Craig Jacobson is Vice President of Sales and Marketing of Ortho Kinetics Corporation.

Stephanie Jacobson is 10 years old and a student at Flora Vista Elementary School in 5th grade.

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Craig's initial comments: "My eldest daughter is Stephanie. We have been following here situation closely for a few years and along with her orthodontist, Dr. Will Andrews, have decided that it is time to begin her orthodontic treatment. Here is the beginning of the our orthodontic journey."

My wife and I selected Will to conduct the orthodontic treatment of our children even though his office is a 45 minute to 1 hour drive in each direction. My prior work experience was with "A"-Company orthodontics (a Johnson & Johnson company). As Product (Marketing) Director for orthodontic appliances, I had the opportunity visit thousands of orthodontic offices worldwide. As you have heard, people who work in field have great difficulty choosing their service providers in that field. Just too much knowledge and too many prejudices and loyalties.

Anyway, I have found most orthodontists very dedicated to patients welfare and they are as a group extremely concientious. It didn't make things any easier that I am friendly with several excellent orthodontists. 99.5% of orthodontists are just fantastic dedicated professionals. Most would do a great job treating my child.

As a person who has worked in the product development and sales and marketing end of the orthodontic product field since 1984, this was a big decision. My wife and I talked it over and we chose Dr. Will Andrews of San Diego. His very conservative approach fits well with us.

Dr. Will Andrew's initial assessment of Stephanie's records (Ceph X-ray and articulator mounting) showed several options were available. The preferred approach for best facial harmony for Stephanie was mandibular advancement surgery at age 15-17 followed by orthodontic treatment. However, another option existed which was headgear for 1-2 years and an acceptable (but not quite as good result would be achieved). HOWEVER, the decision needed to be made now. If we chose surgery, it was a matter of waiting 2-4 years to begin treament. If we chose the headgear treatment option, treament needed to start immediately.

My wife and I discussed the pros and cons of oral surgery on a minor child for cosmetic improvement. Our gut feeling was that undergoing general anesthetic and surgery was going to be quite traumatic on Stephanie. However, if it was the best approach, we'd be glad to follow the plan.

Dutifully, my wife (Jane), Stephanie and I went to visit the Oral Surgeon. He examined Stephanie's records carefully and announced that her surgery would be quite routine. Just two cuts on the mandible (lower jaw) and Fixation with 4 screws into the jaw. It would be outpatient surgery and she'd be sore for about a week. This would be planned now and conducted in 5-7 years hence.

I looked over at Stephanie who was white with terror. She was shaking her head vigoursly as if to say "NO WAY...NO WAY". My wife the calming influence was quite helpful. She told Stephanie it was the parents final decision to make but we'd like her input.

My wife looked at other surgical patients before and after records and photos and was quite impressed with how a small mandibular advancement changed people's profiles so much. Stephanie, Jane and I discussed the surgery option over lunch. Jane and I were on the fence but Stephanie was adamant about not having to undego surgery.

I went back to Dr Andrews to discuss Stephaine's diagnosis and treatment plan. He graciously went through the chain of logic on each option. I went back to discuss with my wife.

We decided against Surgery. My issue was that I didn't want to force (mandate) my child to undergo elective surgery with the small but real risks in the future. If the surgery was life threatening...OK we'd have our child under the knife. From my prior experience making surgical trays I had visited too many hospitals and heard too many horror stories about what odd unusual things can go wrong.

I brought Stephanie to Dr Andrew's office on Thursday January 4, 2001. He placed just one separating elastic to make space between her bicuspid tooth and molar tooth for a band which would be placed in the next appointment. Dr Andrews told Stephanie that she may have some discomfort. And that it would pass in a day or two. Just take a few Motrin (ibuprofen) to help the pain.

By dinner that night Stephanie's mouth was sore. We gave her Motrin. Within a few days the pain was just discomfort.

On Thurday January 11th, we went back to Dr Andrews office. Stephanie was fitted with molar bands and buccal tubes on the upper first year molars. Dr Andrews also fitted Stephanie with high pull headgear and a Nitom facebow.

OKC Product Commerial: My reason for selecting these of my products for my child are: The normal facebows don't lock into the patients mouth: Nitom does. I wanted it for safety. I hear an orthodontist who uses Nitom discuss an advantage with us at our AAO tradshow booth last year. He says he has patients just wear the facebow without any headgear for the first month to get used to the appliance. I thought this may be a good idea for my daughter...Will Andrews agreed.

Affirm and Niforce for a constant 500grams of force when worn.

The headgear strap is Stephanie's choice. I just want her to have one that fits properly and is comfortable. I'm sure we'll give her several of these to try.

I gave Stephanie an Open Spaces pillow to make sleeping with a headgear more comfortable. Open Spaces Pillow is a product which is best for side and face down sleepers. Stephanie sleeps on her side 1/3 of the time and on her back 2/3 of the time. She wouldn't be an ideal candidate but she's my daughter and I want her to be as comfortable as possible.

Due to Nitom's unique locking design, we planned to have Stephanie wear Nitom facebow alone without the force modules of high pull strap for a week or so and then add the High Pull strap later. This will ease her adjustment.

Stephanie was very happy with the headgear and put it on many times practicing how to put the facebow into the buccal tubes to show her Mom and just for kicks. By dinner time of the first day, her teeth were sore and she wasn't giddy. By bedtime the first night, she was in tears and convinced that this was all some horrible mistake. She only needed to wear the Nitom locking facebow. I explained the situation about how she needed to wear her headgear every night for 10 hours and all would work out well. I crossed my fingers hoping for the best. 0 hours of wear

The second night, Stephanie was apprehensive but put in her Nitom locking facebow by herself without any parental nagging (whew what a relief). She took Motrin 30 minutes before putting in the facebow. Her mouth was sore from the buccal tubes rubbing her cheek. 9 hours of wear

By the third night, the Nitom needed a little adjustment. I think she leaned on it and deformed one latch but I rebent the latch and all is well. More Motrin. She actually smiled when getting her headgear in. She made a point to tell me she was not at all happy with having to wear headgear but would do her best. 10 hours of wear.

So far so good. She doesn't like this headgear thing a bit but understands the choices. I hope she is a good headgear wearer.

Stephanie has been wearing her headgear every night for 10 hours or more. I have been trying different Ortho Kinetics’s high pull headgear on her. So far she started with Affirm and NiForce and blue cotton high pull strap first. Stephanie liked this headgear.

I switched her to our very popular OKC High Pull strap. She didn’t like that strap very much. It rubbed the front of her ear and made a blister.

Stephanie's favorite: NewGear High Pull extra cushion

                        Stephanie wearing her favorite headgear.

                        Side view:NewGear High Pull extra cushion style

  NewGear High Pull Xtra cushion front view  and side view

(Just like Stephanie's but on glass head)

Since NewGear High Pull was Ortho Kinetics’ first product (seven years ago) and we have invented 4 other high pull headgear since then, I expected to hear that this was not the best or most comfortable one. I am quite surprised to learn from her that this is her favorite. She loves the comfort. She likes the ease of putting it on and likes the color (Purple her favorite color).

I also made Stephanie a headgear compliance calendar. She just colors in blocks to reflect each night’s headgear wear. I have posted this calendar on our website for orthodontists and parents to download and print out for their use.  Link here

Stephanie is now wearing her headgear each night without parental involvement or nagging and seems quite happy… The roughest part of initial adjustment is now behind us. No more Motrin pain reliever.

More as this saga continues...