Referral To Periodontist For Implant Consultation

Dr. Name
Office address
City, State ZIP
(or preferably print on letterhead)



Dr. Periodontist
City, State  Zip

Dear Dr. Perio:

I have re-referred [patient] to you for implant consultation.  She didn’t follow through with her original Feb 2010 referral.

I saw Jane today with #4-x-6 bridge off.  Most of #4 fractured inside the crown; #6 had ¾-coverage.

I recemented it with Rely-X (a permanent cement); informed her that it is a temporary repair, and will probably not hold long.

Before implant surgery, I could cut the bridge between 5-6, leaving gold on 6.  She says she would be okay without a temporary.

She still doesn’t seem to know whether she wants to do implants only to replace 4 & 5, or if she should replace all possible missing teeth.



Dr. ______