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OJW telephone consultation memo
Dear
would-be OJW patient: (Name):
You have received this memo because you are interested in having OJW for the
control of compulsive eating. You probably have chosen this approach since
previous methods of weight control have proven to be inadequate for you, and you
do not wish to take drugs/medications nor have any invasive surgical procedures.
If this is truly the case you should be thoroughly familiar with:
1.
How to proceed when you choose OJW.
2. The
forum on the pros and cons of OJW.
3. Question 4 in the Q and A section on OJW
Why do you lose weight when your jaws are wired together.
4 .
Who is not a good candidate for this procedure (12 questions below
question 4).
You would be wise to let your dentist, your physician and psychologist/
psychiatrist know that you are about to undertake OJW. They may not be
supportive, but if they have a negative opinion on the procedure let them give
you the specifics of their objection. You can direct them to
drted.com if
you feel it would be useful for them to know more about the subject.
You should have your dentist examine you to inform you of the current health
status of your teeth, gums and jaw joints. It would be very useful for you to
send me the molds of your teeth to determine if there will be any problems that
would deter me from doing the OJW on the day of your appointment. I will also
need you to provide me with the name and telephone number of your dentist. I
will not call them unless I have your permission.
If possible you can arrange for me do an initial examination ($125) which
includes a panoramic x-ray when deemed necessary. This fee is included as part
of the fee for OJW if you proceed on. All fee arrangements will need to be
concluded with the office manager and treatment coordinator, prior to
the day of the procedure
Typically I do the procedure after my last orthodontic patient at 12:30pm on
Thursdays. It take about 40 minutes to do the OJW, i.e., place the brackets
which takes about 35 minutes and place the wiring. However, I want you to arrive
at the office not later than 11am to settle in and be relaxed and comfortable.
Most often a Panoramic X-ray is taken. The neighborhood is pleasant and there is
a wonderful view of NY harbor a few steps from the office. You can expect to
leave the office before 2pm.
You should determine if speaking with your mouth closed in the OJW position will
be detrimental at your work (possibility of impaired speech). For those OJW
patients who would feel more comfortable having a professional's letter to
present to their employer you can see the one I would be pleased to provide. See
the letter.
The teeth that will receive the braces/orthodontic brackets are the upper and
lower, right and left, canines, first premolars and second premolars. I will
surely want to know beforehand if any of these teeth will present difficulties
in carrying out the OJW, (ex. missing teeth, crowns on teeth, as well as the
presence of any unusual biting conditions). Although special precautions are
taken to insure the brackets adhere to porcelain surfaces (crowns), the brackets
are more likely to detach from them than if they were natural teeth.
It would be best to bring someone along who will do the wiring for you at home,
but absent such person I will show you how you can do it yourself.
The regime calls for a liquid diet containing not more than 1350 calories (not
one calorie more than that). You will probably feel very uncomfortable during
the first week as your mind/body adjusts to the new conditions of your OJW
status. If you can get by the first week you will have the wind in your sails.
The less active you are the slower will you attain your goal weight. Conclusion:
Eat less, but exercise more. I suggest you read: Orthodontic
Jaw wiring: A.T.’s diary of her experiences during the first two months.
Should a bracket become detached off you can return to the office to have me
replace it, or you can enlist my help in finding an orthodontist where you live
who will reattach it for you. Having three brackets on each of the 4 quadrants
of the mouth is optimal/desirable, however the wiring could be accomplished even
if you had only two brackets in each quadrant. I doubt if you will find any
other general dentist, orthodontist or oral surgeon who will take on the
responsibility of doing the rewiring.
You are required to follow the rule of "55" i.e., you remain wired for five
weeks then remove the wires for five days to exercise the jaws (talking, chewing
gum, and other exercises will be demonstrated at the time of the OJW).
From the moment your jaws are wired until you have finished I will remain on
call 24/7 to be of assistance to you. I will provide you with my email address,
office and home telephone number (if I have not already provided it to you).
When you have reached your goal weight, or you decide that the OJW is ready to
be removed, you can return to the office to have me remove the brackets/adhesive
at no cost to you, or you can have your local orthodontist do it.
You must never forget that if you ever drink alcohol to excess you will become
inebriated to the point of nausea and even passing out. Alcohol suppresses your
gag reflex, hence vomiting may occur. The OJW impedes the easy expulsion of the
vomitus. Some of the vomitus may then enter your trachea/breathing airway.
Vomitus in your airway can lead to sickness, injury and even death by
"suffocation/drowning." Always carry the wire cutters we will provide. You can
remove the wires in less than one minute when necessary. Err on the cautious
side ...carry the wire cutter with you. Other causes of nausea and vomiting
include food poisoning and sudden illnesses to mention only a few. Remember that
oral surgeons around the world routinely wire patient's jaws closed for other
reasons. There is no record of a single person's demise due to this occurrence.
On the other hand the death rate of surgery for obesity is 1/1000.
If you have any questions call the office and speak to a staff member or
myself.
Thank you for choosing me to provide you with OJW. I look forward to meeting you
in person on the day your OJW is scheduled.
Please acknowledge receipt of this memo by forwarding it to:
drted35@aol.com
For the Subject: use
"OJW memo acknowledged."
Cordially, Ted Rothstein, DDS, PhD
Specialist in Cosmetic Orthodontics (Invisalign, Clear and Lingual braces)
35 Remsen St.
Brooklyn, NY 11201 (10 minutes from the Brooklyn Bridge)
718 852 1551 Fax 718 852 1894