         #15 is the Upper left, last tooth                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
220974 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220975 -         #30, #31 are lower right last two teeth.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
220976 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220978 -  ..
220979 - Two Rows Tooth Brush Home Treatment, 2 Weeks                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
220980 - Lower Front Teeth at Beginning Stage of Gengivitis                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
220981 - 
220982 - Dr. Kashani recommended special brushing treatment on the lower front                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220983 - teeth.  He showed a continuous line of minor inflamation along this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
220984 - area, which is the beginning stage of Gengivitis, also called "perio"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
220985 - disease.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
220986 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220987 -     [On 990915 no report of gengivitis. ref SDS 13 1740]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
220989 -  ..
220990 - This brushing is to be performed for a two week period with a "two                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
220991 - row" tooth brush provided by the dentist today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220993 -  ..
220994 - We did not discuss recent life style changes working long hours that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
220995 - cause reduced oral hygiene, which is reflected in the observations                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
220996 - today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
220997 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220998 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
220999 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
221000 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2211 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Teeth ID Numbers                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2303 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
230401 -  ..
230402 - Doctor's Report on Examination and Confirming Instructions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
230403 - 
230404 - During the examination, Dr. Kashani made a number of recommendations                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230405 - for special home brushing treatment for 7 different teeth, as                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
230406 - explained above. ref SDS 0 1326, ref SDS 0 2496                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230408 -  ..
230409 - A third form of treatment was recommended for a different group of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230410 - teeth. ref SDS 0 4592                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
230412 -  ..
230413 - There was discussion, that remembering specific forms and areas of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
230414 - treatment on teeth can be aided by a report from the doctor.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
230416 -  ..
230417 - Dr. Kashani submitted a hand drawn document that shows the following                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
230418 - table...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
230419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230421 -    UR                       |       1  1  1  1  1    UL                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
230422 -         2  3  4  5  6  7  8 | 9  0  1  2  3  4  5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230423 -                             |
230424 -                       |
230425 -         --------------------+--------------------                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230426 -                             |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
230427 -    LR   3  3  2  2  2  2  2 | 2  2  2  2  2  1  1    LL                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
230428 -         1  0  9  8  7  6  5 | 4  3  2  1  0  9  8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230431 -  ..
230432 - He entered the date 990503, but did not sign it.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
230434 -  ..
230435 - This document has hand written notations with information entered                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
230436 - above on special treatment recommended today.  Handwriting is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
230437 - illegible, so the instructions remain unknown.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
230438 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230439 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230440 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230441 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230442 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230443 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230444 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230445 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
230446 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2305 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
Distribution. . . . See "CONTACTS"