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Clinical Notes: Christina B. Homemaker, Westfield, NJ, Age 35, 5'5'' 185 lbs, BMI 30.8, Mildly active, willing to commit 6 months passionately to OJW.    (Expected weight loss 50 pounds),                                    SEE CB'D BLOG AT:

July 31. 2008:*
    Examination of teeth, gums, all soft tissues, extent of movement of jaws, and TMJ (Temporo-Mandibular Joint) reveals that Christine is in good health. Her medical dental history indicated that she had no medical or dental problems related to treatment using OJW. A routine panoramic X-ray was taken, which further showed that her teeth and TM joint were normal. Her occlusion was tested with articulating paper in order to test for/locate any possible traumatic occlusion. None was noted. (The Temporo-Mandibular Joint (TMJ)) is a "ball and socket" joint. The "ball" is the top part of your lower jaw and is called the "condyle". You can feel them by putting your fingers just in front of your ears when opening and closing your mouth. Christine was told that in OJW the jaws are wired together but the teeth of the upper and lower jaw will be wired apart allowing her ample movement to of her lower jaw to speak well and keep her jaw joint in good health (thus avoiding the possibility of her TM joint from becoming stiff (see photos below). Consequently, no pressure is placed on the TM joint. She signed the informed consent for jaw wiring . She came with her husband mark. I provided a review of the entire procedure and the dangers she might encounter and how to avoid them. I reviewed the informed consent and the FAQ's were reviewed and she signed the OJW Telephone memo indicating that she was aware of all aspects of the OJW treatment method for the control of compulsive overeating. "Begg" brackets were bonded on upper teeth 4,5,6 and 11, 12, 13 and lower teeth 29,28,27 and 22,21, and 20. (the canines and first and second premolars). Both the teeth and the brackets were micro etched and the teeth were then also acid etched. All of the teeth to which brackets were bonded had normal enamel. All excessive and unsightly adhesives was removed and the space between the teeth was checked for unimpeded passage of dental floss. Christine and Mark were shown the t-t-b wiring method and practiced on the intraoral wiring training device under Dr. Ted's supervision with precautionary advisements. Finally, she was asked to put her teeth gently together and the wiring was done with "dead soft" .014 inch diameter stainless steel round wire.  Christine observed the wiring technique and then cut out the wire as a practice procedure which she did with ease in about 5 seconds. She was then wired closed on the right and left sides. She agreed to follow the recommended protocol: After 5 weeks snip off the wires, exercise for 5 days and return to the office for evaluation, cleaning and rewiring.  She said her jaws were very comfortable and that the jaw wires permitted her a slight bit of jaw movement. She was given instructions and practice regarding how and when to remove the wire. She was given instructions on how to exercise her jaws  during the 5 days she would be released from the wires and advised re the possibility of the joint becoming more limited in motion over time (two fingers of opening rather than 3 fingers).  She was counseled to adhere to a 1000 calorie  low/no salt liquid diet.  She was advised to always carry her wire-cutter with her. Lacking a wire cutter a simple fork could accomplish the emergency removal of the wire. She was provided with instruments to assist in the removal and replacement of the wires.  
Ps. I suggested she keep log of her weight loss. She indicated that she intended to return for follow up visits. However, the option to have her husband rewire her remained opened.   I gave her the OJW reminders to patients,

What is different about this case is the use of the t-t-b (through-the-bracket) method of wiring the jaws apart from the very start...see below.

* See free course covering all aspects of Orthodontic Jaw Wiring