Oral Health Group
Feature

A Selfcare Survival Guide for Busy Dental Professionals

May 12, 2020
by Uche Odiatu, DMD; Mahsa Bakhshandeh, RDH


Many of us only think of getting fit and healthy to look good for college reunions or to rebound after the failure of a relationship (the proverbial “revenge body”). It’s beyond just looking good; it’s about creating a body that can help you weather a financial storm, an emotional storm or even survive a pandemic. When pushed to the limit and life asks everything from us, we need a reserve. Just like having money in the bank helps you weather a financial storm, having impeccable health will help you in get through a global storm of mammoth dimensions.

There are four sections to our Selfcare Survival Guide:

Advertisement






  1. Get physical
  2. Eat right
  3. Slay stress
  4. Sleep well

After this column you will have a foundation to be your physical and emotional best.

Get Physical
Exercise has the inherent ability to build strength and endurance into the human body. Most people already know this. A strong body can lift things up, it can get things done – you can live independently. Can the benefits go beyond the physical? This is where it gets mindblowing. Psychiatrist and Harvard Medical School professor writes, “I have to cement the idea that exercise has a profound effect on cognitive abilities and mental health.”1 Dental professionals think just reading more and practising continuing education is all it takes to build our minds. Who would have thought that getting physically fit could have such far reaching effects. BDNF, one of the 100 chemicals working muscles release, encourages new learning or neuroplasticity. We need excellent synaptic connections to think outside of the box and be creative when our lives are disrupted by crisis.

Of course, there’s counselling and cognitive behavioral therapy (CBT). Sports scientists have shown a session of resistance training – yes, the type of training that gives you Jennifer Aniston shoulders – also has the ability to improve your emotional state. Maybe you are upset. Perhaps the online application for COVID-19 financial support was supposed to be deposited today and it didn’t arrive. You had a disagreement with a family member and now you cannot fall asleep. Progressive muscle relaxation and nasal breathing can help you quiet your overactive sympathetic nervous system get you to sleep within a few minutes.2

Regular exercise habits have powerful antidepressant ability. In the American College of Sports Medicine Journal February 2012, they found an inverse relationship between physical activity and depressive symptoms. Whenever we have prolonged sympathetic nervous system activation it is fatiguing and leads to a feeling of helplessness. If poor sleep quality goes on long enough it supports depression. It is one of the most destructive and disabling mental disorders and is mentioned as one of the highest causes of disability in the western world. Sieverdes researchers and associates showed that even moderate exercise intensity is effective for supporting emotional health. You do not have to run a marathon to get fit and enjoy the mental health benefits.

Can your cardiovascular system weather a crisis? Heart disease is still the biggest killer with a person suffering a heart attack every 35 seconds in North America. An Iowa state study of 55,137 middle-aged runners in 2014 showed that running at any speed as low as 7 minutes a day could reduce the likelihood for a heart attack by 47 percent.

Pedersen BK et al at the Centre of Inflammation and Metabolism in Denmark showed muscle – yes, muscle – is the largest organ in the body and when it flexes and contracts at regular intervals, they release 100 MYOKINES into the circulation, telling every organ, every tissue that we are alive and well. IL4/IL10 and manganese superoxide dismutase are powerful anti-inflammatory and harmonizing agents that promote balance and bring the body back to homeostasis.3

How much exercise do we need? It could be a 60-minute Zoom video conference call with your dental team led by a local yoga instructor. If on your own, YouTube has numerous total body exercise videos where no equipment is needed.

The American Council on Exercise (ACE) recommends 2–3 days a week of total body strength training for muscle toning. Flexibility training should be done at least two days a week for 10 minutes, holding a static stretch for 20–30 seconds. Aerobic activities? There’s a new science of HIIT or interval training, but the gold standard was 30 minutes, 5 days a week. 4

Eat right
Food is woven into the fabric of life. We eat to celebrate – we have food at weddings, staff meetings, lunch and learns, romantic dinners. We feel better when we are sick if mom makes us our favourite meal. This human trait will never go away – food is social. One of the first things patients ask after an appointment is, “When can I eat?” Food is one of the most popular ways to comfort ourselves during emotional upset. Eating while upset or anxious has been proven scientifically not to be a good stress management strategy. You see, when we are in a fight or flight mode, all the systems of the body are geared towards keeping you alive. Anger, frustration and resentment ignite the sympathetic nervous system. The body wants you to live through the crisis. The primitive reptilian brain is activated; all the blood goes to your 600 muscles for running or fighting. Increased ability for the blood to clot and prevent bleeding to death. Bad news: immune function is put on hold as is digestion.

The last thing your body wants is a huge sandwich or for you to dig into a deep dish pizza. All the energy goes to the brain for thinking of the next tactical move. This is one of the reasons for indigestion and reflux with volatility and disagreements at the dinner table. This is one of the reasons the Mediterranean diet is so highly regarded. It’s not just the red wine and cheese, but the habit of eating in a relaxed manner, without TV, for nutrient absorption.

We like to eat ice cream to calm our nerves. Janet Tomiyama PhD in a UCLA study of 59 women saw those who ate fatty sugary comfort foods when stressed had a down regulated response to stress. Lukas Van Oudenhove, a psychiatrist from Belgium, noted the same short-term response when fat and sugar is present in the gut during stress exposure. From a physiological point of view, the body is able to modulate the amount of cortisol in the body. What’s wrong with stress eating? What is wrong with buying your favorite treats or goodies in bulk and then keeping them beside you when you are into your third hour of Netflix? The modulated cortisol is good as this master hormone is tempered and your body is brought back to homeostasis. But over the long term (weeks, months and years) our pancreas is not able to keep up with the gustatory deluge, elevated A1C levels happen, our arteries thicken and we gain weight. We have short-term benefits of feeling better, but long-term health disaster.

What’s the best thing to do? Choose an activity other than eating when you have a stressful event happen. For example: shutting off the incessant drama of 24-hour news and going for a short walk. Calling a supportive friend. Doing an online exercise class. The simple act of boiling water and adding fresh mint (aids digestion) or cinnamon sticks (helps manage blood sugar) and sipping it can be comforting and bring a mindfulness to consumption activities.

Slay Stress
Any time we are gripped with angst by challenges beyond our control, our autonomic nervous system is activated. The majority of our 40,000 thoughts a day go toward trying to make sense of the loose ends and the unknowns. Julia Enders MD, author of the book Gut, reports as long as we have a pressing problem to solve, the brain directs all its energy toward finding a solution.5 What gets left out? Digestion gets put on hold. Mastication, breakdown and absorption of nutrients through the body’s 26 feet of gastrointestinal tract takes a load of energy. Energy is better spent running from the perceived lion of a problem of paying your mortgage.

An article in the Journal of Occupational Environmental Medicine verified the intense cardiometabolic and psychological disturbances placed on first responders dealing with fight or flight events at work.6 It measured the physical breakdown that happens when the body mind is in constant activation – the chronic elevation of inflammatory chemicals, the suppression of the immune system and over time distress and feelings of helplessness. It showed that fit first responders had lower cortisol released and a lower heart rate response. This meant their systems weren’t thrown off as much as their unfit colleagues. Besides these physical benefits they perceived events as less threatening and were better able to harness a response. This is one of the reasons first responders are given access to excellent fitness facilities and healthcare for themselves. In conclusion: fit people perform better during crisis.

Mindfulness is another way to train the body. It is a learned skill and takes practice to do it automatically when our world is rocked by unknowns. Sitting still to relax and meditate is an effective stress management strategy. Herbert Bensen, cardiologist and founder of the Mind Body Medical Institute at Massachusetts General Hospital in Boston, had demonstrated circulating amounts of stress hormones decreases with relaxation exercises.

Walter Zimmerman, a very successful investor and host of a monthly webcast credits his accurate financial guidance in the volatile energy markets to his twice daily meditation practice. It strengthens parts of the brain needed for executive function and decision making, improves attention span and memory, restores psychomotor vigilance and increases emotional intelligence.

Sleep Well
Quality sleep is not just a pillar of the selfcare guide, it is the foundation. Mary O’Brien MD, in the Healing Power of Sleep, says it’s the unsung hero of most people’s get-healthy plan.7 We simply assume we are getting what we need. We never fully realize how we sabotage our body’s ability to heal, grow and recover from simply being awake. Neuroscientist Matthew Walked PhD, author of Why We Sleep, says wakefulness is low-level brain damage as this incredibly dynamic organ longs for slumber to process emotion, solidify memory and purge itself of toxins. Rapid eye movement (REM) sleep is not just about dreaming of your special someone, but has been shown by sleep scientists and gastroenterologists like Emeran Mayer MD to help soften the rough edges of your day as the brain does a systematic review.

When our schedules are thrown out of whack and we are in the middle of any kind of crisis, this oxygen hog of an organ makes even more exhaust. Facing challenges all day, putting out family fires, taking hours of virtual online CE or chatting with family members in other countries all promote the need for pruning and neural cleansing at nighttime. The brain hates unfinished business. It needs a nightly reboot and recovery. One of the ways it does this is with the glymphatic system. This highly specialized system flushes cerebral spinal fluid between all the neurons, cleansing and purging free radicals and toxins from the hardworking brain. This process goes on by day, but while we sleep it is turned up 10 to 20 times the daytime rate. And people who don’t sleep well do not tap into the rejuvenating or cleansing effects of this physiological sewer system.

With heightened anxiety and the Hypothalamic-Pituitary-Adrenal (HPA) system firing without a break, the body mind is almost too tired for sleep by evening time. High levels of cortisol are incompatible with the pineal gland releasing melatonin. Blasting through a commonly held sleep myth, that melatonin doesn’t help you get to sleep it helps you stay asleep. And without its nightly peak, sleep does not hold its usual immune system strengthening power. This is why shift work is called the “graveyard” shift because it slowly, but surely, damages the worker.

Learning good sleep hygiene practices is imperative. Not just for ordinary, everyday living, but especially during a global crisis or personal emotional storm. Here are a few sleep hygiene strategies:

  • A cool, dark bedroom facilitates deep sleep.
  • Little or no food before bed helps to focus the body’s energy on healing and recovery, not digestion.
  • Have little or no screen time with the hours before bed so the blue light of your laptop doesn’t interfere with the pineal gland pumping out melatonin.
  • Do relaxing activities before bed vs doing your taxes or paying bills.
  • Complete intense exercises or activities earlier in the night so the heightened hormonal cascade of CrossFit or other intense exercise practices are done away from slumber.
  • Have little or no fluids before bed so you are not up all night in the bathroom. This interrupts deep sleep cycles and, over time, wears the body down as much as, or more than, daytime stress damage.

Keeping a regular sleep schedule is even more important with age. Many people think just as older people are known to sleep less it does not mean they don’t need as much as younger people. The research shows the older people need just as much as their younger counterparts – and with their poor sleep efficiency it leads to poor wound healing, weakening immune function, ill repair of joints, cognitive decline and accelerated aging.

Look beyond the quick fix of alcohol or over-the-counter sleep aids, or just barreling through tough times. You can see there are some easy go- to tools for us to process emotion and replenish our physical bodies. By utilizing these selfcare strategies, you will not only survive, but thrive, during the storms of life.

References

  1. Ratey J. Spark:The Revolutionary New Science of Exercise and the Brain © 2008 Little Brown & Company
  2. Walker M.  Why We Sleep © 2017 Scribner
  3. Pedersen BK et al. Muscles, exercise and obesity: skeletal muscles as a secretory organ. Nat Rev Endocrinology 2012; 8(8) 457-465
  4. American Council on Exercise ACE www.acefitness.org
  5. Enders J. GUT © 2014 Greystone Books
  6. Journal of Occupational Environmental Medicine 2010
  7. O’Brien M The Healing Power of Sleep © 2009 Biomed

About the Authors

Uche Odiatu, DMD is a Toronto area dentist and a professional member of the American College of Sports Medicine and lectures throughout North America on total patient health. Follow him on Instagram @Fitspeakers

 

 

Mahsa Bakhshandeh, RDH graduated from Durham College and has been in private practice for ten years. She enjoys travelling and exploring the world, its many cultures & their variety of wonderful cuisines. Mahsa is a licenced Zumba Instructor and a certified meditation workshop facilitator. Follow her on Instagram @tooth_boss


Please click here to see more articles from the 2020 May issue of Oral Hygiene!