Ted Rothstein, DDS, PhD
Specialist in Orthodontics for Adults and Children
Member American Association of Orthodontics
35 Remsen St., Brooklyn, NY 11201
718 852 1551   Fx 718 852 1894  

drted35@aol.com*   www.drted.com

Founder DPOJW  See: www.drted.com/DPOJW.html
 

Dr. Mark B. McClellan

Administrator of Federal Centers for Medicare and Medicaid Services

200 Independence Ave. SW, Rm. 314G

Washington, DC  20201

 

August 4, 2004

 

Re: the astronomical cost of bariatric surgery to M-M; other obesity control options such as OJW and the DPOJW

 

Dear Dr. McClellan:

 

    Your name first came to my attention when you were referenced in a NY Times article that appeared July 18, 2004 entitled "Weight-Loss Field Awaits Change in Medicare Policy"--(the article). In the article you expressed serious concerns about the astronomical expenditures expected as a result of the declaration at M-M that obesity, even unaccompanied by any other collateral disease, was a disease in and of itself. 

 

    Indeed, another recent NY Times article has shown that the cost of bariatric surgery often rises to $65,000 when complications occur as they frequently do--(the article).

 

        You noted back in 2004 that Medicare was convening and advisory committee ('this fall") to review the related problems and review what if any alternative  treatments were more cost effective and other related issues.

 

    I was further galvanized to contact you when I read still another article that appeared 8/1/06 in the NY Times in which I read that Medicare-Medicaid funding for certain medical procedures was being pared back substantially.

 

    I would like to know if bariatric procedures were among the list of services that funding was being reduced. Moreover, I would like to know the agency's present take on alternative procedures that are being considered.

 

    Having said the above I would like to make you aware of my activity in the weight/control-loss field.

 

  Most recently I authorized the filing of 501(c) forms to realize an organization I have dreamed of for many years to promote research regarding a method of weight control for obesity and compulsive overeating that I have been providing to carefully selected patients.

 

   I named it the DPOJW (Dentist Providers of Orthodontic Jaw Wiring). See definition below.

 

   I have treated over forty five patients using OJW, using Orthodontic Jaw Wiring (OJW), See Photo, which I devised and have championed for the past five years helping them regain a measure of control over spiraling weight problems and compulsive overeating. Jay, a Colorado lawyer, provides insight (and praise) about the procedure: READ JAY'S LETTER.

      

   The subject remains little known, and controversial: The OJW Controversy Article. This article highlights the polarity in the dental community over this approach to weight control. Two prominent members of the orthodontic community express there views therein.

    

    I have presented my work in this field at major dental and orthodontic conferences in New York, Paris, and Las Vegas between 2004 and 2006: Las Vegas May 2006.  I was heartened by praise received for daring to illuminate a technique that dentists seem somewhat embarrassed to use.  Call ten dentists at random, and you will see my point.

    

        My contribution is to have developed a protocol for providing OJW in which the possibility of jaw joint stiffening is addressed; devised a practical Informed Consent Informed Consent  for the dental community; shown how it could be done using orthodontic attachments instead of threading wires through gums and teeth, and addressed the problem of how to select appropriate patients: POWER POINT PRESENTATION 

 

    As you know, obesity is a real disease. An alarming statistic is that three to four persons per thousand who undergo gastric bypass surgery die as a result of the procedure. It is my goal to expose the dental and medical community to an alternative with a zero mortality rate.

 

    A dentist may not diagnose "obesity," but surely he can apply the hardware and monitor the health of the teeth, gums and jaw joints while the patients get a jumpstart in behavioral change.  

OJW is not for everybody and is not a panacea. It is for carefully selected patients who think there is still a chance left to save them from having to face the bariatric surgeon.

 

    Might you look ever my work via the hyperlinks I have provided in this letter and provide some insight that might be inspiring to me? [http://www.drted.com/Dr. Mark B. McClellan.html]

 

In summary, considering  gastric surgery [The risks of gastric surgery; [The long-term outlook].

Medicare responsibles have recognized the need to find less costly procedures than bariatric surgery ($35,000).

 

    I believe OJW is the right step for some, and should be considered among alternative approaches prior to, (BMI <38), the need for gastric bypass surgery.  I have provided OJW to patients who came from as far away as California.  I believe that there is a trend toward this option and OJW would enjoy more currency were it more widely known. The DPOJW is also part of my contribution: www.drted.com/DPOJW.html.
.

Cordially,

 

Dr. Ted Rothstein
* http://www.drted.com/Dr. Mark B. McClellan.html : the URL where the links can be accessed.