C10024771 / invoice 10000

Reason: Tooth Fell Out. GHC.Appointment Notes: Doesn't like strangers. GHC & Incisor fell out 1/3. recommended to come in sooner if there are any concerns. BAR, EDDU normal6mth hx of looking at roof and sniffing. o. googled and is worried that is neurological. CCSHReason: History: One of the teeth fell out recently; O unsure when Bad breath for a while O has tried different dental health preventatives 4-5 month sniff up; originally doing in occasionally; does it daily now, mainly in lounge room There's no light movement/shadows according to OO friend's husband checked roof and there's nothing in the roofO thinks guttering could be blocked, unsure if making noise which is distracting himDiet: cooked meat and dry foodNot up to date with parasite preventionExamination: Anxious; minimal exam due to behaviorChest sounds: NADBCS: 3/5Teeth: O lifted the lips up for me to look; one of the incisors missing on upper arcade; rest of the teeth have some plaque buildup Assessment: Daily episodes of sniffing/looking up ddx: secondary to noise vs shadows vs focal seizuresDental grade 2 Incisor missing upper arcade ddx: secondary to dental disease vs fracture?Plan:Bloods taken for TAHPDifficult to say if sniffing/looking up is behavioral secondary to noise/shadows vs possible focal seizure like episodesGiven the option of referral to a neurologist for consultation and advanced imaging such as MRIOther option is cleaning the gutters, monitoring if episodes resolve by themselves; if not resolving consider trialling seizure medications and monitoring response?. Also advised O to take some videos.Ideally needs a stage 1 dental but best to work out the sniffing/looking up episodes prior to dental; difficult to say if any extractions required and if any retaining roots from missing incisor    Vital Signs