Why do some patients heal faster than others? Why do some continue to experience gingivitis even though they floss and brush daily? What is it about shift workers that make them more challenging to treat?
Patients spend 2-4 hours of the year in our dental offices. Dental professionals need to know those patients spend 8,595 hours outside of our dental offices. It’s during this time lifestyle habits influence how they respond to dental treatments. Four habits in particular adversely effect how they respond to our treatments.
Poor sleepers make poor healers
“Sleep is one of the most vital but incompletely understood human functions” – Mary O’Brien MD, board certified internal medicine & author of The Healing Power of Sleep.
There is a lot of misinformation and unfounded beliefs about this important part of our day. and Many people look down on people who like their sleep or who need more than eight hours. There is a certain bravado or machismo “who needs to sleep? I will sleep when I am dead.” However, little do these same people know many of the body’s repair and maintenance processes occur during deep sleep.
We don’t have a word for working yourself to death in North America. In Korea “death by overwork” is Kwarosa; in Japan Karoshi means “overwork death.” One thing German sleep researchers know for sure was that the immune system is basically on stand by during the day and doesn’t shift into high gear until sleeping. From patients recovering from surgery (implant placement, extractions, deep scaling, bone grafting, etc they all need an excellent immune response for a full recovery or response to surgery. The fact that 66% of Americans have problems with sleep quality and quantity it would be prudent to have a discussion with patients before a procedure.
Stress and healing
Chronic stress is deadly
No one will argue about the heightened demands of living in our busy western world. The challenge with our overworked, over-stimulated patients is the overactivation of the sympathetic nervous system. When the body is under fight or flight commands, all systems focus on the current events – key takeway for the dentist or hygienist who want an optimal healing response – long term healing is put on hold.
Gastroenterologist Emeran Meyer MD reports that chronic stress and the compensatory comfort foods that accompany this lifestyle – it supports chronically elevated inflammatory condition. This is the key connection between stress and poor wound healing. Periodontitis is initiated by plaque biofilm, but most of the destruction of tissue comes from an abnormal inflammatory response. What can the dental professional do? Acknowledge the role of stress in healing and provide some guidance to help manage the stresses in their lives: occlusal guards for clenching, better sleep habits and possibly recommending consultation with a life coach, counsellor or their family physician.
Repercussions of sedentary living
Sitting is the new smoking
Exercise scientists have demonstrated that a regular exercise habit represents a foundational element in the primary prevention of at least 35 chronic conditions. A big part of the health benefit of exercise is its ability to lower inflammation in the body. The body’s 600 muscles, 206 bones and 360 joints when working full out release 100’s of chemical messengers. IL4 and IL10 and TGF beta help lower inflammation. Exercisers also have increases in antioxidants (GSH) which also support a healthy immune system.
The latest information on the human microbiome shows that regular exercise prevents gut barrier dysfunction. 70 percent of the body’s immune cells are located in the GI tract; gut barrier permeability issues are associated with a chronically elevated inflammatory state. Only 10 percent of people in North American participate in a regular exercise program, so 90 percent of people don’t have access to the anti-inflammatory benefits. The dental professional would be prudent in asking about physical activity habits and to share with patients about the immune system benefits of active living.
Poor eating habits
“All disease begins in the gut” – Hippocrates 300BC
There’s irrefutable scientific evidence that the macronutrients and micronutrients in food have the ability to ramp up inflammation or dial it back down. Our patients eat three to five times a day, or 1095 to 1800 opportunities, to douse or boost the flames of inflammation. This appears promising until one looks at some of poor eating patterns:
1. 70% of people don’t eat a single piece of fruit daily.
2. Only 5% of adults eat the recommended five to nine servings of fruit and vegetables daily
3. One in three people eat junk food daily.
4. One in five meals are eaten in the car. Just 20 teaspoons of sugar consumed daily adds up to a whopping 65 pounds sugar in a year.
When we overfeed our cells, we overload our Kreb’s cycle. This leads to the formation of free radicals, oxidative stress and a chronically elevated inflammatory status. Inflammation and weight gain are destructive partners.
Research quoted in Obesity Journal 2010 and Oral Health revealed that a heightened fat mass in the body spews out more than ten destructive chemical messengers. Chronic background inflammation supports and fans the flames of diseases of modern life from gingivitis, periodontitis, heart disease, arthritis, diabetes and more. Dentists and hygienists, because of our nutrition training in college, are within their scope of practice to share with patients basic nutritional guidelines and the value of taking control of their diets in a way that supports oral and overall health
These are exciting times in dentistry as we are the health care professionals that care for the masticatory apparatus. The mouth is the gateway to the body, but the relationship is bidirectional. We need to be able to chew food well and start the process toward each morsel of food becoming a part of our body. Occlusal stability, healthy periodontal tissues, solid teeth and freedom of pain supports adequate digestion.
Now you aware of four key patients’ lifestyle habits that directly and indirectly the health of our oral tissues, and therefore, our treatment outcomes.