Referral To Periodontist For Comprehensive Evaluation
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Dear Dr Perio:
I have referred [patient] to you for comprehensive perio/restorative/implant evaluation. FMX from 2/9/2010 enclosed; you may keep.
Joe has been a patient since 1994. He is 52 years old. He has always been very sporadic with his recalls. Last scaling/root planing was in 2008. Last cleaning/exam was 3/2009.
He has always had a high caries rate. He is a controlled diabetic, but he drinks lots of soda pop. I have warned him many times in the past that it is destroying his mouth. His decay always seems to be deeper than expected when we get into it clinically; dentin seems softer than normal. He quit smoking last month.
Problems identified at 2/9/10 exam:
- Caries 2DB, 4D & B, 5B, 7F & L, 9F, 13B, 14L, 15L, 29B.
- Periapical radiolucencies on 3 (fractured root?), 9, 22, 30; possibly 5.
- Chronic generalized adult periodontitis
Options for upper arch are:
- Restoring with all new crowns, bridges, and implants;
- Saving some teeth; crown abutments; making removable partial denture;
- Full upper denture, possibly with implant retention.
On lower arch, the 21-22 cantilever bridge might be lost after 22 RCT; may need implant. Otherwise the lower arch is savable with a crown on 29.
Joe was undecided on which course of action to take. I suggested a consult with you so we could formulate some treatment plan options to present to him. Let’s get together to discuss this case.