Dr. Hirschinger Facial Pain Headaches TMJ Sleep Apnea

This coming Wednesday, September 16th at 5 pm Pacific Time, I will be the guest on Clinical Chats hosted by Dr. Christopher Marchack and Dr. Frank Vidjak. We are going to chat about the newest dental specialty, orofacial pain. Have you heard of occlusal dysesthesia? Do you know how to differentiate between tooth pain and trigeminal neuralgia? Please join us for this exciting episode to learn more! Sign up at https://www.ilovedentistry.online/clinicalchats8/ #dentist #dentistry #orofacial #orofacialpain #ilovedentistry #clincalchats #gentlejaw #thegentlejaw

If anyone is interested in learning more about diagnosing and treating primary headaches, I'm doing a Livestream tomorrow night at 5 pm PDT with @SciBabe. She presented to my practice with a headache for 9.5 years. Yes, years. I diagnosed her headache as hemicrania continua, prescribed a therapeutic dose of indomethacin, which is an anti-inflammatory medication that requires a prescription, and the headache aborted in about 5 days. If you have questions, please post them below and I will try to answer them on the Livestream, which will be at: youtube.com/scibabetv twitch.tv/thescibabe fb.com/scibabe

I haven't had a real haircut in several months but it was time to update my photo since I now wear scrubs at the office.

For my dental colleagues: As a reminder, "sharp, shooting, and/or electrical pain" that is intermittent is rarely caused by odontogenic pain. I saw an 80-year-old male last Monday. Here are my notes, "The pain is a 'shock.' If he takes a pain killer such as Tramadol or Excedrin it helps. If he drinks, eats, or brushes his teeth he can get a sharp pain. Talking can trigger the pain. The shock can be a second or two, which can occur several times over a couple of minutes. It do...es not wake him at night. The pain now is similar to the pain he had before the first three endos. The endos were done at separate procedures. He had an RCT on #19, then on #18 a month later, then on #20 a month later by the first endodontist, and then #17 by a different endodontist. I diagnosed him with trigeminal neuralgia. I prescribed gabapentin 300 mg HS for 3 days, then 300 mg BID for three days, and today he will start taking 300 mg TID. I ordered an MRI, which I received today and it shows two compressions of the left trigeminal nerve, which can account for the pain. Please do not do irreversible procedures such as crowns, endodontics, and/or extractions without having a clinical and/or radiographic diagnosis. As an expert witness, I can defend you if you treat one tooth but the pain remains. I cannot defend you if you treat multiple teeth since it looks like you are guessing. I hope that makes sense. Stay safe everyone.

gentle jaw is now listed as an "Amazon's Choice." Buy it on Amazon at https://www.amazon.com/Gentle-Jaw-Passive-Str//ref=sr_1_2 or at www.gentlejaw.com