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 and treatment.  His father has referral and x-rays, and should be calling for appointment.

I saw Joe on 9/13/2010.  He said he was in a go-kart accident on 9/11/2010.  He has lots of scrapes and bruises.  He fractured 6, 7, 8, & 9.  I noted:

• 6 — facial enamel sheared off.
• 7 — fractured almost entirely at gumline; a little facial enamel sticking up; pinpoint vital pulpal exposure.
• 8 — fractured horizontally; about 3mm of enamel left on facial and lingual; dentin was discolored very deep purple, typical of internal hemorrhage; close to pulp, but no exposure noted.
• 9 — oblique fracture; no indication of pulp proximity.

My initial impressions:

• 7 will need root canal treatment due to pulpal exposure and for restorative purposes.
• 8 probably should be treated also for restorative purposes; given the color of the dentin, I wouldn’t bet on long-term pulpal health anyway.
• 6 & 9 – see how they test.

I took intraoral photos before I restored them; I will send you a copy via email.

I plan to crown 7, 8, & 9 after endodontic treatment; possibly splinting together 7 & 8.

Sincerely,

Dr. _____