EFTA00139078

# Bureau of Prisons Health Services Dental A&O Exam

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |
| :--- | :--- |
| Date of Birth: | 01/20/1953 |
| Encounter Date: | 07/26/2019 07:47 |

| Sex: M | Race: WHITE |
| :--- | :--- |
| Provider: | DDS |

| Reg #: | 76318-054 |
| :--- | :--- |
| Facility: | NYM |
| Unit: | H01 |

Reviewed Health Status: Yes

Occlusion: Class I

Oral Hygiene: Fair

CPITN:

<table border="1"><tr><td>3</td><td>2</td><td>3</td></tr><tr><td>3</td><td>2</td><td>3</td></tr></table>

Hard and soft tissue examination performed and documented on BP618 form: Yes

Head & Neck/Soft Tissue within normal limits? No

**Comments:** moderate to advanced upper posterior gingival recession

<table border="1"><tr><td>Decayed:</td><td>Missing:</td><td>Filled:</td></tr><tr><td>0</td><td>1</td><td>14</td></tr></table>

**Comments:** Lower anterior crowding

Approved for hygiene appointment and radiographs: Yes

Instructed inmate how to obtain routine and emergency dental care. Oral hygiene instructions given: Yes

Dental A&O Screening Exam findings entered on EPSTEIN, JEFFREY EDWARD by DDS on 07/26/2019 07:47.

Generated 07/26/2019 08:00 by

DDS

Bureau of Prisons - NYM



SDNY 00017442
- Page 1 of 1