Top 5 Topics:

- Sedation Risks in Obese Patients

- Emergency Airway Rescue

- Cardiac Arrest in the Dental Chair

- Post-Op Chest Pain & Heart Attacks

- Life-or-Death Crisis Management

*** These are live recordings of my review sessions for the oral OMFS boards that I’ll be taking in January 2025 - I can get answers and concepts wrong! Please comment, DM me, or text me with any corrections, additions, or your own board prep tips on these topics so we can learn from my mistakes. ***

- Wanna sponsor these episodes? Let me know in my LinkedIn DM or Instagram DM.

Questions & Topics:

00:00 – What’s the ASA classification for a healthy 45-year-old, and why does it matter for IV sedation?

02:23 – How does obesity (BMI 42) change sedation risk and airway complications?

05:14 – Patient drops to 88% O₂ and snores mid-sedation — what’s your first move?

07:57 – BP tanks to 80/50 during sedation — most likely cause and immediate fix?

10:49 – Patient seizes during sedation — what’s the first-line drug and dose?

13:30 – Post-op agitation and thrashing — hypercarbia vs. emergence delirium?

16:03 – Chest pain post-sedation — MI vs. PE vs. aspiration vs. pneumothorax?

19:05 – Patient goes pulseless — what’s the immediate action and first drug to push?

21:32 – Post-resuscitation: What’s the critical info to relay to EMS and first ICU step?

23:47 – Oozing from sockets, INR 2.5, platelets 90K — DIC or warfarin effect, and how do you treat it?

26:25 – Severe ARDS confirmed — what ventilator settings do you adjust, and why?

Now available on:

- Dr. Gallagher’s Podcast & YouTube Channel

My watch in this episode = Citizen Promaster Diver Day Date

- 8.2025

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

*PODCAST EXCLUSIVE* - 8.25.25

- An audio elaboration of this Threads/X thought or idea I just posted:

“Expect a lot of sacrifices, expect a lot of time commitments to studying, to saying no to seeing friends and family. The career path is very long, and it’s a multitude of sacrifices you need to unfortunately accept in order to get there.”

- from TikTok LIVE #73 Podcast

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

Quick Review #284 - #anesthesia #sedation #surgery #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry

- 8.25.25

Post-operative chest pain and shortness of breath in a patient with hypertension undergoing IV sedation includes a differential diagnosis: myocardial infarction (MI), pulmonary embolism (PE), pneumothorax, and aspiration/airway compromise. Recognizing which diagnosis to rule out first is critical.

Step 1: Initial Assessment

Immediately stop all activity, reassess ABCs (airway, breathing, circulation), apply 100% oxygen, and place the patient on full monitoring (ECG, SpO₂, BP). Chest pain with dyspnea must be treated as a presumed cardiac event until proven otherwise.

Step 2: Prioritizing Differential

• MI/ACS is the most urgent to exclude. A hypertensive middle-aged male is high risk. Acute chest pain and dyspnea strongly suggest ischemia. Perform an ECG first, looking for ST elevations, T wave inversions, or new Q waves. Administer chewable aspirin (325 mg) if no bleeding risk, and consider sublingual nitroglycerin (0.4 mg) only if systolic BP >90 mmHg. Call EMS immediately — definitive management requires hospital transfer and possible reperfusion therapy.

• Pulmonary Embolism also presents with acute dyspnea and pleuritic chest pain, often post-op. Tachycardia, hypoxemia, and anxiety raise suspicion. However, diagnosis requires imaging (CT angiogram) not available in the office, making supportive O₂ and EMS transfer the main interventions.

• Pneumothorax can follow PPV or barotrauma. Signs include unilateral chest pain, absent breath sounds, and hypotension if tension physiology develops. Requires urgent O₂, EMS transfer, and if crashing, needle decompression.

• Aspiration/airway compromise is also possible, especially in sedation. Coughing, wheezing, or stridor point toward this. Immediate suctioning, airway maneuvers, and PPV with 100% O₂ are essential.

Step 3: Key Learning Point

The most immediate diagnosis to rule out is MI because it is both common and most rapidly fatal. The first test is ECG — fast, accessible, and diagnostic. PE, pneumothorax, and aspiration remain high-yield considerations, but they are second-line in acute triage.

References:

1. Cleveland Clinic. (2023). NSTEMI: Non-ST-elevation myocardial infarction (heart attack). Cleveland Clinic.

2. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. (2022). Peterson’s Principles of Oral and Maxillofacial Surgery (4th ed.). Springer.

3. Abubaker, A. O., Lam, D., & Benson, K. (2016). Oral and Maxillofacial Surgery Secrets (3rd ed.). Elsevier.

4. ChatGPT.2025.

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

Topics:

💀 Oral & Maxillofacial Surgery

📖 CBSE Exam Material

🔬Oral Pathology

🫀Anatomy

💉Anesthesia

🚑 ATLS (Advanced Trauma Life Support)

🔗 Links to my platforms: https://linktr.ee/doctorgallagher/

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

🎙️ Clip from TikTok LIVE #73

👉 Full episode on Dr. Gallagher’s Podcast on Spotify, Apple Podcasts and YouTube Channel

🏆 Top 5 Longest Viewers of the TikTok LIVE get a shoutout in the caption!

🗓️ I do TikTok LIVE’s usually on Sunday evenings randomly between 6:00-9:30pm EST (or Monday evenings, if I’m in the OR or presenting early Monday morning) so stay tuned on my TikTok @doctorgallagher_

🔗 Links to my platforms: https://linktr.ee/doctorgallagher/

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

Top 5 Topics:

- Is Dentistry Still Worth It? The Harsh Reality of Debt, Insurance & Sacrifice

- Floss Before or After Brushing? Dentists & Science Weigh In

- DSOs vs Private Practice: The Truth They Don’t Want You to Hear

- Best Parts of Oral & Maxillofacial Surgery Residency

Top 5 Viewers on this Episode on TikTok LIVE #73 Q&A:

1st - Ryocld, @liebertura

2nd – user1740920596581, @intheozon3

3rd – Youssefhakim, @youssefhakim.__

4th – Geoffferson S. Raskin, @allergic.to.vegetables

5th – mischa, @mischa.devincent

6th - Persephanie Guerrero, @persephanieguerre

7th - JoeyAKA-HOMELANDER, @batman17387

Quotes & Wisdom:

“Expect a lot of sacrifices, expect a lot of time commitments to studying, to saying no to seeing friends and family. The career path is very long, and it’s a multitude of sacrifices you need to unfortunately accept in order to get there.”

“Some of the best parts of residency were the people—your team, your support system. You’re in the trenches together, and that makes the tough times worth it.”

“All the costs of everything else have gone up over time—tuition, materials, implants—while reimbursement from insurance companies hasn’t increased since the 70s, 80s and 90s. You’re constantly fighting an uphill battle.”

“One thing I’m not a fan of is when people sell out their multi-practice to DSOs, make millions, and then say it’s the best thing ever. The next generation will never make that same money. That’s not the same reality we’re living in.”

“I love surgery. That’s why I finished residency. But when does the light at the end of the tunnel finally come? I’m waiting for life to finally get comfortable.”

“I didn’t go into this just to clock in and clock out. I want skin in the game. I want to own a practice one day, treat patients in the community, and build something lasting.”

“You’re going to be frustrated often in healthcare. I’m still waiting to finally see a winning battle. But you push forward because you believe in what you’re building.”

Questions:

(00:00) Do you floss before or after brushing, and why?

(05:39) Is dentistry still worth it given the financial and emotional sacrifices of residency and practice?

(08:15) Should general dentists rely on CE courses to learn procedures they’re uncomfortable with, or refer out?

(10:48) As a UK dental student, should you pursue a U.S. DMD conversion or an AEGD?

(13:46) How do current reimbursement rates and declining trust affect dentists today?

(16:19) What is the right balance between opioids and Tylenol with NSAIDs for post-op pain management?

(18:54) What advice would you give to a pre-dental student who wants to follow your path?

(21:22) Would you ever start your own practice instead of being an associate?

(25:40) What role do externships and GPA really play in OMFS residency acceptance?

(29:15) What was your favorite part of OMFS residency training?

Now available on:

- Dr. Gallagher’s Podcast & YouTube Channel

My watch in this episode = Citizen Promaster Diver Day Date

- 8.2025

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

🎙️ Clip from the June 2025, Monthly Insta Story Q&A sessions I do at the end of every month- stay tuned the last week of the month on my Instagram @doctorgallagher 🙌

🔗 Links to my platforms: https://linktr.ee/doctorgallagher/

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

🎙️ Clip from TikTok LIVE #68

👉 Full episode on Dr. Gallagher’s Podcast on Spotify, Apple Podcasts and YouTube Channel

🏆 Top 5 Longest Viewers of the TikTok LIVE get a shoutout in the caption!

🗓️ I do TikTok LIVE’s usually on Sunday evenings randomly between 6:00-9:30pm EST (or Monday evenings, if I’m in the OR or presenting early Monday morning) so stay tuned on my TikTok @doctorgallagher_

🔗 Links to my platforms: https://linktr.ee/doctorgallagher/

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

Quick Review #183 - #anesthesia #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #bradycardia

- 8.23.25

Management of bradycardia with hypotension during IV sedation requires rapid recognition and a stepwise approach because seconds can determine whether the patient stabilizes or deteriorates. The scenario involves a patient who becomes pale, with BP 90/50 and HR 40, while under sedation. This combination reflects inadequate cardiac output and oxygen delivery.

#1 - First step is airway and oxygenation. Immediately stop sedation drugs such as propofol or fentanyl that may be depressing respiration or cardiac function. Apply 100% oxygen via non-rebreather mask, and confirm airway patency. Hypoventilation and hypoxia can drive bradycardia and hypotension, so airway support comes before pharmacology. Monitoring SpO₂ and ETCO₂ is critical to identify hypoventilation early.

#2 - Second, circulation support. Establish IV access and give a rapid fluid bolus (e.g., 500 mL normal saline) if no contraindication like heart failure. This supports preload and perfusion while addressing possible vasodilation or intravascular depletion.

#3 - Third, pharmacologic intervention. For HR 40 with symptomatic hypotension, the drug of choice is Atropine 0.5 mg IV push, repeatable every 3–5 minutes to a maximum of 3 mg. Atropine blocks vagal influence on the SA node, increasing HR and improving cardiac output. Importantly, phenylephrine is avoided because, as a pure α-agonist, it can increase afterload but worsen reflex bradycardia. Epinephrine is reserved for cardiac arrest or refractory anaphylaxis, not first-line for isolated bradycardia with a perfusing rhythm.

#4 - Fourth, reassess and escalate. If the patient fails to respond, prepare for advanced measures: epinephrine infusion, transcutaneous pacing, or EMS activation for hospital transfer. Always check ECG for underlying rhythm changes, but only after stabilizing airway, breathing, and circulation.

Key Takeaway: Sequence matters—airway and oxygen first, fluids for support, then atropine to directly treat bradycardia. Recognizing oversedation and preventing recurrence with careful titration and continuous monitoring are equally essential.

References:

1. Osmosis. (n.d.). Approach to bradycardia: Clinical sciences. Elsevier. Retrieved August 23, 2025, from https://lnkd.in/enGbptP9

2. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. (2022). Peterson’s Principles of Oral and Maxillofacial Surgery (4th ed.). Springer.

3. Abubaker, A. O., Lam, D., & Benson, K. (2016). Oral and Maxillofacial Surgery Secrets (3rd ed.). Elsevier.

4. ChatGPT.2025

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher

📍It’s the 2nd half of 2025, I just graduated residency in Oral & Maxillofacial Surgery in June, now starting to work at All County Oral Surgery in Melville on Long Island, NY. I’ll be an associate surgeon here & working toward a personal goal of becoming a partner one day. Outside of dentistry, I have side projects & companies to bring my passions to life, including mentorship, education, and life strategy, and I obnoxiously share a lot of content on it all as I go hahahaha

👉 Keep an eye out for my weekly TikTok LIVE Q&A Session (usually Sunday evenings) and the monthly Q&A session on Instagram (end of every month). Let me know how I can help you

🌎 *** PreDent Mentor Map is now LIVE, at predentmentormap.org ! *** it’s a free resource for predental students to use for data on every dental school, and to connect with current dental students for personalized mentoring.

🙋🏼‍♂️ If you’re an organization or club at a school and you’d like to discuss a partnership, event or conference, DM me on Instagram or LinkedIn- that is the best way to contact me directly

❤️ MOST importantly: THANK 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

🤠 Sincerely, Brendan @doctorgallagher

🔗 Links to my platforms: https://linktr.ee/doctorgallagher/

#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #dentistlife #oralsurgeon #doctorgallagher