OJW telephone consultation memo
http://www.drted.com/Ojw telephone consultation memo.html
You have received this memo because you are interested in having OJW for the
control of compulsive eating. You probably have chosen this approach since
previous methods of weight control have proven to be inadequate for you, and
you do not wish to take drugs/medications nor have any invasive surgical
If this is truly the case you should be thoroughly familiar with:
How to proceed when you choose OJW.
The Informed Consent for OJW
is not a good candidate for this procedure (12 questions below
HOW and WHY OJW helps you lose weight is understandable
read my explanation in question 3.
You would be wise to let your dentist, your physician and psychologist/
psychiatrist know that you are about to undertake OJW. They may not be
supportive, but if they have a negative opinion on the procedure let them
give you the specifics of their objection. You can direct them to
drted.com if you feel it would be useful for them to know more about the
You should have your dentist examine you to inform you of the current health
status of your teeth, gums and jaw joints. It would be very useful for you
to send me the molds of your teeth to determine if there will be any
problems that would deter me from doing the OJW on the day of your
appointment. I will also need you to provide me with the name and telephone
number of your dentist. I will not call them unless I have your permission.
If possible you can arrange for me do an initial examination ($125) which
includes a panoramic x-ray when deemed necessary. This fee is included as
part of the fee for OJW if you proceed on. All fee arrangements will need to
be concluded with the office manager and treatment coordinator, prior to
the day of the procedure
It take about 40 minutes to do the OJW, i.e., place the brackets which
takes about 35 minutes and place the wiring. However, I want you to arrive
at the office an hour earlier settle in and be relaxed and comfortable.
Most often a Panoramic X-ray is taken. The neighborhood is pleasant and
there is a wonderful view of NY harbor a few steps from the office. You can
expect to leave the office before. Let us know in detail
about your travel itinerary, for example, your arriving and departing flight
times and the airport (Laguardia is the most convenient).
You should determine if speaking with your mouth closed in the
"OJW position" will be detrimental at your work (possibility of impaired
speech). For those OJW patients who would feel more comfortable having a
professional's letter to present to their employer you can see the one I
would be pleased to provide. See
The teeth that will receive the braces/orthodontic brackets are the upper
and lower, right and left, canines, first premolars and second premolars. I
will surely want to know beforehand if any of these teeth will present
difficulties in carrying out the OJW, (ex. missing teeth, crowns on teeth,
as well as the presence of any unusual biting conditions). Although special
precautions are taken to insure the brackets adhere to porcelain surfaces
(crowns), the brackets are more likely to detach from them than if they were
It would be best to bring someone along who will do the wiring for you at
home, but absent such person I will show you how you can do it yourself.
The regime calls for a liquid diet containing not more than 1000 fem; 1300
male, calories (not one calorie more than that). You will probably feel very
uncomfortable during the first week as your mind/body adjusts to the new
conditions of your OJW status. If you can get by the first week you will
have the wind in your sails. The less active you are the slower will you
attain your goal weight. Conclusion: Eat less, count calories! try
to exercise a bit more if possible. I suggest you read: Orthodontic
Jaw wiring: A.T.ís diary of her experiences during the first two months.
Should a bracket become detached off you can return to the office to have me
replace it, or you can enlist my help in finding an orthodontist where you
live who will reattach it for you. Having three brackets on each of the 4
quadrants of the mouth is optimal/desirable, however the wiring could be
accomplished even if you had only two brackets in each quadrant. I doubt if
you will find any other general dentist, orthodontist or oral surgeon who
will take on the responsibility of doing the rewiring.
You are required to follow the rule of "55" i.e., you remain wired for five
weeks then remove the wires for five days to exercise the jaws (talking,
chewing gum, and other exercises will be demonstrated at the time of the
From the moment your jaws are wired until you have finished I will remain on
call 24/7 to be of assistance to you. I will provide you with my email
address, office and home telephone number (if I have not already provided it
When you have reached your goal weight, or you decide that the OJW is ready
to be removed, you can return to the office to have me remove the
brackets/adhesive at no cost to you, or you can have your local orthodontist
You must never forget that if you ever drink alcohol to excess you will
become inebriated to the point of nausea and even passing out. Alcohol
suppresses your gag reflex, hence vomiting may occur. The OJW impedes the
easy expulsion of the vomitus. Some of the vomitus may then enter your
Vomitus in your airway can lead to sickness, injury and even death by
"suffocation/drowning." Always carry the wire cutters we will provide. You
can remove the wires in less than one minute when necessary. Err on the
cautious side ...carry the wire cutter with you. Other causes of nausea and
vomiting include food poisoning and sudden illnesses to mention only a few.
Remember that oral surgeons around the world routinely wire patient's jaws
closed for other reasons. There is no record of a single person's demise due
to this occurrence. On the other hand the death rate of surgery for obesity
If you have any questions call the office and speak to a staff member or
Thank you for choosing me to provide you with OJW. I look forward to meeting
you in person on the day your OJW is scheduled.
There are no
payment plans. The OJW few is due at the OJW appointment. The fee includes
all office visits, equipment and supplies and 24/7 contact with Dr.
Rothstein as well as removal of the OJW and teeth polishing
*OJW patients from out-of-state who can
not return to my office to have their OJW brackets removed will, alas,
need to locate a local orthodontist whose fee may range from $200-$350 to
remove the brackets and adhesive.
Please acknowledge receipt of this memo by forwarding it to:
For the Subject: use
"OJW memo acknowledged."
Cordially, Ted Rothstein, DDS, PhD
Specialist in Cosmetic Orthodontics (Invisalign, Clear and Lingual braces)
35 Remsen St.
Brooklyn, NY 11201 (10 minutes from the Brooklyn Bridge)
718 852 1551 Fax 718 852 1894