Jaw wiring itself is nothing new. Invasive jaw wiring procedures such as intermaxillary fixation (IMF) and maxillomandibular fixation (MMF) have been performed by oral surgeons for years, primarily for broken or malformed jaws.

Dr. Rothstein's technique is more like getting braces. Brackets are attached to at least three teeth in each arch -- right and left, upper and lower -- and a soft wire is laced through the mouth, in effect wiring the jaw shut.

For the past six years, Dr. Rothstein has wired approximately 40 overweight people. A woman at the end of her treatment for braces was the first to make the unusual request.

"She said, `Would you provide this service for me?' I said, well I've never done it before, but I don't see any reason not to help you out'. It didn't occur to me to say no. It didn't occur to me to be negative about it."

After he wired that first woman's jaw, Dr. Rothstein began performing the procedure on a semi-regular basis. After they are wired, the patient goes on a liquid diet for a period of up to seven months - the lack of solids spurring dramatic weight loss during that time.

For those seven months, the life of the wired person changes. They have to rely on dental rinses instead of brushing their teeth. Speaking clearly is also a problem.

"Just bring your teeth together and start talking to me," says Dr. Rothstein speaking through clenched teeth to illustrate his point. "It can effect how you speak. So, if you need perfect clarity, that might be impaired."

Why aren't all orthodontists practicing OJW? In Dr. Rothstein's estimation, orthodontists are a stiff collared lot, not likely to try anything that strays too far from the norm. "They're really sheep. They're sheep. They want to stay to the center, no going ahead, or lagging behind or right or left. Just stay in the herd."

Doctor Elliot Moskowitz, associate clinical professor at NYU's School of Orthodontics, rejects Rothstein's assertion. Although he knows and respects Dr. Rothstein, he views this small part of his practice as being "barbaric" and completely out of the purview of an orthodontist.

"Just because people put food through the oral portal does not necessarily mean that this is a dental issue," he contends. "What happens when you open up their mouth - the same habits are there. I think it should be in the hands of physicians and people trained in the causes of obesity."

Dr. Michael Epstein, founder of Digestive Disorders Associates, agrees. He says that a team approach is needed, especially since patients are at risk of malnutrition and other digestive problems by adopting an all-liquid diet for such a long period.

Dr. Rothstein says that all patients must fill out a detailed "informed consent" form in which they agree to speak to their family doctor. According to the form, anyone with possible health risks cannot receive the procedure. Regarding the digestive risks of being on a liquid diet, he provides patients with access to information sources, though he does not require that they see a health professional about their new diet.

"My job is to tell them all about wiring. I'm not a registered dietician. It's a mechanical thing I provide like straightening teeth, only it's holding jaws together, in a safe environment."

For Dr. Moskowitz, the procedure is not only unsound, he views it as physically dangerous to the patient and a possible litigious nightmare for the orthodontist. "What happens if a patient regurgitates and can't get that out. They could swallow their own vomit and die! I don't want to take the responsibility for that," he says. "That's a real risk."

Doctor Rothstein dismisses this argument. If a person were to vomit, argues the doctor, liquid would be expelled, which could easily pass through the nose or through the sides of the mouth. He also provides patients with wire cutters, advising them to snip the wires if they feel sick.

"In any given year, thousands of people are wired by oral surgeons for IMF, for jaw healing as a result of surgery or trauma. There's no report of anybody dying from it," he argues.