Orthodontic Jaw Wiring
The Dental Professions Role in the Control of Compulsive Overeating
This MS power point presentation is an abridged version of the original. The complete presentation (72 slides) is available gratis on the CD prepared for the GNYDM and the American Association of Orthodontists. 8 min. 30 sec. to view
The Dental Professions Role in the Control of Compulsive Overeating:
Orthodontic Jaw Wiring(a kinder gentler way)
Presented at The Greater NY Dental Meeting November 29, 2004 and to the American Association of Orthodontists May 22, 2005
Ted Rothstein DDS, PhD Member of the AAO1973 - PresentFounder DPOJW Dentist Providers of Orthodontic Jaw Wiring Specialist in Orthodontics for Adults and Children 35 Remsen, Brooklyn NY 11201 718 852 1551 Fax 718 852 1894 Web site: www.drted.com Email: firstname.lastname@example.org
Meet Dr. Ted
Dr. Ted and grandsons Caleb and Joshua
Review Dr. Rothsteins CV
Orthodontic Jaw Wiring
JOIN THE DPOJW (Dentist Providers of Orthodontic Jaw Wiring)
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NY State: Article 133 6601. Definition of practice of dentistry.
The practice of the profession of dentistry is defined as diagnosing, treating, operating, or prescribing for any disease, pain, injury, deformity, or physical condition of the oral and maxillofacial area related to restoring and maintaining dental health. The practice of dentistry includes the prescribing and fabrication of dental prostheses and appliances. The practice of dentistry may include performing physical evaluations in conjunction with the provision of dental treatment.
Interpretation of NY State Article 133, 6601 as it relates to the practice of dentistry, and to the dentist who chooses to provide OJW to patients who meet the selection criteria.
Following is a direct quote provided by Dr. Milton Lawney, the Executive Secretary of the NY State Board of Dentistry, given to Dr. Rothstein on Thursday, October 14, 2004 in answer to the question:
Is Orthodontic Jaw Wiringa service within the scope of dentistry?
Dr. Milton Lawney, the Executive Secretary of the State Board of Dentistry responds:
"If the condition is properly diagnosed and a lawful treatment plan is prescribed by a professional authorized to do so, the fitting and attaching of appliances could very well have dental health implications and a dentist may be involved in those services. It is not within the scope of dentistry to diagnose and treat independently the condition of obesity. Dental appliances aimed at weight loss may be prescribed if the condition is diagnosed by the proper authority. -- Interpretation of Article 133 6601 Dr. ML.
CONSIDER:OVERWEIGHT / OBESITY IS EPIDEMIC IN THE UNITED STATES.
Normal life expectancy: males 73 and females 80
But the life expectancy for chronically overweight/obese is: males 68 and females 75
Overweight / Obesity is defined by the Body Mass Index (BMI)
BMI 25.00-25.99= OverweightBMI30.00 = Obese
CALCULATE YOUR BMI NOW:http://nhlbisupport.com/bmi/bmicalc.htm
The Progress of Man: Born 2000 - Died 2065. He ate himself into the grave.
OJW provided by dental professionals in cooperation with the patient's physician offers hope of increased life expectancy to some compulsive overeaters.
DENTAL PROFESSIONALS ARE UNIQUELY EMPOWERED TO PROVIDE OJW TO PROPERLY SELECTED CANDIDATES.
IT IS NOT SURPRISING THAT THE OVERWEIGHT ON THEIR WAY TO OBESITY WOULD CHOOSE OJW WERE IT MORE WIDELY AVAILABLE.
General Conclusions of the Literature Review
1/5. Jaw wiring is generally accepted by the medical community as a therapeutically effective method to lose weight.
2/5. The only study of jaw wiring on teeth, gums and jaw joints per se shows that this procedure has no permanent harmful effects.
3/5. Behavior modification that results in maintenance of weight lost is extremely important.
4/5. There are no studies specifically aimed at the harmful effects on the Temporo-mandibular joint of a long-term "immobilization-rest/exercise TMJ-immobilization" protocol as utilized by Dr. Rothstein.
5/5 Research on jaw wiring has been sadly neglected by dentists and Orthodontists for lack of a protocol and an Informed Consent leading to serious concern about medico-dental and liability issues. I suggest it is time to catch up on that research.
Dentists and orthodontists are uniquely capable to provide a service that no other professional can deliver as safely, efficiently and competently.
What is Compulsive Overeating?
COMPULSIVE OVEREATING: REFERS TO A MULTI-FACTORIAL "EATING DISORDER" characterized by the unintentional, excessive anduncontrolled ingestion of food at mealtime and between meals which results in the patient experiencing depression, spiraling overweight and loss of self-esteem frequently accompanied by systemic problems such as high blood pressure, diabetes, cardiac disease and various pathologiesof the knee and hips. Indeed the mortality rate for such people is considerably higher than those whose weight is closer to normal for their height and skeletal type.
Is jaw wiring for weight control something new?
Not at all. Oral surgeons have been doing it since it was first noticed that when they wired their patients closed to facilitate healing in trauma or pathology cases and placed the patients on a liquid diet the patients lost weight.
So what is new about jaw wiring for controlling weight?
1. The jaws are wired together via orthodontic brackets bonded to the premolars and canines. 2. Until now the delivery of jaw wiring had no protocol and no informed consent. 3. Until now no one had addressed the problem of how to choose patients (who to exclude as a candidate). 4. Until now no one had addressed the issue of possible TMJ stiffening over time.
Following are some comments from people who had OJW
G.S.-- First, I want to say how very important it is that Dr. Ted provide this service. For some people it is the only way to lose weight and conquer uncontrollable eating habits. Detractors really need to gain a little more insight into the problem of compulsive eating before being judgmental. I feel thatthe considerable and growing problem of obesity and overweight in this country will not be solved until food addiction is recognized as a valid condition the same as alcoholism, smoking and gambling.Any amount of help is available for addicts with those problems and one wouldn't dream of telling an alcoholic to just stop drinking without any help, it is almost impossible so why then is itexpected that people with eating problems are told to just stop overeating? After all, doesn't obesity cause myriad health problems also?
J.G. -- I needed to do something also as my health was going down hill. I do not enter into things lightly. I researched all of my options for quite some time. I did not want to gamble with my life and to me bariatric surgery is a BIG, BIG gamble. (The death rate is 3/1000). Those odds are very high and besides they cut you open like a tuna. And later: I am down 31lbs. and cant tell you enough how excited I am about this program. Now this procedure is not without its ups and downs, but it works! I am almost half way to my goal.
OJW in a Nutshell
Brackets are bonded.
Jaws are methodically wired to allow 1.5 mm of mandibular movement in all excursions.
1 minute to place wiring
Note error in placing the wire according to the figure 8 wiring pattern.
Why do you lose weight when your jaws are wired together?
7/7. You see yourself losing weight, maybe for the first time, and it gives you pleasure. You see yourself as being in control, maybe for the first time, and it gives you more pleasure and a sense of success. You recognize you can modify your behavior and you begin to take small steps to do so on a more permanent basis. Your aspirations to regain self-control are renewed.
CONSIDER:DENTAL PROFESSIONALS ARE UNIQUELY EMPOWERED TO PROVIDE OJW TO PROPERLY SELECTED CANDIDATES.
RATIONALE FOR MEMBERS OF THE PROFESSION TO PROVIDE OJW: OJW for weight loss is a treatment modality for a serious "social, psychological and physiological" problem that can help some people to get a start on treating a problem with potentially grave consequences. Obesity is legion and epidemic and recognized as a precursor to a host of serious illnesses. I am exploring the orthodontic approach to help alleviate this epidemic in those cases where it may be applicable. I think orthodontists,or for that matter, any member of the dental profession,can deliver this service with compassion and intelligence. My experience to date is that it is safe, and reasonably effective when performed with proper protocols that are presented herein.
10 REASONS TO PROVIDE OJW TO THE OVERWEIGHT / OBESE
1.You are a dentistwho believes the "risk / benefit" ratio of OJW would be inside your "comfort zone.
2. You strongly believe dentists are guardians of the mouth and the TM joint and are well positioned in helping the overweight.