8.5.24 - *PODCAST EXCLUSIVE*

8.5.24

Quick Review #196 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #bellspalsy #facialpalsy #facialparalysis

Bell’s palsy is an acute peripheral facial neuropathy that results in the sudden onset of facial paralysis or weakness. This condition affects the seventh cranial nerve (facial nerve), which controls the muscles of facial expression. The etiology is often linked to viral infections such as herpes simplex virus type 1 (HSV-1), varicella-zoster virus, and, less commonly, Epstein-Barr virus.

Symptoms and Clinical Presentation:

The hallmark of Bell’s palsy is the rapid onset of unilateral facial paralysis or weakness, which can develop over a few hours to a couple of days. Additional signs & symptoms include:

• Facial Droop: The affected side of the face may appear to droop, particularly noticeable in the mouth and eyelid. Patients often struggle to close the eye or smile on the affected side.

• Loss of Nasolabial Fold: The crease between the nose and the corner of the mouth flattens.

• Inability to Blink or Close the Eye: This can lead to dryness and irritation of the eye, necessitating protective measures such as eye drops or patches.

• Drooling: Difficulty controlling saliva due to weakened facial muscles.

• Altered Taste: Patients may experience a loss or alteration in taste, particularly affecting the anterior two-thirds of the tongue.

• Hyperacusis: Increased sensitivity to sound in one ear, due to the involvement of the nerve fibers that control the stapedius muscle in the middle ear.

• Pain or Discomfort: Pain behind the ear or in the jaw may precede or accompany the paralysis.

Diagnosis:

Diagnosis of Bell’s palsy is primarily clinical, based on the sudden onset of unilateral facial weakness. A thorough neurological examination is conducted to rule out other causes of facial paralysis, such as stroke, tumors, Lyme disease, and Ramsay Hunt syndrome. Imaging studies, such as MRI or CT scans, are typically reserved for atypical presentations or when another underlying condition is suspected.

Treatment:

The mainstay of treatment for Bell’s palsy includes corticosteroids, such as prednisone, which help reduce inflammation of the facial nerve. Antiviral medications may be prescribed if a viral infection is suspected. Early treatment within 72 hours of symptom onset improves the likelihood of complete recovery.

References:

1. Harvard Health Publishing. (2021, September 17). Bell’s palsy overview. Harvard Medical School.

2. Hauser, W. A., Karnes, W. E., Annis, J., & Kurland, L. T. (1971). Incidence and prognosis of Bell’s palsy in the population of Rochester, Minnesota. Mayo Clinic Proceedings, 46(4), 258-264.

3. Peitersen, E. (2002). Bell’s palsy: The spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Oto-Laryngologica, 122(7), 733-740.

4. ChatGPT.2024

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Topics:

💀 Oral & Maxillofacial Surgery

📖 CBSE Exam Material

🔬Oral Pathology

🫀Anatomy

💉Anesthesia

🚑 ATLS (Advanced Trauma Life Support)

#podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher

8.4.24 - *PODCAST EXCLUSIVE*

Also a major hack I’ve been doing lately is the “Audiobooks” tab on Spotify, I’ll listen to a book while I do my wind-down routine at the end of the night prepping lunch and breakfast and water for the next day etc. This has been a tremendous addition to my routine for added learning

Especially like how the @garyvee “Day Trading Attention” audiobook is actually in his voice which is important, imo. Dale Carnegie’s audio books have a great voice/reader too, idk who that dude is but I wish I had his voice instead my LongIsland accent 😅

Lmk what you think!


8.4.24 from July’s Q&A Session last week :)

#podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher

8.4.24 - *PODCAST EXCLUSIVE* - off the cuff for some thoughts I got after hearing a clip from the Elon musk & Lex Friedman podcast on productivity

8.3.24

Quick Review #195 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #bonyisland #idiopathicosteosclerosis

A dense bony island is an area of sclerotic (increased density) bone that is usually asymptomatic and does not have an associated radiolucent border. These areas are typically considered benign and are often idiopathic, meaning their exact cause is unknown.

Radiographic Characteristics:

• Appearance: On radiographs, dense bony islands appear as well-defined, radiopaque (white) areas within the jawbone. They can vary in size but are typically less than 2 cm in diameter.

• Borders: The borders of a bony island are well-defined but blend smoothly into the surrounding normal bone without a distinct margin or halo.

• Location: They can occur in both the maxilla and mandible but are more commonly found in the posterior mandible, particularly in the premolar-molar region.

• Effect on Surrounding Structures: Dense bony islands do not cause root resorption or displacement of teeth. They also do not expand the cortex of the bone or invade the surrounding soft tissues.

Clinical Characteristics:

• Symptoms: Dense bony islands are typically asymptomatic and are usually discovered incidentally on radiographs taken for other reasons.

• Growth: These lesions are generally stable and do not exhibit significant growth over time. They remain unchanged on subsequent radiographs, confirming their benign nature.

• Associated Conditions: There is usually no associated clinical condition or syndrome. However, it is important to differentiate them from other radiopaque lesions, such as cemento-osseous dysplasia, hypercementosis, or odontomas, which may have clinical significance.

Differential Diagnosis: When identifying a dense bony island, it is essential to differentiate it from other radiopaque lesions such as:

• Cementoblastoma: Typically associated with the root of a tooth and may cause pain or expansion.

• Condensing Osteitis: Associated with an inflammatory process, often near the apex of a tooth with a history of infection or inflammation.

Management:

Dense bony islands usually do not require any treatment, as they are benign and asymptomatic. Regular monitoring through periodic radiographs may be recommended.

References:

1. Wang, S., Xu, L., Cai, C., Liu, Z., Zhang, L., Wang, C., & Xu, J. (2022). Longitudinal investigation of idiopathic osteosclerosis lesions of the jaws in a group of Chinese orthodontically-treated patients using digital panoramic radiography. Journal of Dental Sciences, 17(1), 113-121.

2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2016). Oral and Maxillofacial Pathology (4th ed.). Elsevier.

3. White, S. C., & Pharoah, M. J. (2018). Oral Radiology: Principles and Interpretation (8th ed.). Elsevier.

4. Langlais, R. P., & Langland, O. E. (2017). Diagnostic Imaging of the Jaws (2nd ed.). Wiley-Blackwell.

5. ChatGPT.2024

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Topics:

🦷 General Dentistry INBDE Boards Question Concepts

🔬Oral Pathology

🫀Anatomy

🧾Dental Insurance

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👉 Do you have questions about applying to Oral & Maxillofacial Surgery residency 💀 or dental school 🦷? Keep an eye out for my next Q&A session, held on Instagram at the end of every month, for my live & personalized mentoring. This is for YOU 🤜🤛

🙋🏼‍♂️ These are clips from Instagram LIVE Q&A sessions, TikToks & Reels, and zoom events that I’ve hosted both individually and with our company Top Professionals 🙌 If you’re a club or organization and you’d like me to host your zoom event or conference, DM me on insta that is the best way to contact me directly 👌

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⛈ If you have questions, thoughts or ideas that you’d like to discuss involving my other ventures, including entrepreneurship (Top Professionals LLC 🏔, Vé Club 🍷), our products/services (PreDent Mentor Map, Dentist Map, Winery Map), NFTs 🖼(@feelings.nft 🎨, or my NFTs story highlight) workouts 💪, music producing/performing 🎶 (SoundCloud, violin 🎻 ), DM me and let’s talk 🤙

❤️ MOST importantly: THANK YOU for watching and being on my team- I do this for YOU. Mentoring is what got me here, and it is how I’ll help you achieve your dream goals as best I can. You are a MASSIVE part of this journey to me, more than you know 🙌🙏🙌

🤠 @doctorgallagher

https://www.instagram.com/doctorgallagher/

🦷 Oral & Maxillofacial Surgery Resident

🏔 Top Professionals Cofounder

🗺️ PreDent Mentor Map

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8.2.24

Quick Review #194 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental #closedreduction

The treatment of mandibular fractures with closed reduction and maxillomandibular fixation (MMF) involves a specific timeline and protocol that varies depending on the fracture location:

General Principles:

1. Initial MMF: Maxillomandibular fixation is used to immobilize the mandible and facilitate healing. The duration of MMF typically ranges from 4 to 6 weeks but can be adjusted based on the fracture’s healing progress and location.

2. Transition from MMF to Elastics:

• Tight Elastics: After an initial period of MMF, tight elastics can be used to allow some mobility while maintaining occlusal alignment. This stage usually begins around 2 to 3 weeks into treatment.

• Light Elastics: As healing progresses, light elastics are introduced, typically around 4 to 5 weeks. This allows more functional movement and encourages the development of normal jaw function.

• Release from MMF: Complete release from MMF and elastics is typically considered after 6 weeks, depending on clinical and radiographic evidence of fracture healing.

Specific Fracture Locations:

1. Symphysis Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Begin tight elastics at 2 weeks, light elastics at 4 weeks, and release at 6 weeks.

2. Body Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Tight elastics at 2 to 3 weeks, light elastics at 4 to 5 weeks, release at 6 weeks.

3. Angle Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Start tight elastics at 2 to 3 weeks, light elastics at 4 to 5 weeks, release at 6 weeks.

4. Ramus Fractures:

• MMF Duration: 4 to 6 weeks

• Transition: Tight elastics at 2 to 3 weeks, light elastics at 4 to 5 weeks, release at 6 weeks.

5. Condylar and Subcondylar Fractures:

• MMF Duration: Often shorter, around 2 to 4 weeks, to prevent ankylosis.

• Transition: Begin early mobilization with light elastics around 2 weeks and gradually increase mobility. Complete release may occur at 4 to 6 weeks, with emphasis on physical therapy and functional rehabilitation.

References:

1. Elias, N., Nish, I. A., & Pynn, B. R. (2019, June 10). Maxillofacial hardware – A review of techniques and radiographic appearance for the general practitioner. Oral Health Group.

2. Ellis, E., & Walker, L. R. (1996). Treatment of mandibular angle fractures using two mini-dynamic compression plates. Journal of Oral and Maxillofacial Surgery, 54(8), 864–869. https://lnkd.in/eztDF4YX

3. Maloney, P. L., & Doku, H. C. (1968). Condylar fractures of the mandible: Part I. Journal of Oral Surgery, 26(8), 457–464.

4. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. D. (Eds.). (2022). Peterson’s principles of oral and maxillofacial surgery (4th ed.). Springer.

5. ChatGPT.2024

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