Jaw wiring training for the “do-it-yourselfer”

 Jaw wiring 101.

Drive three tacks (the kind of tacks with plastic heads that wont allow the wire to slip up/off) into a board in a straight line 1/4'' apart like the Q, W and E keys on your keyboard so that they are about 1/8" above the surface of the board. Then drive in three more tacks like the A, S and D keys and in the same way as they relate to the Q, W and E keys, that is, staggered one half key more forward.

The tacks represent the brackets around which the wire is weaved, and the relationship of the position of the two rows of tacks represents the three upper teeth QWE and the three lower teeth as the diagram shows.  Now get a piece of thin or flexible wire about 8 inches long and begin wrapping it around the Q under the A and over the W and under the D AT THE SAME TIME AS you are wrapping the top half of the wire over the Q then under the S and over the E. The two ends will meet near the upper left corner of the V on the keyboard. Twist the two ends of the wire into a "pig tail" with about 8 twists. Cut off the excess wire beyond the pigtail and tuck the pigtail neatly back toward the D, voila teeth are wired. 

The problem is that the weaving of .016 dead-soft wire is more difficult because it is stiffer. In a real mouth it is also wet and dark therefore a "lip retractor" can be held by the patient so that the cheek is pulled out. I can supply you with a lip retractor, but a less glamorous tool is a soupspoon. Someone else can hold a flashlight on the teeth being wired.  One other problem is how tight the jaws should be held together while the wiring is taking place. The teeth should be touching gently and the end result of the wiring is feeling of balance on the right and left sides of the jaw. The lower jaw should have the ability to move about 1/32" to the right or left...perhaps a bit more or less.

The patient will tell you if the wiring is too tight or too loose.  Carefully study the position of the brackets that I bond on. If one breaks scrape off the leftover adhesive and use the materials I gave you to rebond the bracket. Let me know when you have weaving the wire down to an art. The brackets do not come off easily, but in hands that are unaccustomed breakage may occur...it's the risk you take. It is more likely that when the wires are removed the patient indulges in foods that are crispy, crunch or crusty. THESE FOODS ARE YOUR ENEMIES. You have in your kit .014 and .016 wire. Practice with .014 but wire with .016.

Jaw wiring 201.

Buy some nails with head no larger than this O (font is 12) and nail them into a board 1 3/4" x 1 3/4"   as a described previously"  Better yet, do it exactly as I have typed in the O's below. Hopefully the way you see them is similar to the way they look to me.

                                     O  O  O
                                              
O  O  O     that is: 3 capitals "O''s with 2 spaces between each then another layer of  O's about 1/4 inch just below and staggered forward.   Now the nails** that you are going to use must have heads that are no bigger than between 1/16th and 1/8th inch. 

Finally, they must be hammered into the board so that the space between the head of the nail and the board is no larger than Capital I bold (I) that is, the size of the slot into which the wire will be threaded  (approx. .020 inch opening. (Send me your address and I'll send you some .016 dead soft wire, but I bet you can get something close to it at the hardware store.)

The note says: "Side view of a hand-held training device to learn how to wire jaws closed. the heads of the nails represent the brackets. The nail heads are 3/32' in diameter." Dr. Ted using his shiny  wire twisting instrument to tighten the wire as though it were being done in the mouth. The office manager,  demonstrates how to hold the JW  extra-oral simulator. Here I am using a .018 dead-soft stainless steel wire. The note says: "Front view of the same device". If you look carefully you can see the heads of the nails have been driven in to allow a space the thickness of less then 1/16th of an inch.

Now hold your 1 3/4" x 1 3/4" creation with nails in front of you so that the nails are facing to your right side. You have now created the right side of the mouth with tooth ur3, ur4 and ur5  positioned above   lr3, lr4 and lr5   (ur = upper right and lr = lower right).  Now sit in a chair and hold the “simulate” with right hand (thumb and index finger) against your cheek, better yet on a chair laying back 45 degrees with your helpmate choosing the most comfortable side that is best to beginning wiring your jaws closed. Now let helpmate practice doing his/her wiring.

 
Here is a template showing the exact size of the template shown above and the position of the nails that simulate the brackets as well as  size of the nails to use. This template will produce a Jaw wiring simulate of the teeth on the right side of the mouth. Simply hammer the nails almost all the way in to a piece of wood 3/4" thick and begin practice wiring.  

In jaw wiring 301 you can make an intra-oral simulate such that your helpmate can really get the "hang" of doing the wiring with the simulate in your mouth.  Use a spoon to hold your cheek out and away from your teeth.  I am sure Jaw wiring 301, when completed, will provide you (with practice and mastery) not only all the technique you need, but will provide you and your other significant an abundance of laughter. I can send you a bracket, wire and a dental "lip retractor".  I would suggest your helpmate really feel comfortable with the wiring simulate before allowing them to enter your mouth.. Hint: begin first jaw wiring exercises with thread or very thin easy- to-weave substances (like .014 dead-soft wire) before graduating to .016 wire.

 Jaw wiring 301.

Since the lower teeth in a real mouth are "inset" more toward the tongue (about 1/8 inch) than the upper teeth, cut the 1 3/4" x 1 3/4" board you hammered the nails into in half the long way and reglue the two halves together so that the upper teeth half block of wood juts "outward" over the lower half a little bit less than 1/8 inch (Do look in your own mouth to see what I mean, or simply run your finger downward across your upper and then lower teeth).  I can easily send you 6 brackets to create the best possible intra-oral simulate.  You will need to glue (epoxy best) the brackets onto a 1/16 thick piece of Plexiglass about 1 1/8 inches wide and 1 inch high. 

The note says: "Side view of a training device to learn how to wire the jaws closed." The dark round images are brackets that have been bonded on to the plexi-glass. Dr. Ted holding the intra-oral training device between his teeth The note says: "Front view of the same device showing the "wing" used to bite on that holds the device in position while the rewiring person is practicing."
Dr. Ted  holding  the JW intraoral simulator between his teeth. .  .   ll.

 

while the office manager, practices "wiring"  Dr. Ted.  It took her no faster than you can say "Jimminy Cricket." to have me wired and she's never done it before.

  Then glue on to the non-bracket side a perpendicular tab (strong and thin as possible) about 1 inch wide and .5 inches deep.  You will then be able to hold the simulate between your teeth while your helpmate practices wiring the upper to the lower brackets. 

** "Escutchion Pins #18 x 3/4, brass plated, From House Mate Hardware .97 cents, 50/box (Home Depot)

Dr. Ted

April 4, 2001

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