Responses to OJW Protocol Report Updated: September 22, 2003
Subj: Orthodontic Jaw wiring for weight loss (OJW): A primer and protocol for orthodontists updated.
Read the letter/report which generated the responses below
1. From Dr. Larry Jerrold respected legal counselor in the orthodontic profession, orthodontist and Head of the Department of Orthodontics University of Jacksonville:
I have gone over your informed consent documentation regarding your orthodontic jaw wiring protocol and am prepared to make the following comments.
My biggest problem is that the services that you render do not fall within the statutory definition of the practice of dentistry as elaborated in the New York State Dental Practice Act. Having said this I do believe that there are methods to resolve this issue however I find them either lacking or uncompelling. This is not to say that you are not rendering a valuable service, quite the opposite. I believe that control of compulsive overeating is a major problem facing the population of the United States today. Your attempt to address this condition is laudable.
I would be infinitely more comfortable if your therapy were adjunctive to treatment for this condition that is being rendered by a physician. I would like to see a physician examine a patient BEFORE you render any treatment and actually recommend this procedure for you to perform. As long as the primary care physician for the patient is an MD who personally recommends this procedure, asks you to perform it, and then is willing to supervise the patient’s response to the jaw wiring therapy in conjunction with the help of other ancillary health care practitioners, e.g. psychiatrists, dieticians, physical therapists, etc., I have no problem. For you, or any other orthodontist who assumes the role of primary care practitioner is fraught with potential problems from a medico-legal perspective.
I know that your informed consent form provides that the patient must avail themselves of the services of these other health care practitioners; however, I believe that from a legal perspective, the cart has been placed before the horse.
Please reconsider the “chain of command” issue as I see it and if it is reconfigured, I wish you all of the praises that can be lavished upon one who is seeking to better the overall health status of those compulsive overeaters who have the good sense to seek a remedy which might prevent them from reaching the point of being morbidly obese and then requiring bariatric surgery where the mortality rate is now 1%.
Dear Dr. Jerrold
2. From Jim Bowlin, legal counsel for the American Association of Orthodontists:
Confirming our conversations in regard to this matter, this will confirm that I have no objection to the AJO/DO addressing the issue of orthodontic jaw wiring. I think it would be best that any article relating to the issue originate with Dr. Jerrold (or anyone else similarly trained) given his legal and orthodontic background. I would be happy to review the material, and offer any additional legal information that may be helpful. Please let me know if you need anything further.
3. Reserved for Dr. Miki Kuftinec, NYU
Post Grad Orthodontic Department arch-demonizer of OJW who said" 0n 3/27/02:
I urge you to stop that totally unscientific nonsense.
The procedure is not supported by the human nutritionists in this or in other
countries. This fact was made clear to Ted. While he is at it and in order to
increase the number and the kinds of patients he "can help as orthodontist" [or
did he say that he has an obligation to help?] perhaps we should pronounce that
the jaw wiring can stop various speech impediments, swallowing patterns, even
saying the wrong things!!! If it could only stop someone from using his keyboard
Stop this nonsense, please." (Response
from Dr. Rothstein:
credentials qualify you above all to provide us with literature citations to
support your contention as it pertains to OJW for weight loss. Please feel free
to post your response to "OJW
protocol updated (responses)"
Scientific literature in support of Jaw wiring in general: See Jaw wiring for weight loss literature references
See also Article in Lancet; See also use of magnets as substitute for jaw wiring
4. From Jay Freeman
December 11, 2003
Today Jay Freeman, attorney from Littleton, Colorado, was placed in OJW by his dentist Dr. Ivan Naiman. Jay originally intended travel to NYC to have me provide the service. However, after speaking to Dr. Naiman, his dentist, on a number of occasions to my surprise he agreed to provide the service to Jay, and I happily agreed to be at his beck and call.
----- Original Message -----From:Sent: 12/11/2003 12:55:35 PMSubject: congratualtions on leaving the starting line...Best wishes to Jay
Dear Ivan and Jay:
- I hope both of you will one day contribute your thoughts to:Responses to the letter of 9/22/03. and
- 48. You can see the "TYPICAL FIRST VISIT" medical chart entry for an OJW patient.[GO].Best wishes to you both. I remain at your disposal should you have any need of me. Cordially, Dr. Ted Rothstein...Best wishes for all the holidays.
JANUARY 9, 2004
STATUS REPORT FROM JAY FREEMAN...FIRST PATIENT TO BE WIRED BY HIS OWN DENTIST IN COLORADO
We are doing OJW in our office, Hollywood Bracestm, for the last 10 years, with-out big advertising or public debate; I did not see a one patient who had any TMJ or periodontal problems after OJW, most of the time we offer OJW with referral from MD and with dietitian’s supervision. We recommend our entire OJW patient pool to visit your web site for step by step instruction and pro and con, before they start treatment
Dr. Yury Geylikman
323 656-9111; 323 650-9499 fax
OJW patient: Dawn Bolen:
0ctober 9, 2003 (Dawn's response to the letter) Hello Dr. Ted. This is Dawn Bolen, I came to your office for OJW on July 17, 2003. Well this has truly been an experience. I began the OJW weighing in at 195 pounds as of today I am 165. Not to bad!! I lost good the first couple of weeks and then slower over the next few, but since I plan on having the wires removed at the end of October in just 2-1/2 more weeks, I have really buckled down with a drastic fast for the past 10 days and have seen more noticeable weight loss. Yesterday I had my first headache and it lingered on all day. I have really been fortunate. My stomach growls a lot, but that's ok it ate good for a long time!! A few co-workers still think I am crazy but they are amazed at my appearance! I had to adjust my story of why my mouth was wired a few times depending on who I talked to. I rewired myself only once and this was after 6 weeks. My jaw was too sore to open to 3 fingers and I felt that I really couldn't be trusted, the temptation was strong so I put them on 2 days later while my jaws were still basically closed. I know that I can't take them off and put them back on now, mentally that part of the commitment is over. I am 15 pounds from my goal of 150 so I am very happy. I just received some appetite suppressants from my Dr. to help me adjust and maintain over the next 6 months once these are removed. I refuse to gain any weight back. This has been a blessing. I would say on a scale of 1 to 10 with 10 being the greatest, that the difficulty level in having my jaws wired was a 4. It was an adjustment not being able to lick my lips or when I put on lipstick, not being able to smooth my lips together. The day I left your office I had a 5 hour drive back to Maryland. It was crazy to say the least, I had to keep talking myself out of cutting them off right then and there, convincing myself that I have thrown away more than $1800 before. But around the 4th hour I was getting my head together. I can't believe how many times I had to stop and get coffee, because I had convinced myself that I could not be awake with my mouth like this. Anyway, once I made it home and stared at myself in disbelief the fear began to settle and before I knew it I had made it through my first week and was heading to my family reunion in Philadelphia.
I made it through 2 family reunions and 2 weddings this summer. The key is having your "mind right". Although I believe I hit a weight plateau in September, so I had to drop the Ensure (I think it may have had too much nutrients for me, because I maintained for a little while) I have never, not once gotten, sick or even felt like I couldn't go on. The bottom results have always been my motivating goal. My sisters and mother have been encouraging and supporting me all the way (My mother thinks I should keep them on until December --- to lose even more -- just in case I gain, she has memories of me skinny and I don't know how long ago that was) but that is not going to happen. My children, both boys ages 12 and 13 have had a problem with it the whole time because it cut into their eating out and "free for alls". Now my boyfriend has had his own issues with it (but I don't care), he had issues with the weight gain also. Anyway I got my first compliment from him this morning.... "You may have lost a pound or two..." Ah, the key is truly having your "mind right". Pants that I had at one time squeezed into and popped the top button, now hang loosely! But I haven't reached my goal yet - I have to keep reminding myself or I just might get satisfied. I began in July wearing a size 16 and I am now back in a size 12, my goal is size 10.
In the beginning I tried to exercise, but I found myself starving and exhausted. Before OJW, I was used to a 3 day 45 minute cardio work out, but once I was wired that was not working for me. I needed a 2 hour nap after my workout. So I basically stopped working out. I just recently began doing a 20 minute walk. Most of the time I know I could do more, but I just don't want to. I am positive that if I had worked out more I would be further along - physically I didn't have the energy. I didn't just have liquids either. I fell in love with mashed potatoes!! In the beginning once a week I would treat myself to a medium McDonald's Strawberry Milk shake (460 calories). But I had to stop that also, I haven't had one in 4 weeks. Well wish me luck with the rest!
October 10, 2003