Orthodontic Jaw Wiring OJW for Dental Professionals Documentary

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Orthodontic Jaw Wiring OJW^TM Documentary for Dental Professionals by Dr. Ted Rothstein a 28 minute video airing June 7 2011, Video producers can appreciate how much pre-production is required. Here you can see the final script and design for the actual film which you can see on YouTube.com. The videographer and editor of the film is: Vimeo: Jack Pearley and YouTube: Jack Pearley. I counted the number of emails that passed between us from 12/7/10 thru 4/21/11--250 to be EXACT. You will rarely find a professional with as much expertise as Jack; the Documentary speaks for itself. If you compare the script to the film you can tell that there were some major differences between the plan for the film and actual footage. One major problem that occurred was that the patient who graciously permitted us to film her OJW experience, quite unexpectedly requested that I remove it shortly before she returned home to Georgia with her mother who decidedly her best interests at heart. This created a problem of significant proportions. Her mother, a registered nurse and psychologist, gave me permission to simply omit mentioning it in the film. However, following much agonizing regarding my professional responsibility to report the facts rather than spinning reality I came to my senses. I had no choice other than to reveal what had actually happened. I rationalized it as follows: In reality, the outcome of our patient's treatment is not always a "successful" outcome. Indeed, the medicine/treatment sometimes fails to remedy the patient's "illness" for a variety of reasons. That fact does not diminish the medicine or the treatment method itself. Jack and I talked about how to depict it in the film. I thought Jack handled the problem with integrity sparing us both a moral and ethical dilemma. See for yourself. April 23, 2011

1 view/stills from the promenade of lower Manhattan NY harbor, Liberty Lady and the Brooklyn Bridge

3. Shot of framed and mounted display poster 3'x2' (tryptich) giving dates of subject presentation and venues (see below

4. Professionally finished display poster 8' 11" in reception room to promote interest

5. ***Under 10 minute Digital video showing Dawna Darling rewiring herself at home

Appropriate background instrumental music to be selected and placed where indicated (light Jazz?)

CREDIT
A film by Ted Rothstein, DDS PhD
American Association of Orthodontists
Specialist in Orthodontics and Dentofacial Orthopedics
Specialist in Orthodontic Jaw Wiring (OJW) for weight control
With Brook Swan

CREDIT
Terence Dudley
INTRODUCTORY PROLOGUE SCROLLS
Obesity is legion and epidemic. OJW for weight loss is a behavior modification modality for this serious, social, psychological and physiological problem, that can help carefully selected, overweight or obese persons, to begin regaining a measure of control over their excessive eating habits with their potentially grave consequences. Dental professionals as part of, and in cooperation with, their healthcare medical counterparts are uniquely suited to provide this service, which in my experience and research has proven to be safe and effective under the protocol presented herein.

The objective of this documentary is to demonstrate the essential steps that dental professionals should follow when providing the OJW service.

DrTed now addresses Dr. Swan: Doctor you are a psychologist and have no doubt treated patients who eat compulsively. What misgivings did you have for Brooke when she told you she had chosen OJW?

Brooke is not obese judging by her BMI of 28. Do you think her goal of reaching 125 pounds is realistic or excessive for her?

Being supportive at home is very important. As a psychologist by training does that prepare you better support this undertaking

Bonding brackets to teeth beginning patient's: upper rt, 3 lower rt.3; upper left 3; lower left 3

Mom invited into Treatment room (as though to see a new-borne)-- Brooke speaks

Brian takes photo of Dr. Ted, Brooke and Dr, Swan together in front of rainbow.

Dr. Ted gives Brooke reminders and precautions: reads off three most important

Camera establishes that we are in Brooklyn NY at the office of Dr.Ted Rothstein, 35 Remsen St., Brooklyn, NY

DrTed in suit is sitting at red table in reception room with Greater NY Dental Meeting triptych (see below) behind him on brick wall. He introduces the historical importance of the subject camera zooms for a moment to the triptych.

AUDIO-VIDEO CLIP The ADA has for the first time in history recognized in the Nov. 2010 issue of the JADA that dental professionals have expertise that empowers them to be part of the Healthcare team providing services to the overweight and obese, who presently number more than 80 million in the Us Orthodontic Jaw Wiring is a service I have been providing to patients since 1998.to assist them to control compulsive overeating and lose weight we thank Brooke Swan who comes from the Brunswick GA (the peach state) for agreeing to participate in this film which shows how OJW is done Now meet Brooke and her mom who is a psychologist

Brooke and mom enter the reception and DrTed gets up to greet and seat them.

DrTed addressing them: Brooke I'm happy to meet you at last. Dr, Swan it's a pleasure to meet you as well. Please take a moment to relax and leaves (to put on his clinic jacket)

Drted enters reception room now wearing clinical gown and sits down to join them.

Dr. Ted What led up to you choosing OJW? You noted on your medical dental form that you are taking Adipex, a weight loss medication. Has it helped.? What would tell others about using weight loss medications?

Dr. Ted: referring to the Informed Consent asks: When you completed the informed consent did it frighten you?

Dr. Ted continues: "you know Brooke after the informed consent the most important document you provided me with is the release from your physician to begin a long-term low-calorie liquid diet. (Dr. Ted hands Brook the release to see

I asked you for this release from your physician because it assures me you that you will not be harmed by beginning a long-term low-calorie diet

DrTed picks up models showing OJW: OJW consists of the bracket attached to the teeth and the wiring to prevent you from eating solid food. The OJW protocol requires that you remove the wiring every 5 weeks for 5 days to allow your jaw joints to resume normal movement: if you can put 3 fingers in your mouth like this (demo) you may rewire yourself as I am going to show you later . I am going to give you the instruments you need to remove the wires and to replace them SHOWS A WIRE CUTTER AND A WIRE TWISTER. PLEASE CARRY THE WIRE CUTTER WITH YOU ALL THE TIME.

Success with OJW is dependent on your passionate dedication and discipline. The first few days are the hardest. You will be pleasantly surprised see how clear your speech will be.

1 COLLEAGUES MY EXPERIENCE WITH OJW IS THAT IT IS A SAFE AND EFFECTIVE METHOD FOR CONTROLLING WEIGHT.

2 SELECTIVELY CHOOSING PATIENTS ON OBJECTIVE BELIEF THEY ARE LIKELY TO SUCCEED IS PRIME.

3 THE INF-CON, AND MED-DENT FORMS AND YOUR PROFESSIONAL ACUMEN WILL ASSSIST YOU IN PATIENT SELECTION.

4 MOREOVER, I HAVE PROVIDED GUIDELINES TO HELP U RECOGNIZE PATIENTS WHO R NOT GOOD CANDIDATES.

5 FINALLY, IT IS IMPORTANT TO ADVISE WOULD-BE NEW PATIENTS THAT THE FIRST 3 DAYS ARE THE MOST DIFFICULT TO TOLERATE AND THAT UPON INFREQUENT OCCASION PATIENTS HAVE ELECTED TO HAVE THE OJW REMOVED PREMATURELY.

Brooke: Ready as rain or On your mark get set go or ready when you are drted or ? .......................................

Dr. Ted: Ok Brooke please follow Brian he s going to make an x-ray and take some photos of the you as you are now. When we meet again in the treatment room I'm going to do an oral examination.

Brooks goes off with Brain to take an X-ray and photographs Camera follows to watch a bit.

DrTed now addresses Dr. Swan: Doctor you are a psychologist and have no doubt treated patients who eat compulsively. What misgivings did you have for Brooke when she told you she had chosen OJW?

Brooke is not obese judging by her BMI of 28. Do you think her goal of reaching 125 pounds is realistic or excessive for her?

Being supportive at home is very important. As a psychologist by training does that prepare you better support this undertaking

Brain brings X-ray and Brook into Treatment room and goes out to Reception room to get Dr. Ted

Brooke is seen sitting in dental chair with Dr. Ted sitting on her left side. Dr. Ted is holding X-ray up to ceiling light to read it.

Dr.Ted: Commenting on X-ray. Well Brooke your teeth and jaw bones look quite healthy.

DrTed; Upon completion of exam says your teeth and gums look normal. Can we begin putting the brackets on IF YOU NEED ME STOP AT ANY TIME JUST RAISE THIS FINGER (DRTED LIFTS HER FINGER) AND I WILL STOP WHATEVER I AM DOING.

All the brackets and adhesive and instruments and wires arranged on the clinic work table.

DrTed: I going to prepare the surface of you teeth so that the brackets will adhere very tightly.

Drted and assistant Brian work together to air spray the teeth with cleaning dust and then paint with another cleaner chemical for a minute more. Brooke rinses and DrTed dries teeth and Brian begins placing adhesive on brackets and hands them to DrTed who places them on the three upper right teeth. Brian shines an intense blue light on the brackets for 10 seconds which causes the adhesive to set. Procedure is repeated for lower right teeth then upper left teeth then lower left teeth. (elapsed time 25- 30 minutes)

Camera will film attaching only the upper right three brackets and the lower left three brackets

Camera films DrTed doing the wiring on the OJW simulator device (1-2-3-6; 1-4-5-6 twist, cut and tuck) (See device below)

THE OJW POSITION OF PHYSIOLOGIC REST is a parted resting position of the mandible at which the muscles of mastication are in a minimally contracted position thereby allowing the lower jaw to be suspended from the maxillary teeth in a condition of "weightlessness". Inter-occlusal wiring permits the mandible to move 2.0 mm - 4.0 mm laterally, vertically and antero-posteriorly thereby minimally impeding speech and minimizing the possibility of TMJ stiffening. This position is often congruent with an observable inter-occlusal space of 2.0 mm - 4.0 mm and closely approximates the position we know as the "physiologic jaw resting" position, the initial position from which all jaw excursions begin. It is this condition of jaw "weightlessness" that precludes the possibility that the upper/lower teeth are extruded during the time the OJW device is in place.

DrTed shows how Brooke how wire is removed with a single nip using the take-home wire cutter.

DrTed then wires left side and asks Brooke "does the left side feel about the same as the right side?

DrTed: Great Brooke now Brooke I want test your speech: please count from 1- 6 and then do the alphabet A-G

DrTed: Brooke here are the Reminders and Precautions note to take with you. (See Below):

These are especially important: Remove the wire every 5 weeks for 5 days, always carry your wire cutter. And adhere to 1000/day liquid diet. You have my home phone call me whenever you want.

DrTed: I'm glad you are going to be here until the 20^th. Let me know immediately if a bracket detaches.

Have a wonderful vacation. Thank you for choosing me to do your OJW and being a great patient &have a great day.

AUDIO-VIDEO CLIP:My experience providing OJW demonstrates that OJW is safe and effective when performed as I have presented My experience and RESEARCH have proven that the overweight and obese would welcome dental professionals as part of the healthcare team to help them regain control of their sometimes compulsive eating habits, which often lead to other serious health consequences Keep in mind doctors that In OJW you are responsible for maintaining the health of teeth, gums and jaw joints, while losing weight with the assistance of the OJW appliance is the patient's responsibility finally, Even in cases where the patients regain weight, they will not hold you responsible

EPILOGUE SCROLLING TEXT
“ Brooke was unable tolerate the OJW and after three days requested it be removed. She had already removed the wiring with her nippers. The brackets were removed and the surfaces of the teeth were cleaned in accordance with the mandates of the Informed Consent."