1. 12 orthodontic
brackets of any kind: Dr. Rothstein uses TP Begg brackets Cat. No.
256576, cost about $15 for 12 of them. TP Company Tel. No.: 800 348
8856.
2. An adhesive system
to bond brackets either direct (Dr. Ted's preference) or light
cure.
One syringe of
direct bond adhesive $15.00 and one small bottle
primer catalyst $26 from Advance Orthodontics Tel. No.: 718 252
4295.
3. 2 - 10" pieces
of .014" (E-126) or .016" (E128) dead soft ligating wire:
One roll 25' from. (Rocky Mountain (Tel. No.303
534 8181)
Cost $2.65.
4. One 5" Mathieu
needle holder to twist ends of dead-soft ligature wire together.
Cost $20. Patient keeps until term of commitment to OJW.
5. One dead-soft
wire cutter to cut excess ends of wire used to wire jaws closed.
Cost 15-$25.
5. One
hardware-store quality small-nose wire cutter for patient
to cut wire when undoing jaw wiring. Cost $5.00..patient keeps.
The total start-up cost
of equipment and supplies to deliver patient-care in OJW:
Under $100.
The post-start-up cost
of equipment and supplies per patient to deliver OJW : $25.
Dr.'s Time to do OJW: 30 minutes.
Assistant's
time 45 minutes.
Fee for initial service:
$1400- $2685, then $85-$125 for gingivo-dental-TMJ evaluation
examination, prophylaxis and rewiring.
Dr.'s responsibility PRIOR to OJW visit:
a. To have reviewed
patient's signed Informed Consent and Medical and Dental history 10
minutes
c. To have contacted
patient's Physician and Dentist to coordinate treatment with them as
the OJW provider and patient deemed appropriate. 5-15 minutes.
d. To have received back
a signed copy of the document sent to the patient called "How
to Proceed When You Choose OJW" to assist in the control of
compulsive overeating, and the OJW
Telephone Memo.
e. Remind the patient that
they must provide you with a note from their physician saying: "The
patient is in good health and may choose to begin a weight loss
program that involves wiring the jaws together that entails a low
calorie liquid diet".
Dr.'s responsibility at the time of the Initial
OJW visit:
a. Review
the patient's Informed Consent
with the patient.
b. Review the OJW Telephone Memo with the patient and have him/her sign it.
c. Bond the brackets and place one side of the wiring allowing 1.0-1.5mm
of play in all the directions.
d. Have the patient snip off the wire.
e. Rewire both right and left sides,
allowing 1.0 -1.5mm of play in all the directions. See
wiring diagram.
f. Appoint patient to next visit in 5 weeks and advise them to
remove the wires for 5 days (for exercising jaws) prior to return to
office.
g. Remind them that for effective weight loss they will need to be on a
1350 (female) -, 1450 (male) - calorie liquid diet.
h. Remind them to carry a wire cutter at all times and to remove the
wires immediately at the least suspicion of illness or nausea.
i. Take a whole body photo of the patient and obtain their starting weight.
j. Document your service in detail in the patient's treatment
chart.
See a typical
initial chart entry.
k. Make sure have received the Physician's note...see note e. above.
l. Assistant will provide kit instruments and supplies especially when it
is certain that patient will be unable to return to be rewired by
you regularly*:
1. 5" Mathieu needle holder
2. 8 pieces of .014 dead soft
wire
3. A wire cutter
4. 3 spare brackets
* All orthodontists will rebond a bracket, but no orthodontist will
take on the responsibility of rewiring a patient. Therefore if the
OJW provider is certain the patient will not return for exam and
rewiring the provider must provide the patient with the know-how to
do it for themselves. See
wiring diagram.
Treatment coordinator's/assistant's time 45: minutes
a. To gather and layout
beforehand all the instruments needed for OJW.
b. Assistant will
demonstrate on models (before that patient sees the dental
professional and then again after) how to do the jaw wiring if a
dental professional cannot be found to provide the service. This
demonstration (tell, show, and do) is given to the person having the
OJW as well as the OJW patient's spouse or significant other.
c. To photograph the
patient and document the patient's weight.
d. To appoint the
patient to return in 5 weeks for oral and TMJ exam- prophylaxis and rewiring.
Administrator's job prior to OJW:
To assure that the
patient's file contains:
a. A properly
signed OJW Informed Consent.
b. Medical and
Dental history.
d. Scheduled the
OJW appointment.
e. To have
collected the "(non-refundable)
appointment reservation fee"
$350-$450
(deducted from total fee due for OJW procedure). The OJW
appointment is scheduled after this fee is paid (either by credit
card or money order). Collect the balance of fee upon arrival for the OJW
appointment. If the
patient cancels the appointment after paying the fee, the
reservation fee is applied to a rescheduled date. Reservation
fee has been returned in the past when a patient cancelled the day
after reserving appointment which was approximately one month prior
to OJW appointment.
f.
To call to confirm
patient's appointment 2-4 days in advance.
g. To provide the OJW
patient a letter to present to their employer explaining in a
non-embarrassing way that they are under treatment. (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 provide.
See the
letter.