Dr. Name
Office address
City, State ZIP
(or preferably print on letterhead)

Date

Dr. Endodontist
Address
City, State  Zip

Dear Dr. Endo:

I have referred [patient name] to you for evaluation of #9.  She has a current periapical x-ray with her referral slip.

Kathy is a new patient to me; she came in yesterday for a consultation.  Her chief complaint was dark tooth #9.  She was also concerned about linguoverted #10.

The only history of trauma to this area was a bike accident when she was in first grade.  It occasionally has a dull ache.

The tooth is quite opaque when transilluminated.  On the x-ray, the pulp chamber and canal appears much larger than #8.

I discussed porcelain facing; full crown; possible need for RCT depending on pulpal status.

The more I think about it, however, the more I would like to see the darkening treated via endodontics and internal bleaching if possible.  I think this would give more satisfactory esthetic results; it might still need porcelain facing sometime in future however. 

I have recommended orthodontic treatment to correct #10, as there isn’t enough space to simply tip it forward with a retainer.

Let me know if you need any more information.

Sincerely,

Dr. ______