Clinical Notes: T.P. A teacher, living just South of Little Rock, AR, Age 35, 5"5',  235 lbs:  Goal 155 pounds, Moderatey active, willing to devote 6 months passionately to OJW.  Email address: communications to T. P. via DrTed35@aol.com.

  Examination of teeth, gums, all soft tissues, extent of movement of jaws, and TMJ (Temporo-Mandibular Joint) reveals that T. is in good health.  (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 fingeres just in front of your ears when opening and closing your mouth. T.P. was escorted by her mom G. A Panoramic X-ray was take and deemed unremarkable. The dangers and precautions of OJW were provided and special instructions were provided regarded as to how the teeth and jaws should be wired so that no pressure is put on the TMJ or the teeth. She previously signed the the informed consent for jaw wiring .  The informed consent and the FAQ's were reviewed. "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). All of the teeth to which brackets were bonded had normal enamel except 4, 19 and 20 which had crowns. Special preparation was given to them to  prepare them for bonding on the brackets. The brackets were "double bonded", in that a second layer of adhesive was place on the flanges of the bracket.  Her mother  was shown the 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 in the manner prescribed and the wiring was done with .014"diameter dead-soft stainless steel wire in the same manner as usual. She 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 wired closed on the right and left sides. She agreed to follow the recommended protocol: After 4-5 weeks snip off the wires, exercise (especially chewing gum) for 4-5 days and return to the office for evaluation, cleaning and rewiring. If a bracket did break and she was unable to return Dr. Ted would help her locate an orthodontist to provide that service.  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 his jaws  during the 4-5 days she would be released from the wires and advised regarding the possibility of the joint becoming more limited in motion over time (two fingers of opening rather than 3 fingers) if she failed to follow the protocol. She was counseled to adhere to a 1400 calorie  low/no salt liquid diet. She had no problem drinking from a cup. Her mother stated she could accomplish the jaw wiring for T.P. with ease and demonstrated that fact on her daughter. 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. A wire cutter was shipped Fedex to her husband at home the following morning. He was was called in the evening to assure him that everything went well and the his support would be very import. He was advised that T's first week would be very difficult.