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

Date

Dr. New Dentist
Address 
City, State Zip

Dear Dr. Dentist:

A previous patient of mine, Mr. John Doe, has moved to your area, and has requested that I send records to you.

Mr. Doe’s dental history is quite extensive; I will summarize here the best I can, but feel free to call me if you need any further information.

My records indicate that he started as a patient of Dr. Dentist1 in 1970, saw Dr. Dentist2 a few times in 1986-88, and I took over his treatment when I joined Dr. Dentist2 in 1988.

He went to Dr. Perio for full perio surgery in 1982, and has been continuing alternating recalls ever since.  He has a long history of root caries, isolated perio procedures, root amps, root canal treatments, cantilever bridges, etc.  Any time a restoration is done, the caries is deeper than anticipated, or the roots are softer than expected.

His existing upper removable partial was made in 9/95.  I have recommended implants, but he feels they are too expensive.

Recent noteworthy treatments:

3/6/97              #20 root canal treatment; Dr. Endo
1/14/97            extract #12 roots from under bridge; Dr. OS
5/7/96              #6 root canal treatment; Dr. Endo
8/16/95            extract #3 and 5; made removable partial
6/15/95            #21 root canal treatment; Dr. Endo
3/14/91            #21-20-x cantilever bridge cemented; recemented on 2/91 with C&B
                           Metabond, and pontic cut off.
12/23/92          #28-29-x cantilever bridge cemented; recemented on 2/94 with C&B
                          Metabond, and pontic cut off.
12/92               #30 & 31 extracted due to perio & deep root caries
1/91                 #19 extracted; Dr. OS

I am sending copies of the latest perio chartings Dr. Perio has provided us, and the latest x-rays taken 12/96.  I am also sending a full mouth x-ray series from 1988.  I don’t have a more recent full mouth series, although numerous periapicals and bitewing x-rays have been taken since 1988.

John’s last cleaning with us was 12/17/96; he was due to see Dr. Perio in 3/97.  He alternates Interplak and Sonicare; uses Proxabrush, Stimudents, Superfloss. 

Dr. Dentist, let me know if I can provide any more information!

Sincerely,

Dr. _______