May 17, 2001

E.A. 29, 5'6,'' 200, "Incessant Snacker", Albany, NY.  Goal weight 150 pounds. Willing to devote 6 months to the regimen with discipline. Expected weight loss 45 pounds.

AE arrived with cousin. Examination of teeth, gums, all soft tissues, extent of movement of jaws, and TMJ (Temporo-Mandibular joints) reveals that J. is in good health. Her medical dental history is unremarkable and the informed consent for jaw wiring has been signed and dated. No radiographs were warranted. Begg brackets were placed on upper teeth 4,5,6 and 11, 12, 13 and lower teeth 29,28,27 and 22,21, and 20.   Additional care was taken to insure that her upper teeth did not contacts the lower brackets lest lower brackets become detached. J. was asked to put her teeth gently together and the wiring was done with "deadsoft" .016 inch diameter stainless steel round wire. Prior to wiring she was given a prophylaxis. J. and her cousin carefully observed the placement and procedure of bonding brackets and wiring and rewiring the jaws in the event that  a dentist/orthodontist is not available to do the work. She said her jaws were very comfortable and that the jaw wires permitted her a slight bit of jaw movement. She and her cousin were given instructions and practice regarding how and  when to remove the wire. She was given instructions on how to exercise her jaws  during the 3-5 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).  Ps. AE was counseled to adhere to a 1300 calorie  low/no salt liquid diet and to have access to  a handy guide to the caloric value of foods. She was provided a kit of instruments and supplies and shown how and when to use them.   She was shown how to remove the wire with the wire cutter provided. She was asked to keep a log and email it every few weeks.   A telephone call to A found her happy and optimistic regarding this undertaking and she was hopeful and confident about reaching her goal.  One interesting thing she related to me is that in the afternoon she had taken a nap later in the afternoon the same day she was wired. Upon awaking from the nap (and not instantly remembering her jaw had been wired much earlier that day) she was momentarily frightened to find that she could not open her mouth.