OJW telephone consultation memo
http://www.drted.com/Ojw telephone consultation memo.html 

Dear -------------:

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 procedures.

If this is truly the case you should be thoroughly familiar with:
1. 
How to proceed when you choose OJW.
2.
The Informed Consent for OJW
3.  Who is not a good candidate for this procedure (12 questions below question 4).
4. 
HOW and WHY OJW helps you lose weight is understandable if you 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 subject.

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 letter.


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 natural teeth.

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 OJW).

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 to you).

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 do it.

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 trachea/breathing airway.

 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 is 2-3/1000.

If you have any questions call the office and speak to a staff member or myself.

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: drted35@aol.com
For the Subject: use
"OJW memo acknowledged."

Revision 090612; 072513

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