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 Joyce Williams
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 infarction
• 01 Jun 2007 Allergic to penicillin
• Smoker

Current Medication:

• Aspirin 100mg every day (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 of referral to the endodontist, Dr Patrick O’Malley, 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.