Patient: 67 year old female with breast cancer diagnosed initially in 1996, relapsed from remission in 2002, and in 2013, currently at advanced stage, high blood pressure, taking Micardis, Exemestane, and Xgeva

Chief Complaint: severe biting sensitivity (tooth #20)

Dental History: There has been no recent dentistry aside from routine cleanings. The composite filling in tooth #20 was reported to have been placed over 20 years prior to the date of consultation. Severe pain to biting, percussion, and chewing began two days prior to the exam. A constant low grade ache was also reported by the patient.