TMJ and TN - The Orofacial Pain Center
We are dedicated to finding the cause of and treatment for severe facial pain and headaches
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Hi all,
I have been so busy with our new information page, I have neglected our office page! If you don't already know, I am an Orofacial Pain Specialist and I have seen a lot of significantly damaged jaw joint patients in the past 25 years. I have developed a treatment philosophy and don’t plan on changing it. I have had 25 years of successful diagnosis and treatment. I disagree with most of the information found online about “TMJ” and take my personal time to try to educate anyone who wants to hear it. I have an information page called "TMJ" support and information, where I answer specific questions
We are still here and seeing lots of new patients and this is why I never get any work done! Jack jack is our adorable office "kitten". We think he is about 1 year old now and he is a lovebug!❤️
When we aren't cuddling him, CIndy and I are talking to and seeing patients with all kinds of facial pain and headaches. CIndy would love to explain how we do things. Just give us a call. 904-296-1990.
Sorry I haven't updated in a while. Cindy and I are doing well and the office is busy. School just started and I have new freshman students needing patients to see. If you need a dental cleaning, xrays and exam for $10.00, FSCJ Dental Hygiene School is the place!
I started a new information page called "TMJ" support and information on Facebook. It is a place for people to come and get true information regarding diagnosis of jaw joint damage, share their stories and ask questions. We would love to have you join!
I always see posts saying Never have jaw joint surgery. I get scared when I see posts advocating for NEVER doing surgery on temporomandibular joints. Saying that is like saying never do surgery on any joint (knees, hips, shoulders, wrists, etc), which is done all the time in medicine. I find the “Never Have Surgery” statement too broad and the misconception that all surgery fails goes back 50 years. In the 1970’s, we didn’t have MRI and CT, so we had no way of knowing what was wrong in cases of facial pain that might be related to the temporomandibular joints. Because of this, they did temporomandibular joint surgery on everyone with “TMJ” and since 80% of “TMJ” patients don’t have anything wrong inside the joints, 80% of surgeries failed. That was 50 years ago, though. Now, we have MRI and CT and can see inside a joint and know exactly what is wrong, if anything. It is easy to find out. The field has been slow to follow, though. In general, I see doctors choosing to diagnose without MRI, so they can’t know what is wrong. I see them doing outdated surgical procedures, such as arthrocentesis. Arthrocentesis is a flushing out procedure. If the joint is healthy and stable, you don’t need any kind of surgery. If the discs are displaced (geenral finding), arthrocentesis does nothing to correct the damage (disc displacement) and generally makes the damage inside the joint worse. It is 100% guaranteed to fail. They also seem to make the patients feel crazy to be in pain and generally ignore the problem.
One of the main problems is calling facial pain “TMJ”. It is way too vague. TMJ stands for temporomandibular joint. Getting a diagnosis of “TMJ” for facial pain is like getting a diagnosis of “KNEE” for leg pain. You would say to the doctor, “What is wrong with my knee?”. They would do a thorough exam and get an MRI. Then they would give a diagnosis of a torn ACL, torn MCL or torn meniscus and tell you can wear a knee brace, take ibuprofen, decrease use of the knee or have surgical correction. If they said you did or didn’t need surgical correction due to “KNEE”, you would think it was strange. Jaw joints should be the same. A thorough exam, MRI specifically of the jaw joints, explain the MRI and give a diagnosis such as osteochondrosis (lack of growth of the jaw joint), disc displacement, torn ligaments, avascular necrosis, etc, should be done. Then develop a treatment plan such as wear a bite guard, decrease use of the jaw, take ibuprofen, or correct the damage.
I had a similar situation with my sister. She suffered from terrible migraines and facial pain for many, many years. When the doctor told us she needed to see a psychiatrist, I decided to figure the problem out. I did and now it is my mission to educate anyone and everyone who will listen to me about how to correctly diagnose jaw joint damage. I found a surgeon who was taking MRI’s in the 1990’s. When we saw her joints, it was obvious what was wrong. Because we didn’t get to her in time, her joints were damaged beyond repair and had to be replaced. The original disc displacement was caused when she broke her collarbone. The disc being out of place, blocked the blood flow to the condyle and caused the growth discrepancy. The surgeon corrected her damage and gave her life back. She has been stable for 25 years. So, I have personal knowledge that the correct diagnosis and treatment does work and I have hundreds of patients who can attest to that.
I have been referring to her surgeon for over 25 years and have had no surgical failures. The surgeon does a procedure called disc removal and fat graft transfer. If you don’t have an MRI, have a doctor who can explain it, does the correct procedure or doesn’t do many procedures, you should not have surgery. But if you do have those things, surgery can save a life. Don’t be scared of fixing it. Surgery is a viable option to prevent further damage, dysfunction and pain. Chronic pain is a huge drain on people’s lives and the medical system.
It is my goal to educate enough people so that there are no more Facebook groups dedicated to this particular chronic pain issue. Some chronic pain is not fixable, like nerve pain, but joint damage is fixable. I am more than happy to answer any questions.
I saw a patient yesterday that reminds me of a lot of cases I see posted on the TN and ON sites. Mr. Smith presented with constant, severe, dull, aching, burning, pain and intermittent, sharp, shooting, pain in his left occipital area and to a lesser degree in the left side of his face. He had a main diagnosis of ON and a probable diagnosis of TN. SInce TN is a diagnosis of exclusion, the other 9 causes of facial pain need to ruled out, first. One that had not been ruled out was jaw joint damage. I see a lot of patients diagnosed with TN when they actually have damaged jaw joints that are the source of their pain. This is because there is a branch of the trigeminal nerve called the auriculotemporal nerve that only goes through the jaw joints. if the joints are damaged, it can cause TN pain. It often gets overlooked for two reasons, one, we use the term "TMJ" which is a woefully inadequate term for facial pain diagnosis that doesn't actually take into account the health and stability of the jaw joints themselves and two, because doctors rarely look inside the joints for the cause of facial pain. "TMJ" stands for temporomandibular joint. Getting a diagnosis of "TMJ" for facial pain is like getting a diagnosis of KNEE for leg pain. It doesn't take into account the many sources inside the knee (joint) that could be causing the pain. You could have a torn ACL, torn MCL, torn meniscus, etc. You have to know which is the cause of the pain in order to know how to fix it. "TMJ" is the same way. We have to know what, if anything, is wrong inside the joints to know how to fix it. That can only be done with an MRI specifically of the jaw joints. Also, if the joints are damaged, they are unstable. This joint instability can cause neck pain, shoulder pain and occipital pain. I ordered an MRI of Mr. Smith's joints and he did have damaged joints. To prove if the joints were the cause of his facial and occipital pain, I did an auriculotemporal nerve block. Since the auriculotemporal nerve only goes through the jaw joints, if you numb it and the pain goes away, it is 100% diagnostic that the jaw joints are the cause of the pain. What totally surprised me was that when I did the block, not only did his facial pain go away 100%, but the occipital pain went away 100%, also! That tells me that if we correct the damaged jaw joints, not only will his "TN" pain go away, but his ON pain will go away, also. This situation happens quite frequently in my practice and I am hoping that by posting this story, it will help someone else get a correct diagnosis and treatment. I would be happy to answer any questions.
![Photos from TMJ and TN - The Orofacial Pain Center's post](https://img4.findglocal.com/593/352/726625265933522.jpg)
We had the cutest visitors at the office last week!
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![](https://img5.findglocal.com/598/266/659467155982667.jpg)
Valentine's Day love from a patient. Cindy and I have THE best patients!!!!
I met a 12 year old facial pain patient in my office many years ago. She had significant pain and headaches I got an MRI of her temporomandibular joints and she had significant jaw joint damage. Luckily, she was able to have successful, corrective temporomandibular joint surgery. After her surgery, I didn't see her again, which is the goal of my office!
Fast forward about 14 years to the Dental Hygiene school where I teach. It was during COVID, so everybody was wearing masks. This shy young lady told me she had been my patients many years ago. After racking my old brain cells, I recognized her. 😊 She told me she was still pain free since her surgery!
She was an excellent student for the whole rigorous program and graduated to become a Certified Registered Dental Hygienist 2 years ago.
Last night, I went to her wedding. I saw a beautiful, happy young lady marry the man of her dreams.
This is what makes me keep going, educating people about the correct way to diagnose facial pain, get a TMJ MRI and correct the damage, if need be. No other doctors would have corrected her damage at such an early age. They would have let her damage just keep progressing. She would have been in so much pain by this point, I doubt she could have completed a college degree, let alone another degree in Dental Hygiene. She is proof this procedure works and has been working for many. many years.
![Photos from TMJ and TN - The Orofacial Pain Center's post](https://img5.findglocal.com/032/448/649382350324481.jpg)
One of my very favorite patients just posted this following her temporomandibular joint surgery with Dr. Brian Shah.
Thank you for your kind words. We wish you a speedy recovery and know you will make a Great Dentist, spreading the word about jaw joint health.
Karah - Finally on our way HOME from St. Petersburg!!! This has been the longest two weeks, but it couldn’t have been more worth it. I am so overwhelmed with gratitude that I am unable to even describe.
First, to Dr. Brian Shah, for saving my jaws and quality of life, and for continuing the legacy of Dr. Piper, refusing to think inside the box as so many oral surgeons and dentists do. For your kindness and conversation and inspiring me to be like you one day. And his ENTIRE staff for giving loving and gentle care to their patients.
Second, to Dr. Peggy Dennis, for FIGHTING for her patients with debilitating orofacial pain, no matter what people say about her or do to discourage her work. And of course, for being a dear friend, professor in hygiene school, and mentor.
Third, to my wonderful mother and husband for their selfless care for me and helping me get through these last two weeks. I would absolutely have not been able to do it without them.
And finally, to all of my other friends, family, coworkers, church, etc… THANK YOU for your love, prayers, meals, and encouragement. My cup is overflowing from the people I am so blessed to be loved by.
![Here’s What the CDC’s New Opioid Guidelines Mean for Your Pain Management](https://img5.findglocal.com/212/323/598061452123238.jpg)
Here’s What the CDC’s New Opioid Guidelines Mean for Your Pain Management Experts say the updated recommendations reflect the need for individualized, compassionate care.
I answer a lot of questions on Facebook and find the number one problem with a "TMJ" diagnosis is a lack of MRI. The temporomandibualr joint (TMJ) is just a joint like any other in the body. If you had leg pain and went to the doctor and they said, "You have KNEE?" Not only would you think they were crazy, but you would say, "What is wrong with my knee?". The same thing has to happen with jaw joints. There has to be a diagnosis of joint health before treatment is started.
So, it happened again. A very nice lady from Arkansas I had been talking to on one of the pages was vacationing in Florida and came to see me. Her history is very similar to many people’s I see on here. She had left side facial pain, diagnosed as TN. Over the past 6 years, she had MVD, nerve excision, teeth extracted, implant placed, almost had implant removed, bite guard, multiple medications and no relief. Nobody ever looked at the jaw joints. When I saw her, I could tell by her facial proportions, smaller chin, she probably had jaw joint damage. She had some noise on jaw movement, but not loud clicking or popping. She had normal opening, with pain. I got an MRI specifically of the jaw joints and it showed significant and severe bone and soft tissue damage. I did a thorough clinical exam, including a diagnostic auriculotemporal nerve block. During her exam, there was pain on toughing all her facial muscles as well as bilateral temporal tendon pain. These tendons run from the temporalis muscle to the lower jaw. If the joints are not stable, the tendons have to overwork and can become painful, just like tennis elbow or tendonitis in the elbow. It’s called temporal tendonitis. This was the case with her. This finding also indicates jaw joint/muscle not TN to me. The block was done on the right jaw joint and I also numbed the right and left temporal tendon. Her pain went away 100%. Next, I showed her a normal jaw joint MRI and then hers to compare. We discussed options to treat the damage. If she is able to treat the damage, correctly, I expect 100% pain relief. I am not posting this to tout my own horn, but to show there is a very real way to treat TN, especially, ATN pain that nobody seems to even consider. Not only do I see this a lot, but recently I have seen 2 people from these pages that have proved me out. One has had the surgery and is pain free and now one, if she has the surgery will be pain free. I am including the protocol I use to get the scan. It has codes and all the information to order the scan. Any doctor can order it. If they don’t know about jaw joints, I can help explain it to you. A pain management doctor, Oral Surgeon and possibly a Dentist can give the block. They can see how to do it on Google. There is no reason not to look at jaw joints. This may mean you have to ask and they may balk, because they lacking knowledge. The only way to change this is to do it ourselves. I think it is worth it to stop the suffering. Please don’t hesitate to ask questions. I am here to help.
Protocol for TMJ MRI
Here are a few questions to ask when scheduling yourself for a TMJ MRI. Do you have a P*P that might be willing to write a prescription for a center that is on your insurance? They can just order – a bilateral TMJ MRI following the attached protocol. Questions to ask the Imaging Center:
1. Do you take my insurance?
2. Do you have a TMJ coil, not just a head coil?
3. Have you done TMJ MRI’s before? How often do you do them?
4. Will you follow a protocol from an out of town doctor? (I can fax or email it to you prior to scheduling my appt.)
5. Has your radiologist ever read a TMJ MRI scan?
6. Can you forward the scan to Dr. Dennis or would I need to send a disc copy to her? Will there be a charge for an extra disc copy?
Dr. Dennis
We use these medical diagnostic codes for the scan
Limited opening (M26.52)
Facial pain/daily headaches (R51)
Bruxism (G47.63)
Disc disorder (M26.63)
The Orofacial Pain Center MR Scan Protocol
(taken from The Piper Clinic MR Scan Protocol)
1. Axial T1 skull localizer
a. Slice thickness 4mm
b. 4-5 mm intervals
c. Ramus to superior orbital fissure
2. Sagittal T1 seated (teeth closed)
a. Corrected sagittal orientation/parallel to the lateral pterygoid muscles and perpendicular to long axis of the condyle
b. Slice thickness 3mm
c. 2.5-3.0mm intervals
d. Includes slices internal and external to the joint
3. Sagittal STIR or T2 seated (teeth closed)
a. Corrected sagittal orientation parallel to the lateral pterygoid muscles and perpendicular to long axis of the condyle
b. Slice thickness 3mm
c. 2.5-3.0mm intervals
d. Includes slices internal and external to the joint
4. Sagittal Proton Density seated (teeth closed)
a. Corrected sagittal orientation parallel to the lateral pterygoid muscles and perpendicular to long axis of the condyle
b. Slice thickness 3mm
c. 2.5-3.0mm intervals
d. Includes slices internal and external to the joint
5. Sagittal Proton Density with mouth open and measurement recorded (generally 30-35mm or limited by pain)
a. Straight sagittal orientation
b. Slice thickness 3mm
c. 2.5-3.0mm intervals
d. Includes slices internal and external to the joint
6. Coronal Proton Density seated (teeth closed)
a. Slice thickness 3mm
b. 2.5-3.0mm intervals
c. Slices start at the bony ear canal and extend anteriorly
7. Coronal STIR seated (teeth closed)
a. Slice thickness 3mm
b. 2.5-3.0mm intervals
c. Slices start at the bony ear canal and extend anteriorly
8. Coronal Proton Density with mouth open and measurement recorded (generally 30-35mm or limited by pain)
a. Slice thickness 3mm
b. 2.5-3.0mm intervals
c. Slices start at the bony ear canal and extend anteriorly
The axial sequences are used primarily to localize the mandibular condyles to correct the sagittal and coronal slices to the condylar axis. We are asking for additional slices adjacent to the skull base and intracranially to screen for additional pathology such as sinus disease, parotid tumors, lymphadenopathy, mastoiditis, subarachnoid cysts brain tumors, multiple sclerosis and brain parenchymal small vessel disease or stroke. Patients are aware that this is not a complete brain or skull base examination and therefore if there are other clinical findings that warrant additional scanning, then these must be performed separate from the TMJ MRI.
Please give patient the scan on CD to bring to their appointment. Thank you!
Suggestions for decreasing “TMJ” pain
1. Soft to no chew diet - no steak, pizza crust, bagels, ice, gum, etc. The softer the diet, the better you will feel.
2. Ice or heat on painful areas – alternate 20 minutes on and 20 minutes off. Can also alternate heat and cold. For example, 20 minutes on of heat, off 20 minutes, on 20 minutes of cold, off 20 minutes, on 20 minutes of heat, etc as often as possible.
3. Limited opening – try to limit opening during yawning. No biting into sandwiches or hamburgers.
4. Limit daytime clenching. Practice lips apart, teeth apart and tongue resting on the floor of the mouth.
5. Clock regulated, q8h, (ex. breakfast, lunch and dinner), 600-800 mg Ibuprofen during painful periods.
6. Practice good posture with shoulders back and down, ear over shoulder and relaxed positioning.
7. Limit activities that stress your jaw such as singing, playing a musical wind instrument, etc.
8. Practice abdominal breathing
9. Get good sleep
10. Limit caffeine
If jaw locks open, place thumbs over bottom back teeth and press down. This will allow the lower jaw to slip back and up, into place.
I presented virtually at a great Trigeminal Neuralgia support group last night. The oh so cool thing was with the power of the internet, it was in the Pacific Northwest! Lovely people in the group that were so welcoming.
I spoke about the "TMJ"/ TN connection and answered as many questions as I could about TN. I find it such a learning experience for myself to speak to TN sufferers.
RSD, also known as Reflex Sympathetic Dystrophy Syndrome is now known as and called CRPS, or Chronic Regional Pain Syndrome.
Over a hundred years old, but yet most people have never heard of it (WHY?)
It is a progressive disease of the autonomic nervous system.
In plain everdyay English, it's unexplained chronic pain that is debilitating and severe in nature and has way to many ulgy heads
causes it's sufferers to live with intense chronic pain, emotional and physical distress. The purpose of Helping Hands is to educate others... whether
your suffering from this condition, or Chronic Pain, if you, or a friend or loved one suffering with this condition, or you would like more information to be better informed.
Helping Hands is here to Help
One of the ulgy things about RSD or Chronic Pain is that it can and will cause ruined marriage and friendships
I have had seen this happen to my friends and some of my family couldn't deal with the physical and emotional burdens it placed in my life and subsequently, theirs
Because of this, I feel it's important for others to understand what it is that people like myself live with and why it causes us to act the way we do.
It's a permanent part of my life and not going away anytime soon. These dieases like you and I, who lives with the gift that keeps on giving
and of other who suffer from it and it affects anyone that's involved in our lives.
What are the symptoms of this ulgy dieases of RSD/CRPS? (The gift that keeps on giving)
These are just a few and I would like for more to share there symptoms.
I tell you something I think is sad, and kind of good all at the some time, we know more about these dieases then the doctor's treating us
1) Constant chronic burning pain (includes allodynia - extreme sensitivity to touch, sound, and vibration)
2) Inflammation (this can affect the appearance of the skin, bruising, mottling, etc.)
3) Spasms-in blood vessels and muscles of the extremities
4) Insomnia/Emotional Disturbance (includes the major changes to the limbic system such as short-term memory problems, concentration difficulties, etc.)
5) Movement disorders- difficulty in moving the affected body part
6) Increased Tone- Muscle and skin brightness
7) Increased reflexes- Muscle and skin tightness
😎 General weakness- increased fatigue, swelling, sores, rashes, and fever are all possible
9) Skin color changes- skin may turn shiny, become red and tight. May have a mottled appearance. Can also be blue-ish purple. Increased sweating with either increased temperature or decreased temperature.
10) Nails/ Hair- On affected areas, the hair can grow more rapidly or not at all. Nails can become brittle and cracked.
11) Bone Changes --- Softening of the bones, Osteoarthritis, Osteoporosis, joint stiffness/tenderness.
12) Sleep Patterns --- Insomnia is often seen, also disrupted sleep pattern. Some Medications help this.
13) Miscellaneous --- Dizziness, Tinnitus, Agitation, Irritability, Visual disturbances such as blurriness, dry eyes and others. Also, sounds/vibrations even strong winds can exacerbate the pain as well.
The most common symptoms are the first 4 listed above and the major signs doctors look for when diagnosing this disease. As you can see, it's quite a list and for the sufferers of this disease it can be quite an ordeal to endure on a day to day basis when there is little or no relief to be had.
Did you know that CRPS is ranked in the McGILL Pain Index and that CRPS is ranked as the most painful form of chronic pain that exists today and it ranked on the McGill Pain Index at a whopping 42!
To understand just how bad the pain is, cancer pain is ranked at 24. Now do you have a better understanding of what it's sufferers have to endure? Why they develop depression and anxiety? Why they don't (or cannot) do many activities that many people take for granted?
Thanks for reading,
Have a great week and weekend
Sending Cajun hugs, smiles, hope and lot of love
Lynn Red, I hope this helps a little
![With Great Mercy | Kathy Maresca's Site](https://img4.findglocal.com/883/988/4111932178839881.jpg)
http://kathymaresca.com/?fbclid=IwAR0cT8sLo_176OBm4bVMsYa8m9v25X8bLq_W-HaGZ9Wkvwil6iIPFzMLlOk
Great website and blog
With Great Mercy | Kathy Maresca's Site Hope exists for you. Pain affects our relationships, our work, our finances, and our sense of well being. Trigeminal neuralgia can be an isolating experience. Even when people surround us, we often feel alone because others do not seem to understand our situation. Sometimes God seems far away, but H...
![A weary world rejoices | With Great Mercy](https://img5.findglocal.com/286/050/4071725972860502.jpg)
A friend with jaw joint pain has a great web site. Take a look!❤️
A weary world rejoices | With Great Mercy A weary world rejoices by Kathy Maresca | Dec 22, 2020 | Uncategorized Ready or not, willing or unwilling, the season to celebrate has arrived. For so much of 2020, celebrating has been the last thing on my mind. I have had long talks with God, asking Him if He is listening. So many people in my fam...
"No thief, however skillful, can rob one of knowledge, and that is why knowledge is the best and safest treasure to acquire."
-- L. Frank Baum
Hi, everyone. I hope all is well with you. Cindy and are are healthy and still working like mad! I had a couple of interesting cases recently that got me thinking. I had two patients who had MVD for Trigeminal Neuralgia. They both reported successful results, but some pain still present. Both reported a significant change in their bite and jaw joint position after their surgery. It got me thinking about failed MVD's. The jaw joints are innervated by a branch of the trigeminal nerve called the ariculotemporal nerve. If the joints are damaged, this branch of the nerve can cause TN pain. I am wondering how many "failed" MVD's are not really failed, but their pain is now due to their jaw joints that were damaged during their surgery. It is something to think about if you fall into this category. It only takes an MRI of the jaw joints to know f they are damaged. I see this kind of damage a lot. I actually had a patient come out of surgery with a fractured jaw, once. I would be happy to answer any questions.
![Timeline photos](https://img4.findglocal.com/558/039/3877860415580393.jpg)
FPA's new book, Facial Pain: A 21st Century Guide, is now available.
World experts in the diagnosis, treatment, and management of trigeminal neuralgia contribute their expertise to cover the full breadth of knowledge in the field, including the following topics:
The dental dilemma
Do I have the right diagnosis?
How to find the best doctor
What is the best imaging study to get?
What medication is best?
The surgical solutions
What to do when nothing seems to help
In addition, this guidebook covers complementary and alternative medicine considerations, including:
Weather and its effects on pain
Acupuncture
Medical ma*****na
Upper cervical chiropractic
Also included is the latest information on the future of care for trigeminal neuropathic pain. If you are newly diagnosed, misdiagnosed, in need of another solution, a friend or family member, young or old, or doing well but wish to know more about why, this book has been written for you.
Get the E-Book Here:
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Our office is somewhat different from other pain management practices. It is just me, so I see all my chronic pain patients every month. I get very attached to them😊. Sunday, we lost a great patient. He was always so gentlemanly; asking how we were, petting Brewster, never complaining. I have been seeing him for many years for Trigeminal Neuralgia pain. I shared his joy at finally retiring, I shared his tears when his dog died. He was one of the ones we looked forward to seeing. We always had a nice visit. When we saw him last month, he was the same as always. He left as usual with a "take care of yourself, see you next month". I never thought that was the last time I would see him. RIP, sorry we won't see you next month. 😢
![Orofacial pain, the 12th specialty](https://img4.findglocal.com/019/256/3565072040192567.jpg)
Orofacial Pain is officially recognized as the 12th Dental Specialty. Finally!
Orofacial pain, the 12th specialty On March 31, 2020, the National Commission on Recognition of Dental Specialties and Certifying Boards recognized orofacial pain (OFP) as the 12th specialty in dentistry. Recognition of this specialty solidifies another link between dentistry and medicine, acknowledging that the orofacial region, ora...
Hi all,
I hope everyone is staying safe and wearing your masks😷. I wanted to relate a sad story just as a reminder not to ignore headaches, especially in children. A distant friend’s daughter had headaches from about age 12. They went to many doctors, but no one ever recommended she have an MRI. Now she is 23 and the headaches have changed. Someone finally said get an MRI and unfortunately, they discovered a large brain tumor. This makes me so mad, because I see patients that have severe headaches and have been made out to be crazy people. Brain tumors are not the main cause of headaches, but it is so easy to rule them out or diagnose them early enough to correct them. Headaches in children (under age 20) are not normal.
![ChicagoLakeDental organized by Ali Barbarawi](https://img4.findglocal.com/307/478/3402916573074782.jpg)
ChicagoLakeDental organized by Ali Barbarawi In the early hours of Saturday morning, Dr. Ali Barbarawi, the owner of Chicago Lake Family dental, wa… Ali Barbarawi needs your support for ChicagoLakeDental
![Henry Gremillion Obituary - New Orleans, LA | The Times-Picayune](https://img5.findglocal.com/380/853/3362245703808536.jpg)
One of the leaders in Orofacial Pain passed.
Henry Gremillion Obituary - New Orleans, LA | The Times-Picayune Henry Alan Gremillion, DDS (68) passed away suddenly on May 18, 2020. The void for all those who love him is immeasurable. At age seven months, Henry was adopted from an orphanage in North Louisiana
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