EFTA00059487


# Bureau of Prisons
## Health Services
## Dental Health History Screen

**Inmate Name:** EPSTEIN, JEFFREY EDWARD
**Date of Birth:** 01/20/1953
**Encounter Date:** 07/26/2019 07:54

| Health Problem | Status |
| :--- | :--- |
| Hyperlipidemia, unspecified | Current |
| HYPERTRIGLYCERIDEMIA | |
| Sleep apnea | Current |
| Constipation, unspecified | Current |
| Low back pain | Current |
| Neuralgia and neuritis, unspecified | Current |
| No Diagnosis | Current |
| Injury, unspecified | Current |
| R/O self Inflicted injuries. | |

**Medical History as of Dental Health History Encounter date:** 07/26/2019 07:54

**Medical History:**

- **Allergies:** Denied
- **Seizures:** Denied
- **Diabetes:** Denied
- **Cardiovascular:** Denied
- **CVA:** Denied
- **Hypertension:** Denied
- **Respiratory:** Denied
- **Sickle Cell Anemia:** Denied
- **Carcinoma/Lymphoma:** Denied

**HIV History:**

- When Tested: 2019
- Test Result: Negative
- When Diagnosed AIDS:
- Last CD4:
- Comments:

**Hepatitis:** Denied

Generated 07/26/2019 07:59 by

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DDS

Bureau of Prisons - NYM

EFTA00059488

### Inmate Name: EPSTEIN, JEFFREY EDWARD
Date of Birth: 01/20/1953
Encounter Date: 07/26/2019 07:54

#### Other Infectious Diseases:

- **Syphilis:** No
- **Syphilis Last Treatment:** N/A
- **Genital Warts:** No
- **Chlamydia:** Yes
- **Gonorrhea:** No
- **Herpes:** No
- **Chicken Pox:** Yes
- **Other:** No

**Comments:** Chlamydia in 2015, treated
   Chicken pox in childhood

#### Other Health Issues:

- Other Medical Conditions And Treatment: sleep apnea
- Current Medical Conditions:
- Other Current Treatments:

#### Pregnant: N/A

### Dental Observations as of Dental Health History Encounter date: 07/26/2019 07:54

#### History:

- Alcohol: No
- Methamphetamine: No
- Tobacco products: No
- Other drugs: No
- Sensitive teeth: No
- Bleeding gums: Yes
- Food impaction: Yes
- Pain around ear: No
- Toothache: No
- Wear partial dentures: No
- Unusual sounds while eating: No
- Snoring: Yes
- Blisters on lips or mouth: No
- Clenching or grinding: Yes
- Swelling or lumps in mouth/throat: No
- Burning tongue: No
- Bad breath: No
- Decayed teeth: No
- Loose teeth: No
- Wear dentures: No
- None: No

**Comments:**

Generated 07/26/2019 07:59 by DDS Bureau of Prisons - NYM



EFTA00059489


| Inmate Name: EPSTEIN, JEFFREY EDWARD | Sex: M | Race: WHITE | Reg #: 76318-054 |
| :--- | :--- | :--- | :--- |
| Date of Birth: 01/20/1953 | Provider: | DDS | Facility: NYM |
| Encounter Date: 07/26/2019 07:54 | | | Unit: H01 |

**Cardiac Condition Requiring Prophylaxis:** No

**Prosthetic joint(s):** No

**Radiation history of head or neck:** No

**Excessive bleeding:** No

**Bisphosphonates:** No

**Comments:**

**Medications as of Dental Health History Encounter date:** 07/26/2019 07:54

**Medications:**
- Docusate Sodium 100 MG Cap Exp: 08/11/2019 SIG: Take one capsule (100 MG) by mouth twice daily for 30 days
- Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by mouth with food

**OTCs: Listing of all known OTCs this inmate is currently taking.**

Instructed inmate how to obtain medical, dental, and mental health care.

**Copay Required:** No
**Cosign Required:** No

**Telephone/Verbal Order:** No

Completed by DDS on 07/26/2019 07:59

Generated 07/26/2019 07:59 by

DDS

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Bureau of Prisons - NYM