| EXAM DATE: | 09/09/2010 | ||
| PATIENT NAME: | Abbott, Patricia | ||
| DIAGNOSIS: | Periodontitis | DIAGNOSTIC CODE: 123456 | |
| PATIENT STATUS: | Adult | ||
| PERIO STATUS: | Chronic | ||
| GINGIVA: | |||
| 
 | Color: | Pink | |
| 
 | Texture: | Glossy | |
| 
 | Margins: | Clefts | |
| 
 | Attachment: | Recession | |
| 
 | Papillae: | Blunted | |
| 
 | Sulcus: | Blood | |
| 
 | Contour: | Irregular | |
| 
 | Suppuration: | Mild | |
| 
 | Bleeding: | Mild | |
| X-RAY: | |||
| 
 | Bone Loss: | Moderate | |
| 
 | Bone Defects: | Craters | |
| ORAL HYGIENE: | |||
| 
 | Plaque: | Light | |
| 
 | Calculus: | Light | |
| 
 | Stain: | Light | |
| NOTES: Patient says she never flosses. | |||
| EXAMINED BY: Kerry Henshaw, R.D.H. | |||
| Attached you will find my chart of the probing depths. I hope this helps speed the consultation process and the approved payment. Sincerely, Dennis D. Smith, D.D.S. | |||