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THE TYPICAL FIRST VISIT ENTRY FOR AN OJW PATIENT WHO ARRIVES AT THE OFFICE BY THEMSELVES (the ratio of females to males is 6:1)
Clinical Notes: Desiré Talousewaith, Court stenographer, Brooklyn, NY, Age 36, 5'4'' 222 lbs: Goal 165 pounds, Mildly active, willing to commit 6 months passionately to OJW. Email address: foundojw@yahoo.com (Expected weight loss 50 pounds)
October
16, 2003:
Examination of teeth, gums, all soft tissues, extent of
movement of jaws, and TMJ (Temporo-Mandibular Joint) reveals that Desiré is in
good health. Her medical dental history indicated that she had no medical or
dental problems related to treatment using OJW. A routine panoramic X-ray was
taken, which further showed that her teeth and TM joint were normal. Her
occlusion was tested with articulating paper in order to test for/locate any
possible traumatic occlusion. None was noted. (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 fingers just in front of your ears when opening and closing your
mouth. Desiré was told that in
OJW the jaws are wired together but the teeth of the upper and lower jaw touch
just barely, thus allowing about 1.0 mm of lower jaw movement in ever direction. Consequently, no pressure is placed on the
TM joint. She
signed the
informed consent for jaw wiring . She
came alone. and was provide a review of the entire procedure and was advised of the
dangers she might encounter and how to avoid them. the informed consent and the
FAQ's were reviewed and she signed the
OJW Telephone memo
indicating that she was aware of all aspects of the OJW treatment method for the
control of compulsive overeating. "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 Both the
teeth and the brackets were micro etched and the teeth were then also acid
etched. All of
the teeth to which brackets were bonded had normal enamel. The brackets were "double bonded", in that a second layer of adhesive
was place on the flanges of the bracket. All
excessive and unsightly adhesives was removed and the space between the teeth
was checked for unimpeded passage of dental floss. Desiré 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 and
the
wiring was done with "dead soft" .014 inch diameter stainless steel
round wire. Desiré 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 then wired closed on the
right and left sides. She agreed to follow the recommended protocol: After 5 weeks snip off the wires,
exercise for 5 days and return to the office for evaluation, cleaning and
rewiring. 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 her jaws during the 5 days she would be released from the wires
and advised re the possibility of the joint becoming more limited in motion over
time (two fingers of opening rather than 3 fingers). She was
counseled to adhere to a 1350 calorie low/no salt liquid diet. 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.
Ps. She indicated that she intended to
return for follow up visits and was advised to weigh herself each day. She
was instructed to keep a graph of her weight loss 18"wide (each day) by 9" high
(weight) and make an entry every day/week.
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