Clinical Notes Alicia F., 27, 5'3'' 197 lbs:
March 6, 2001:
Examination of teeth, gums, all soft tissues, extent of
movement of jaws, and TMJ (Temporo-Mandibular joints) reveals that Alicia 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. Her bite mandated that the lower brackets be placed
closer to the gums than was desired in order to keep them out of harm's way from
the upper teeth. Alicia 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. Her husband observed
the placement and procedure of rebonding brackets 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 was 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. Alicia was
counseled to adhere to a 1400 calorie low/no salt liquid diet and to have
access to a handy guide to the caloric value of foods such as one of the
below.
A kit of materials including the
following was provided her.
1. Wire cutter.
2. Lengths of wire of .014, .016 and .018 deadsoft wire.
3. Bonding catalyst, adhesive, acid etch and application brushes.
4. A pliar to twist wire.
5. A roll of cotton rolls to suppress saliva.
6. 5 Begg Brackets.
7. A lip retractor.
8. A small bottle of Listerine
9. A business card and office and home telephone.
March 14, 2001:
Email from A.F. reports a bracket failed: "It was the 3rd bracket, lower, right side. It was loosened the day after you put it on. I went to dive into the swimming pool, and gasped for air, as one naturally would do. I felt what can best be discribed as a crack. When I looked at it, I saw the glue was lifting at the bottom. I decided to leave it alone until I had to mess with it. All was fine until yesterday when I found it laying in my mouth. It came off clean, and left no glue residue on my tooth.I think most of the problem in adhering the bracket stemmed from my over bite" Her husband Paul rewired her using only 5 brackets instead of 6. (OK with me) I sent her replacement brackets especially prepared with technical instructions on how to rebond the bracket.
March 25
Alicia reports having lost 22 pounds as of today. Her jaw joints are comfortable and her frame of mind is excellent. I Spoke at length with her husband Paul who agreed to write a review of the experience from the husband's point of view. Paul himself says that his wife is happy and as yet the "patient" has not been a problem for him. It seems that Alicia has gotten to be able to wire herself. I advised him to try and rebond the bracket that detached with special brackets I sent him.
April 4
In recent
communications Alicia reports that as of April 2 she weighed 180 pounds. She
indicates the she has
feelings of well being and is quite happy with her progress.
She sent this picture of her husband Paul and their
three daughters Breanna, Brittany and
Bridgett (The "ThreeBees"). Breanna the oldest is 10. Brittany is 8
and Bridget is 2.
The F's
April 5
Email sent to Mrs. F today:
Dear Mrs. F.
How do you feel today? Are your jaws and teeth comfortable? I am most interested in knowing how you are attending to the feelings that you get from the inside of your mouth. Are you using mouth washes liberally?
Do your tongue and teeth feel like they are coated over with
little furry jackets as A.T. described in her letter. Would you please devote some words to that problem on your website. I would imagine that scrupulous cleaning goes a long way to feeling fresh and keeping
"buzzard" or "fish tank" breath from overtaking you. I would like you to know that your first release in coming up this week. Remember,
fail not to do your jaw exercises. They are
mandatory not suggested. I advise you to buy at the
Walgreen or KayMart, in the dental department, a battery-driven tooth cleaning machine (the kind that drives a rubber cup) and in lieu of going to the dentist for a professional cleaning you "do-it-yourself," that is, a good teeth cleaning 5-6 times before
your husband rewires you. I would counsel you to replace the detached brackets before rewiring. Professionally, Dr. Ted PS. I note with great pleasure and pride your outstanding website and your progress in treatment, and I offer my sincerest congratulations and hopes for continued success. I have come to believe from the optimism in your sprightly notes that you will be successful in achieving your weight goal of
115 pounds.
April 13
Email: Dear Alicia:
In view of the perfect timing of holiday and jaw wiring release. time I am advising you to release your wires and follow the exercising instructions as per explained in the jaw exercises.. Happy Holidays, Cordially, Dr. Ted CC: your chart.
Exercising instructions:
http://www.drted.com/index.html/Jaw wiring exercises.htm
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