Read the case notes and complete the writing task which follows.

Notes:

Assume that today's date is 15 December 2018

Your patient, Mrs Joyce Williams, needs Endodontic treatment to complete Root Canal Therapy on one of her teeth.

Patient:        Mrs Rachel Johns

Address:      56 Oak Lane Stillwater

DOB:              09 May 1966

Reason for Presenting:

• Further Endo required on 37

Dental HIstory:

• Extractions
• Fillings
• Scale and Clean
• regularly Radiographs
• RCTs

Medical History:

• Myocardial infraction
• 01 Jun 2007 Allergic to pencillin
• smoker

Current Medication:

• Aspirin 100mg everyday (Cartia)

Family & Social History:

• Married, 2 children
• Social worker

Examination:

• Missing 18, 28, 48
• Porcelain crowns 15, 24
• RCTs 15, 24
• DO amalgam 23
• MO amalgam 16, 17, 25, 26, 27
• Occ amalgam 38, 47
• MOD amalgam 45, 46

Treatment Record:

13 Oct 2016

• Scale and clean

02 May 2017

• 37 DO tunnel from occlusal v. deep 60% possibility RCT Fuji IX used

03 Aug 2017

• Scale and clean prophylaxis
• 32 mesio-incisal chip; no LA; composite
  

19 Mar 2018

• 37 DB tunnel IRM temp will need RCT
• Patient concerned about cost -  wishes to delay RCT

04 Apr 2018

• Patient complains: pain 37 region since insertion of IRM temp
• Examined occlusion - NAD
• 38 DOB composite
• RCT scheduled for 10 Apr 2018

10 Apr 2018

• RCT appt. cancelled - patient reports pain "gone away"

23 NOv 2018

• Emergency exam: 37 suspected abscess
• Tender to percussion, CO2 -ve
• No fever/malaise
• RCT rescheduled for 25 Nov 2018

25 Nov 2018

• 2.2ml lignocaine 2% with adrenaline mandibular block
• 37 access & debridement
• 3 canals identified & initial debridement
• Difficult access to MB
• No WL taken
• LA difficult. Temporised with Ledermix paste + cavit.

15 Dec 2018

• 37 asymptomatic 
• 2.2ml lignocaine 2% with adrenaline mandibular
• block 37 debridement and instrumentation
• WL: D = 21mm from DB cusp #25 MLi: 19mm from MB cusp #25
• Unable to instrument MB beyond 8mm
• Temporised with ledermix paste and cavit
• PA radiograph unable to determine reason for obstruction
• Refer to endodontist

Writing Task:

Using the information in the case notes, write a letter to referral to endodontist, Dr Pau; Nelson, 17 Longview Road, Newtown.

In your answer:

• Expand the relevant notes into complete sentences
• Do not use note form
• use letter format

The body of the letter should be approximately 180-200 words.