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Profile in Oral Health by Juli Kagan, RDH, MEd

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What would happen to our entire health-care industry if people were well and happy? What if we had a health-care system that truly represented physical and mental health? The unfortunate reality is that the entire pharmaceutical, medical and insurance industry would collapse; much like the housing bust or dot-com bubble did only recently. We are certainly coming to critical mass and a tipping point because many Americans are fed up with our entire medical system. The sad truth is that we actually have a sick-care system and keeping people ill drives it. Take Betty, RDH, for example. Early last year, while working clinically she injured her right shoulder, sending an instant radiating pain from her shoulder through her elbow and down to her working hand. She saw her chiropractor, but after several visits over a few months, the symptoms actually increased. Betty then saw her doctor who prescribed pain medication and anti-inflammatory drugs. She also regularly saw a physical therapist for treatment – all this with little relief. Betty then took 10 days of vacation to rest her shoulder and afterward felt well enough to return to work. Within the first hour of the first day back, the pain began again, this time in the left shoulder, elbow, wrist and hand.

An MRI of the cervical spine showed slight arthritis, but no nerve problems or bulging discs. EMGs on both hands were negative. An MRI of the left shoulder showed an impingement process so her physician recommended arthroscopic decompression surgery on the right shoulder and a cortisone shot in the left shoulder. Remember, no one has taken the time to look at her work conditions, determine how she was functioning or suggest supportive exercises to create balance and strength in surrounding muscles, connective tissues and joints.

Betty did have the surgery and rather than solving her problems, her symptoms increased. Now she gets stabbing, electrical shocks, numbness and pain in both hands and wrists and can no longer work as a hygienist. The neurologist ruled out MS but implied that Betty’s symptoms might be simply imagined. When Betty asked about the possibility of a repetitive stress injury due to her two-decade-long dental hygiene career, he didn’t see a correlation. Betty still has no diagnosis to explain her condition and only the recommendation of more cortisone shots.

She still has no relief and can’t fall asleep at night because her shoulder hurts, both hands feel as if they are “on fire,” and her wrists feel like they are being squeezed in a vice. Not only does Betty not know what is causing her pain, her doctors don’t either. The most distressing part is that workman’s compensation was denied because of an inconsistent diagnosis. One can only imagine Betty’s frustration, confusion and distress at being accused of being crazy.

Is Betty well? Is she happy? Did she do everything she was told to do by the medical establishment? Now, give some consideration to what would have happened if her tests and surgery were not paid until she was better, defined as symptom-free, thriving and able to work again and contribute to society? What would happen to the medical, insurance and pharmaceutical industries if the essential criteria for payment were in fact, a healthy outcome for the patient?

The real question is: What does one need to do to prevent this type of torment and suffering? Here are some suggestions:

Physically:
  1. Listen to your body – Be honest with yourself while working. At the first sign of discomfort (not pain) do something! Don’t wait until it hurts; at that point it’s usually too late.
  2. Light and magnification – If you are not wearing magnification specifically fit to your eyes and body, it’s time to invest. Being able to easily see in the oral cavity reduces strain on the neck, shoulders and back.
  3. Ergonomic chair – Find an ergonomic chair that is tailored just for you. Many designs are available, but make sure it fits your body, butt, and supports your back, just where you need it. After extensive research and personally testing many chairs, it is this author’s opinion that the most committed company for custom-made seating is Crown Seating.* They design, manufacture and distribute numerous chairs but they will create one specifically for your body type and working needs.
  4. Sharp instruments – Be sure you are using sharp instruments, new burs and ultrasonic tips that are not whittled down.
  5. Stretch break – Take a stretch break between patients. If that means you have to go into the bathroom every hour to do a set of squats with your arms overhead, so be it. Keep moving! Keep stretching. Find ways and times to commit to yourself. Everything starts with you. And if you don’t think you have a minute every hour, just reflect on the potential hours, days and wages you could lose with an injury. Then calculate the impending medical bills and the emotional toll. Ouch! Not sure what to do? For free stretching and exercise videos specifically for the dental professional, visit JuliKagan.com.
  6. Exercise routinely – Four or more times a week do yoga, Pilates, rollerblade, boot camp, walk the mall, Zumba with friends or CrossFit; just do something! Studies prove over and over again the benefits of exercising. Make exercising non-negotiable. Put it in your calendar immediately. If you don’t take the time to take care for yourself, no one else will. Period.
  7. DH visit – Get a professional dental prophylaxis. Seriously! When was the last time you took care of your own oral health?
  8. Green tea – Drink green tea to help burn belly fat2 and improve joint mobility.4 Potent flavonoid catechin compounds in green tea – EGCG and ECG – might also help battle cartilage and collagen destruction in arthritic joints and reduce inflammation. Research also shows a beneficial effect of green tea on periodontal health.
  9. Sleep – Get at least six hours a night and try to make it seven to eight-and-a-half hours. Being restful makes you more alert, yet more peaceful. Studies show chronic sleep loss activates the body’s sympathetic nervous system, leading to an increase in blood pressure and cortisol secretion.7 Worse yet, cortisol has been shown to stimulate appetite and activate the lipoprotein lipase, an enzyme that facilitates fat deposition, thus leading to weight gain.8 Make rest a priority, right next to exercise.
Mentally:
  1. Breathe quietly – Do something quiet every day. Become focused, without distractions, for one to five minutes a day. Slowly inhale the word: Just. Slowly exhale the word: Breathe. Try it! Notice how breathing is an elixir to a calm mind. Five minutes before treating patients in the morning, sit and quiet your mind. It will be transformational to your day.
  2. Green tea again – It cheers you up! Elderly Japanese drinking four or more cups of green tea a day were 44 percent less likely to experience depression.3 Coffee and other teas didn’t have the same emotional benefit as green tea. Researchers suspect an increase in serotonin and dopamine (mood enhancing neurotransmitters). The only caveat here: if you are going to sweeten your tea, use natural xylitol, stevia or natural organic honey (although not preferred for caries prevention). Don’t add sugar or artificial sweeteners.
  3. Keep moving – The hippocampus in the brain is responsible for developing memories and processing emotions, and this area can grow new neurons (neurogenesis). Aerobic exercise increases blood flow to the major muscles of the body (think quadriceps and gluteals) and also improves blood supply to the brain, which can enhance learning.6 So get off you butt and get moving! You’ll be smarter for it. The bottom line (pun intended): More neurons equates to more intellectual firing power, especially as we age.
  4. Go outside – Spend less time in front of the television and more time in nature. Breathe fresh air, smell fresh cut grass or infuse yourself with the clarity a snowfall brings.
  5. Eat healthy oils – Avoid trans fats, commonly found in most comfort foods we think will cheer us up like cookies, crackers, frozen pizza, full-fat dairy and red meat. People who eat more trans fats are at greater risk for depression. Instead cook with water and/or a little extra virgin olive oil and eat more nuts and seeds such as walnuts, almonds and sunflower seeds.

Are you still unsure about all of the above choices? Choose one. Commit to it for 21 days. Then add another for 21 more days. Within a year, you will see significant changes in your physical and mental health. In the meantime, call your doctor just to say hi and, just for the fun of it, express your feelings of being well and happy! Then, when you hang up the phone, decide if he or she was genuinely happy or disappointed about your health. The response will be very revealing and illuminating!

*The author is not paid for this endorsement.

References
  1. Green tea, black tea consumption and risk of lung cancer: a meta-analysis. Tang, N. et al., Lung Cancer 2009 Sep;65(3):274-283.
  2. Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults. Maki, K. C. et al., J Nutr 2009 Feb;139(2):264-270.
  3. Green tea consumption is associated with depressive symptoms in the elderly. Niu, K. et al., Am J Clin Nutr 2009 Dec;90(6):1615-1622.
  4. Catechins from green tea (Camellia sinensis) inhibit bovine and human cartilage proteoglycan and type II collagen degradation in vitro. Adcocks, C., Collin, P., Buttle, D. J., J Nutr 2002 Mar;132(3):341-346.
  5. Relationship between intake of green tea and periodontal disease. Kushiyama, M. et al., J Perio 2009 Mar;80(3):372-377.
  6. Revenge of the “sit”: How lifestyle impacts neuronal and cognitive health through molecular systems that interface energy metabolism with neuronal plasticity. Vaynman, S., & Gomez-Pinilla, F., J Neurosci Res 2006; 84(4), 699-715.
  7. Sleep deprivation: Impact on cognitive performance. Aljola, P. & Polo-Kantola, P., J Neuropsychiatr Dis and Treat 2007; 3(5), 553-67.
  8. Do stress reactions cause abdominal obesity and comorbidities? BjÖrntorp, P.,Obesity Rev 2001; 2, 73-86.
  9. Dietary fat intake and the risk of depression: the SUN Project. Sanchez-Villegas, A. et al., PLoS One 2011 Jan 26;6(1):e16268.


Author's Bio
Juli Kagan, RDH, MEd is a yoga teacher, Pilates instructor, health-care professor and national speaker. She helps you learn to mind your body and live a more meaningful life. Devoted to life-long learning, wellness and passionate about physical and mental fitness, Juli shares an energy and enthusiasm that transforms knowledge into practice. She wrote Mind Your Body and has created numerous free exercise videos on her Web site. Juli’s specialty is proper posture, especially while seated. To purchase her book and/or obtain information about speaking, visit JuliKagan.com.
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