| September 9, 2010 
 Dear Doctor, I have recently visited with Michelle Knowles for additional periodontal examination and treatment. The patient was examined on Monday, September 9, 2010. This most recent examination reveals the following: | |||
| 
 | DIAGNOSIS: | Periodontitis | |
| 
 | GINGIVA: | ||
| 
 | 
 | Color: | Pink | 
| 
 | 
 | Texture: | Glossy | 
| 
 | 
 | Margins: | Clefts | 
| 
 | 
 | Attachment: | Recession | 
| 
 | 
 | Papillae: | Blunted | 
| 
 | 
 | Sulcus: | Blood | 
| 
 | 
 | Contour: | Irregular | 
| 
 | X-RAY: | ||
| 
 | 
 | Bone Loss: | Moderate | 
| 
 | 
 | Bone Defects: | Craters | 
| 
 | ORAL HYGIENE: | ||
| 
 | 
 | Plaque: | Light | 
| 
 | 
 | Calculus: | Light | 
| 
 | 
 | Stain: | Light | 
| We once again express appreciation for your referral of this patient. If additional information is desired feel free to contact my office at anytime. Sincerely, Dennis D. Smith, D.D.S. | |||