OJW FOR WEIGHT CONTROL

Orthodontic Jaw Wiring OJW® for Weight Control in Compulsive Overeating–Guide to getting started

Ted Rothstein, DDS, PhD
Cosmetic Orthodontist for Adults and Children
American Association of Orthodontists
Founder DPOJW
35 Remsen St., Brooklyn, NY 11201
718 852 1551   Fx 718 852 1894  drted35@aol.com   www.drted.com

The rationale, wiring instructions, video of Dawna self-wiring and Jaw position [click here] OJW® is a registered trademark

Orthod5Orthod6

See use of new type of bracket to allow patients to rewire themselves even more easily, especially when they have traveled from out-of-state.

IN BRIEF: Jaws are wired APART about this much |–|. Wires are released every 5 weeks for 5 days to permit jaw joints to move fully and then rewired, etc., etc. The position of your lower jaw in OJW

DEAR WOULD-BE OJW PATIENT: provide this service with pleasure and truly believe in it, Because I have provided it to many patents who expressed delight in the success they achieved regaining control of their self destructive eating habits. OJW is not for everyone and success with OJW is not guaranteed. I try to select candidates on the basis of whether I believe they are likely to be successful with this approach to weight control. HOW and WHY OJW helps you lose weight is understandable if you read my explanation in question 3. you might also like to read: “Why do we eat when we’re not hungry?” Answer and 1000 Weight Maintenance Ideas

ORTHODONTIC JAW WIRING refers to the entire domain of the OJW provider’s responsibility for selecting patients according to a specified criteria, providing them with informed consent so that they are aware of the risks and limitations of OJW, then wiring their jaws (see also) (see also) together by a prescribed, method, transmitting that know-how to the patient (especially if they are not able to return to your office and can not find a professional level provider) and finally, reexamining them and rewiring them periodically after examination has shown that their dentition, gingiva, and TMJ have remained healthy until the period of time that they have elected to receive OJW expires (usually about 6-9 months; representing a weight loss of 50-75 pounds) and you have removed the wiring and brackets. OJW presumes that the service is provided under the auspices of a healthcare team which includes: the patient’s physician and dentist, the provider of the OJW service, a dietician, and when applicable the patient’s psychologist and/or psychotherapist as well as the input of a bariatric surgeon.

HOW TO WIRE THE JAWS CORRECTLY:  http://www.youtube.com/watch?v=_cR2h8latyE  (A 2-Minute video produced by Dr. Rothstein)

HOW OJW WORKS:
How OJW works  See the letter sent to members of the dental and medical profession and educators re a documentary film on the subject. Good to know:  Orthodontic Jaw Wiring FAQS. Finally, you can peruse a compilation of most of the references to OJW on the World Wide Web.
Read the latest press release
HOW TO PROCEED* I determine whether you are a good candidate (likely to achieve your goal weight) after reviewing THREE FORMS:
A. The Informed Consent for OJW (Same see below)  ”sign” in four places and EMAIL to drted35@aol.com
B. The  Medical-Dental History Form (PDF)   FAX to 718 852 1894
C. The Adult Acquaintance Form (PDF) FAX to 718 852 1894
D. A simple note from your physician saying that “you may begin a long term, low-calorie liquid diet.”
When I receive A. B. and C. I will call you and let you know if you are a good candidate.

FEES:
$2785 Paid on the day of the OJW appointment; The fee covers all office visits including all follow up visits for rewiring. The service is deemed completed when you reach your goal weight or request that the brackets be removed.
$2285 Paid in-advance of the OJW appointment date.
$1985 Paid 2-weeks in-advance of the appointment date.

METHODS OF PAYMENT:
Personal check (allow 10 days to clear), certified bank check, cash or Master/Visa/Amex credit cards, Flex-spending and Cash advance cards like Care-credit. Additional administrative fees will be applied with the exception of payment by cash, certified bank check or personal check.

REFUND POLICY:
A service fee of $175 will apply to those who paid the fee but decided not to proceed. Once the OJW has been placed
the fee is not refundable.

*NOTE FOR OUT-OF STATE PATIENTS:
For those OJW patients from out-of-state who can not return to my office to have their OJW brackets removed Dr. Rothstein will assist you in locating an orthodontist as close as possible to your home who will remove the 12 brackets (one minute or less)  and the adhesive (about 5 minutes).  The fee may vary from $175-$250. Do confirm the fee with the orthodontist who you choose to remove the brackets.

INSURANCE COVERAGE:
The 5th edition of the Manual of Diagnostic Disorders (“DSM5″) written by the American Psychiatric Association has been upgraded
and BINGE-EATING DISORDER (BED see WikiPedia), formerly mentioned in the appendix was upgraded to a full-blown diagnosis. Could this mean your insurance company might cover OJW since it is a treatment modality that directly addresses this problem.
AMA RECOGNIZES OBESITYAS A DISEASE NY Times 061913 …more  …more

THE OJW APPOINTMENT:
1. Staff takes a panoramic X-ray and frontal and profile body photos.
images
2. Doctor does an intraoral and jaw movement exam.
3. Doctor bonds the 12 brackets.
4. Doctor demonstrates placing and removing the wires.
5. Patient demonstrates that they are proficient at doing the wiring and rewiring themselves.
6. Patient is given the safety/precautions instructions.
7. Doctor completes the final wiring.
8. Provides patient with a utility kit including wire twisting and wire cutting instruments.
9  Patient removes wiring every 5 weeks for five days and if local returns to the office for rewiring.

RECOMMENDED READING:
Directory/index of all OJW related pages on www.drted.com: Of special interest items: #1.5,   #2, #102 #103 and #121.

DIRECTIONS TO THE OFFICE FROM LAG*, JFK and EWR:
DIRECTIONS FROM ALL AIRPORTS to my office. The Yellow metered cab from LAGUARDIA to the office takes under 30 minutes and costs about $30.
By bus and subway the cost is $2.50. From JFK and EWR expect to pay between $45-$60.

THOSE WHO ARE LESS THAN GOOD CANDIDATES FOR OJW INCLUDE:
Your mouth has many functions both obvious (talking) and not so obvious (sneezing) and is therefore the source of many pleasurable activities. The loss of any of them may provoke anxiety. Therefore one should think carefully about undertaking this method of weight control.

Would-be Patients who cannot obtain A simple note from your physician saying that “you may begin a long term, low-calorie liquid diet.”

Patients who might be allergic to metal components in the brackets/wiring/bracket adhesive: For example, Nickel is component of brackets (Get Information about Nickel allergy). I have had at least one patient who had to abandon OJW for symptoms that mimicked an allergy.

a. Persons who need to floss their teeth due to gum problems or other compulsive reasons.

b. Persons who speak abundantly for business or other reasons whose speech might be rendered less than perfectly clear because of being wired closed. (My long years of experience with OJW patients leads me to conclude that normal speech is not impaired)

Hear Valerie in OJW (same day)  Feb 2002 Listen to Valerie
Hear Pamela In OJW (next day) May 2008  Listen to Pamela

c. Persons whose sex life would be rendered intolerable if intimate oral functions were impaired… even a little.

d. Persons with multiple-missing, loose or decayed teeth:
The teeth typically used in OJW (See photos above):
Upper Right: #4 #5 #6; Upper left: #11 #12 #13
Lower Rt: #29 #28 #27; Lower Lt: #22  #21 #20
(Absent one of these teeth, I will sometimes use a tooth more towards the back or front.)

teeth

(Absent one of these teeth, I will sometimes use a tooth more towards the back or front.)

e. Those with psychological or emotional disorders who might feel powerless/ panicky with their mouths wired closed.

f. Those whose work functions might be impaired such as an actor, singer, waiter, teacher etc.

g. Persons with systemic diseases such as diabetics whose diets could not accommodate a liquid diet.

h. Persons who cannot breathe through their nose and whose breathing might be compromised by being held continuously in a closed bite teeth position.

i. Those who are highly allergic are more at risk.

j. Persons who have respiratory ailments such as snoring and/or sleep apnea as well as those who must use use a broncho-dilator spray such as asthmatics.

k. Persons who have a history of Temporo-Mandibular Joint dysfunction (TMJ). Learn more about the TMJ: [Information source number 1], [Information source number 2].

l. Persons who are taking oral pill/capsule form medications could encounter some difficulties trying to pass a large capsule into the mouth behind the last teeth. It would be virtually impossible if the wisdom teeth were fully in place.

m. Persons who compulsively clench/brux/gnash their teeth.

n. Persons who have, or are suspected of having, anorexia or bulemia to begin with.

o. Persons with frank unresolved periodontal (gum-tooth socket) problems.

p. Persons who drink alcoholic beverages. (Alcohol suppresses the gag reflex). In the event of alcoholic intoxication vomiting can occur. [See note from respected oral-surgeon/orthodontist educator.]

q. Persons who 1. will not provide a telephone number 2. do not have an Email address. 3. below the age of 21 unless accompanied by a parent. 4. are NOT more than 125 pounds overweight or less than 25 pounds overweight (i.e moderately obese and obese, but not “morbidly” obese).

In 2009 I asked my OJW patients to respond to a pressing comprehensive Questionnaire Survey: See their responses  (Excel spread sheet).

OTHER OJW PROVIDERS (BEWARE):
I cannot vouch for the quality of the OJW service provided by any of the doctors noted on the list.  Indeed each doctor may deviate significantly from the protocol
I follow when providing the OJW service.  For example some doctors may use elastics instead of wires (BIG NO-NO), or wire the teeth so that they cannot
move their jaw at all, or worse yet use surgical arch bars instead of orthodontic brackets–Caveat emptor !

OTHER:
See also: OJW Telephone Consultation memo

 Orthodontic Jaw Wiring for Weight Loss (OJW®) Informed Consent

DIRECTIONS:
Carefully read the Informed Consent then fill in the data requested (* information requested is mandatory). Place your initials/name in all places requested and email the Informed Consent to drted35@aol.com. Then just below see hyperlinks to the “Adult Acquaintance” and  “Adult Medical History” forms. Download and complete BOTH  forms and mail or fax them  to the office (fax 718 852 1894 evening best).  When I have received ALL THREE FORMS  I will call you without further delay. With care, Dr. Ted Rothstein.

* Date:    /    / 2013       * Name:                         * Age:     Date of birth:     * Height:
* Present Weight:                               * Goal Weight:          (click on link)—>*Present Body Mass Index (BMI):
* Activity Level  (Life style): (Circle one) inactive, mildly a., moderately a., very active
*Number of months you are initially willing to dedicate passionately to the jaw wiring (OJW) approach to weight loss:  2 3 4 5 6 (3 months/ 21 pounds, assuming 5 pounds first week then 1.5 pounds each week thereafter)
*Address:                        *City:              *State:       * Zip:
*Occupation:
*Home Telephone:                 *and Work Telephone (Other):                 * and Cell/ Mobile Telephone:
*Email Address: Dr. Ted will not contact you if you do not provide this item.
* Your dentist’s name:
Address:
* Telephone number:
I give Dr. Ted my permission to call my dentist by placing my initials here_______.
*You physician’s name:
Address:
*Telephone number:
* I give Dr. Ted my permission to call my physician by placing my initials here_______.
* OJW preferred appointment date:________ ** Alternative OJW appointment date:__________  or “Date undecided”
Please complete both forms indicated below and FAX to my office: 718 852 1894.  After I review the data from ALL THREE FORMS I will call you to discuss your goals and help you arrange an appointment.

I, _________________________, authorize Dr. Rothstein to wire my jaws into the OJW position of physiologic rest ††. realize that I will need to be on a low calorie liquid diet to achieve my weight loss goal.*  I know I can have the  orthodontic jaw wiring (brackets and wire) removed at any time I request. I have read and I understand all the material on Dr. Rothstein’s web site related to the orthodontic jaw wiring procedure. I also recognize that even if I achieve my weight loss goal, I may well regain the weight. I have been advised that the best way to maintain the weight loss is be means of life style changes, which include a low calorie, balanced diet matched to an appropriate exercise regime for my life style.

I understand that Dr. Rothstein requires a note from a physician indicating: “You may begin a long-term, low-calorie liquid diet.”. The purpose of such a note is to rule out for your own safety and my assurance that such a diet would not be harmful to you. Such a release is taken  to mean that you have no gastro-intestinal issues or other medical problems that would harm you by beginning such a diet. Lacking this medical release note the OJW service can not be provided.

I understand that  OJW requires that braces (brackets) be bonded to my teeth; that braces may sometimes become detached and need to be rebonded. Moreover, I realize that if I come from out-of-state and a bracket detaches, I will need to see a local orthodontist to have the bracket(s) rebonded at an additional cost to me ($50-$85/bracket). Finally, that at present there are few if any orthodontists who will rewire me and for that reason I have elected  to rewire myself (or have my significant other do the rewiring for me following the method Dr. Rothstein taught me when the OJW was placed.

Since I may come from out-of-state and may not be able to return to Dr. Rothstein’s office to have my OJW brackets removed, I will need to locate a local orthodontist whose fee may range from $300- $400+  to remove the OJW brackets and adhesive.

I am at liberty to review the results of the survey Dr. Rothstein completed in January of 2009 to see how other OJW patients fared.  View the benefits and problems of OJW (as an Excel spread sheet) and to read  his manuscript on the nature of the OJW service as provided by dental professionals: Orthodontic Jaw Wiring: The Dental Professional’s Role in Weight Control for Compulsive Overeating Leading to Obesity

Dr. Rothstein’s work shall be largely limited to placement and removal of the orthodontic jaw wiring appliance as a whole, periodic rewiring and tooth cleaning of the inside of my teeth, replacement of any accidentally detached brackets and finally, warning me if he thinks that continued use of the orthodontic jaw wiring is causing/may cause harm to my gums, teeth and jaw joints.

The OJW appointment will include an oral examination in conjunction with a panoramic X-ray, and detailed instructions how to place and remove the OJW wiring. I understand that I must remove the wires at the end of five weeks and return to the office (not applicable to out-of-town patients) to have Dr. Rothstein re-examine me to ascertain that my teeth, gums and jaw joints (TMJ) are in healthy condition. Above all, I understand that he will not rewire me if I cannot pass  the three-finger mouth opening test  without difficulty or discomfort. Finally, that Dr. Rothstein will provide me with the prerequisite instruments needed to place and remove the wiring.

I am fully aware that other methods of weight loss are available to me including: weight loss medicines such as Alli, Meridia  Xenical, “Qysymia” formerly Qnexa, Belviq, Weight Watcher’s and Jenny Craig programs and a variety of bariatric surgical techniques. I am also aware of such organizations as
Overeaters anonymous and Greysheeters anonymous (GSA) for compulsive overeaters.

I understand I am required to make a new appointment for between 4 and 6 weeks after each time Dr. Rothstein rewires my jaws and I realize that I must release the wire {See Release methods]  4-6 days prior to that to permit me to exercise my jaw muscles.  [See jaw joint exercises] I realize that if I do not eat a soft diet during those times that my jaw is unwired I may cause brackets to become detached.

I have been advised that if I have any conditions which are medically compromising and that demand special medical attention to dietary details such as, to mention just a few: diabetes, gastric reflux, Crohn’s disease, irritable bowel syndrome and malabsorption syndrome, I should not have this procedure done. I have had a medical exam in the recent past and I am in good health and I have no medical problems that may interfere with or be at odds with this procedure. My physician has not advised me to forego this procedure.

I have read all the  FAQ’s related to OJW and I have especially read the question ,  “Who is NOT a good candidate for the OJW procedure.”   I realize  the list of reasons for not being a good candidate does not cover every possible condition of ill health.  I am confirming that I am a good candidate and I am providing  my initials as acknowledgment in this space _________. There is also the possibility that I might be allergic to metal components in the brackets/wire such as Nickel  (Get Information about Nickel allergy)  or even the adhesive used to bond the brackets to the teeth any of which might require having to have the OJW removed.

I have been advised that prior to orthodontic jaw wiring I should have a complete physical exam including a complete blood study, and an analysis of my present caloric intake by a registered dietitian [Find a registered dietician in the American Dietician's Association]  so that a liquid diet can be designed for my  body type and activity level that is compatible with my weight loss goals.** I realize that while Dr. Rothstein may try to help me with the liquid diet suggestions that it will be my total responsibility to create a liquid diet compatible with my goals. I agree to keep an accurate daily log of my liquid diet showing the calories in each meal and the total of my daily and weekly intake. I agree to show Dr. Rothstein this log at each office appointment. I realize that I may not reach my weight loss goal, but I do not hold Dr. Rothstein responsible since he has not made any guarantee regarding the success of attaining my goal. I realize that exercise is a very important factor in losing weight and that Dr. Rothstein will/has apprise(d) me of the relationship between weight loss and gain and the number of calories and activities I do. [See Dr. Ted's exercise]

I realize that extensive vomiting could result in vomitus being taken into my airway, which could be a very serious medical problem requiring immediate medical attention. Consequently, I realize I should immediately remove the wires that hold my teeth together under conditions of suspected or impending nausea.[Read special note from highly respected teacher, educator and practitioner] Dr. Rothstein will/has also show(n) me how to remove the wiring with a Nippy wire cutter and even a fork. I have been advised to carry at all times the Nippy wire cutter that Dr. Rothstein gave me.  Dr. Rothstein has told/shown me how to remove the wire in an emergency with a simple fork and shown me that it can be easily accomplished in less than 10 seconds. [SEE INSTRUMENTS AND METHODS OF REMOVING THE WIRE.]  Dr. Rothstein has/will give(n) me his home phone with special instructions to call him if I ever have any problems related to this procedure outside of regular office hours. I acknowledge by my  signature here that I understand the above._________

I have been told that my speech may be somewhat impaired, that Listerine rinses will be the only way to keep the insides of my teeth and mouth clean. I have been told to avoid and/or report any gnashing/bruxing or sideways grinding of my teeth or any jaw muscle aches since they can cause problems to my teeth and jaw joints.

Dr. Rothstein has prepared me for the uncommon possibility of “panic attack” upon being wired and  that I may have to release/remove  the wiring immediately or within a few days from the OJW appointment  because I find that I am unable to adapt to/tolerate my jaws wired in the “OJW position of physiologic rest Or, or I may find the orthodontic brackets and wiring themselves are feeling “foreign”/uncomfortable to me.†† Consequently, I understand there will  be an initial trial period when the OJW is first placed when I will have to adapt to novel situation that I have never experienced before. I understand that Dr. Rothstein will remove the OJW Immediately if requested, or rewire me when I am ready for it (at no additional charge as long as the brackets are still in place. [Read D.V.'s experience.]

I understand that if I pay the fee prior to the OJW appointment and then decide that I do not want to proceed with the OJW that Dr. Rothstein will refund all of the fee I paid except a service fee of $175.

I understand that the OJW placement  is non-refundable following insertion/placement of the OJW and that the removal of the wiring and all braces and final cleaning at the last visit is included in the fee. However, for those OJW patients from out-of-state who can not return to my office to have their  OJW brackets removed, Dr. Rothstein will assist you in locating an orthodontist as close as possible to your home who will remove the 12 brackets (one minute or less)  and the adhesive (about 5 minutes).  The fee may vary from $75 -175 so do confirm the fee before having the local orthodontist perform the OJW removal.

Finally, I permit Dr. Rothstein, if he chooses, to show the chart entries of my case on his website in the “orthodontic jaw wiring for weight loss section.” I realize he will respect my right to anonymity. And, I authorize Dr. Rothstein to share my records with other dental, medical and related healthcare professionals concerned with helping the overweight control their problem as part his goal to further the gathering of knowledge about OJW (which is still an experimental method for weight control in obesity) into a national database.

OJW has not as yet been submitted to the FDA for its approval.  Dr. Rothstein has provided OJW to 150+ patients. A utility patent application was submitted to the USPTO and an application to was submitted to the USPTO to register the mark “OJW” and OJW was approved as a registered trade mark for Orthodontic Jaw Wiring for weight control/loss

Readers are urged to read Dr. Rothstein’s paper on OJW as a Treatment Modality for Binge Eaters [Click here].

I have read the Informed Consent above including the hyperlinks directing me to supporting educational material. I fully understand the OJW service that Dr. Rothstein is going to provide me with. My signature acknowledges my consent for Dr. Rothstein to provide me with the OJW appliance:
PATIENT’S SIGNATURE:_______________________________________  DATE:____________

 

071413

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