Referral To Orthodontist After Accident
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(or preferably print on letterhead)
City, State Zip
Dear Dr. Ortho:
You will be seeing our patient, Irida Bike for comprehensive orthodontic evaluation and treatment.
Irida had a motorized scooter accident on September 7, 2011. She went to Sacred Heart Emergency Room. The next day she saw Dr. Oral Surgeon. He repositioned and splinted the injured teeth; splint was removed October 13th. A copy of his report is enclosed.
Irida then saw Dr. Endodontist for root canal treatment of #8, 9, & 24.
I first saw Irida for evaluation on October 25th. We built up #24 with a huge composite. She still needs composites on 7, 8, & 9, but tooth alignment and occlusion would not allow for very good restorations. I’m sending a copy of photos taken that day.
I am hoping that you will be able to initiate orthodontic treatment, and at least improve anterior alignment so I will be able to place composite restorations.
I need to see Irida one more time to remove the Cavit and seal #8 & 9 RC access holes with composites, preferably before you begin treatment.
Please call me if you need any further information.