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THE ‘PERFECT’

Sustaining Our Practice, Our Patients and Our Lives

Today’s Woman vs. Yesterday’s Woman

Often caught between 2 generations

Working full time both in office and at home

Responsibility as a financial contributor or doing it all on our own

Own health taking a back seat o 82% of people said they would be more active and 63% say

they would eat healthier if they could o Time is the major obstacle

I’m Every Woman “Whatever you want, Whatever you need, Anything you want done, baby, I'll do it naturally 'Cause I'm every woman It's all in me. It's all in me!”

The 21st Century Stress Syndrome: Adrenal Fatigue

How can I tell if my adrenals are fatigued?

• You feel tired for no reason • You have trouble getting up in the morning , even after a good night’s

sleep • You are feeling run down or overwhelmed • You have difficulty bouncing back from illness or stress and seem to

get frequent respiratory illnesses or flu • Often lightheaded when rising from a supine position • Memory loss • You need stimulants ½ way through the day to keep going • You experience diminished sex drive • You gain weight for no particular reason and find it more difficult to

lose • You crave salty, fatty and high protein food such as meat and cheese • You feel more awake and alert after 6 pm, than any other time of the

day Adrenal Fatigue vs. Adrenal Insufficiency:

Adrenal fatigue is a collection of signs and symptoms, known as a syndrome that results when the adrenal glands function below the necessary level.

Many stressors that can lead to AFS Anger/emotional upset/life crisis, chronic fatigue, chronic illness/infection,

chronic pain, depression, gluten intolerance, low BP, surgery, sleep deprivation, excessive sugar/caffeine/stimulants in diet, excessive exercise

Adrenal insufficiency is an endocrine or hormonal disorder than is the result of impaired adrenal gland function also referred to as Addison’s disease

Presented by: Jo-Anne Jones, President, RDH Connection 2018 Dentistry Today CE Leader Email: jjones@jo-annejones.com

Lecture Outline:

We have been sold a bill of goods encouraging women to be all things to all people maintaining the perfect ‘10’ persona and image. We are called to be the ultimate business woman sharing the responsibility of contributing to and managing the family income often sandwiched between raising children and caring for aging parents; the equivalency of 2 full time jobs. This is all accomplished while maintaining composure and grace chairside then morphing into a sex goddess at night! The Perfect ‘10’ will explore the signs of burnout and recognize the pathway to prevention. Life isn’t about surviving the storm. It’s about dancing in the rain.

Learning Objectives:

To identify the signs of burnout and recognize the pathway to prevention Understand the contribution of healthy habits to our oral health, overall health, and well being To educate and promote health promotion strategies that apply to our dental hygiene patients Analyze through self-evaluation the areas that create and sustain balance in our busy personal and professional lives

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References: Whitney Houston’s “I’m Every Woman” recorded in 1993. Take the Online DISC Personality Profile Test: https://www.123test.com/disc-personality-test/ Take the Adrenal Fatigue Quiz http://adrenalfatigue.org/take-the-adrenal-fatigue-questionnaire/

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What Are The Signs of Burnout? Take the Questionnaire…

Rate each question on a scale from 0 to 5; 0 being least like you and 5 being most like you 1. Do you tire more easily? _____ 2. Do you feel run down and drained of physical and emotional energy? _____

3. Are people commenting on how tired you look lately? _____

4. Do you seem to be working harder yet accomplishing less? _____

5. Are you becoming increasingly more cynical about life? _____

6. Do you often experience unexplained sadness? _____

7. Are you becoming more forgetful lately? _____

8. Have you become more irritable? _____

9. Are you more short tempered? _____

10. Are you easily irritated by small problems, or by co-workers and team? _____

11. Are you seeing close friends and family less frequently? ____

12. Are you feeling too busy to do routine things like call a _____ friend, send a card…? 13. Are you experiencing increased physical complaints such as

headaches, lingering colds, aches, and pains? _____ 14. Do you feel that you do not have the time to do many of the things that are important to doing a good quality job. _____ 15. Are you feeling less sympathetic towards others and Increasingly more annoyed? _____

16. Do you find yourself laughing less and less? _____ 17. Does sex seem like more trouble than its worth? _____

18. Do you feel less talkative in social situations? _____ YOUR TOTAL SCORE: _____ 0-30: You are doing fine. 31-50: Your stress is starting to show. 51-70: You are a candidate for burnout. 71-90: YOU ARE BURNING OUT.

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References: https://www.niddk.nih.gov/health-information/health-topics/endocrine/adrenal-insufficiency-addisons-disease/Pages/fact-sheet.aspx Betterle C, Morlin L. Autoimmune Addison’s disease. In: Ghizzoni L, Cappa M, Chrousos G, Loche S, Maghnie M, eds. Pediatric Adrenal Diseases. Endocrine Development. Vol. 20. Padova, Italy: Karger Publishers; 2011: 161–172 Neary N, Nieman L. Adrenal insufficiency: etiology, diagnosis and treatment. Current Opinion in Endocrinology, Diabetes and Obesity. 2010;(3):217–223. Burnout Questionnaires: https://adrenalfatigue.org/burnout-questionnaire/ Adapted from “Symptoms of Burnout” (Freudenberger, H. Burnout. P18; Bantum, NY, NY; 1981). Copywright- 1999 Dr. James L. Wilson https://www.mindtools.com/pages/article/newTCS_08.htm

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The Perfect ‘10’: Health Promotion Strategies for Sustaining our Practice, our Patients and our Lives 1. Maintain a healthy blood pressure

2. Know the subtle signs of heart disease for women

3. Reduce inflammation and stop premature aging!

4. Start with breakfast

5. Exercise

6. Hydrate!

7. Maintain pH balance

8. Get better sleep

9. Decompress and Disconnect

10. Cultivate Work/Life Balance

1. Maintain a Healthy Blood Pressure

Is it mandatory to take my patient’s blood pressure?

Important to have a baseline as part of initial assessment Requirement of blood pressure to be taken when medical history indicates a need Ensure patient is not being placed at risk before initiating dental hygiene treatment If patient’s history is clear, a dental hygienist is encouraged to take a baseline assessment; prudent and proactive to periodically monitor as often asymptomatic (referred to as the ‘siletnt killer’)

Dental Professional Update: Blood Pressure Guidelines Changed!

December 19, 2017.

In November 2017, the American Heart Association (AHA) and American College of Cardiology (ACC) released a new clinical practice guideline on hypertension. In December 2017, the American Dental Association (ADA) reported the AHA and ACC updates. The guidelines, in a nutshell, state that normal blood pressure is under 120/80 mm Hg. Previously, normal was under 140/90 mm Hg. The categories of prehypertension, hypertension stage 1, and hypertension stage 2 have also changed.

What does this mean to our clinical practice?

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References: https://www.cdc.gov/bloodpressure/infographic.htm https://www.cdc.gov/bloodpressure/facts.htm American Heart Association www.heart.org Heart and Stroke Risk Test: http://www.heartandstroke.ca/get-healthy/health-etools Myles IA. Fast food fever: reviewing the impacts of the Western diet on immunity. Nutr J 2014 Jun 17;13:61 The Autoimmune Paleo Cookbook and Action Plan. Trescott, Mickey. The Autoimmune Paleo Cookbook.

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2. Know the subtle signs of heart disease for women

The Disturbing Subtle Signs:

1 month prior to experiencing a heart attack, many women report subtle signs;

• 70% experienced fatigue • 48% experienced sleep disturbances • 42% experienced problem breathing

As with men, women’s most common symptom is chest pain or discomfort. Women less likely to experience other common symptoms such as shortness of breath, nausea, vomiting, back or jaw pain More likely to report severe heartburn in upper abdomen or pain in breast

“Even though heart disease is the No. 1 killer of women, women often chalk up the symptoms to less life-threatening conditions like acid reflux, the flu or aging. They do this because they are scared and because they put their families first. There are still many women who are shocked that they could be having a heart attack.” Dr. Nieca Goldberg,

Women’s Health, NYU

Manage your risk of heart disease and stroke: Small changes will add years to your life! Take the heart and stroke risk assessment test; http://www.heartandstroke.ca/get-healthy/health-etools Details will be mailed to you along with a lifespan prediction based on lifestyle factors 3. Reduce Inflammation and Stop Premature Aging! Inflammation: Its’ Deadly Role in Today’s Diseases Relevance to Clinical Practice:

“Research has shown that periodontal disease is associated with several other diseases. For a long time it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions. «

Is Your Practice Compliant with Current Guidelines for Non-Surgical

Treatment of Chronic Periodontitis?

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References: Time Magazine Article: The Secret Killer http://www.inflammationresearchfoundation.org/inflammation-science/inflammation-details/time-cellular-inflammation-article/ www.perio.org/consumer/other-diseases Smiley CJ, Tracy SL, Abt E, et al. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. JADA 2015; 146(7):525-535. Periostat information - http://oralscience.com/en/products/periostat/ The Least Important Thing We Did Today Was Clean Your Teeth – Dr. Tim Donley

https://www.cincinnatidental.org/files/DonleyHandout.pdf

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FOOD IS NOT NEUTRAL; IT EITHER HAS THE POWER TO HARM OR THE

POWER TO HEAL

The Anti-Inflammatory Diet:

Perfect 10: Superfoods

1. Anti-Inflammatory Super Foods

Examples include however are not limited to;

Turmeric, ginger, green leafy vegetables, bok choy, beets, broccoli, blueberries, kale, red grapefruit, pineapple, salmon, walnuts, bone broth, coconut oil, chia seeds, flax seeds etc. Rich hues protect against oxidation by the sun;

Rich in beta-carotene

Essential for eye, skin and immune health as well as protecting from free radical damage

May lower our risk of certain cancers and CVD 4. Start With a Healthy Breakfast The ultimate easy protein smoothie to start your day! 1 scoop New Zealand Whey (26 grams), or Vega Protein (15 - 20 grams) 1 cup Greens – tons of spinach, (kale) ½ cup Fruit – smaller amounts of berries (blueberries, blackberries) 1 tsp. Omega 3 – Udo’s oil, flaxseed oil etc. 1 tsp. Hemp hearts, chia seeds Coconut or almond milk, kefir Sprinkle ginger, kelp, turmeric… Nutrient Boosts to Your Smoothie: Nuts – almonds, cashews, walnuts Super Chargers – goji/acai berries Seeds – chia, flax, hemp, pumpkin, sesame, sunflower Xylitol – Dental Superfood Nature’s weapon again most powerful cariogenic bacteria; Strep mutans Low glycemic index of 7; insulin control and hormone balance Salivary stimulant; 5 carbon polyol Therapeutic dosage; 3 – 8 grams/day taken at minimum twice daily Be aware of OTC options Ideal for xerostomic conditions related to meds, autoimmune disorders such as Sjogren’s, physiological aging, caries susceptible, CPAP, diabetics, etc.

Quick Superfood Recipes

Healthy Quick Salad Dressings: Basic Oil/Vinegar (Keeps 4-5 days in fridge) 2 tbsp. lemon juice ½ cup extra virgin olive oil ¼ cup red wine vinegar ¼ cup Udo’s or flax oil 1 clove garlic, chopped 1 tsp. Herbamare

Lemon Dressing (store in sealed container up to 2 weeks) 1 cup extra-virgin olive oil ½ cup freshly squeezed lemon juice ¼ cup honey 2 tbsp. apple cider vinegar 1 tsp. chopped fresh basil Pinch of sea salt * Autoimmune Paleo Cookbook & Action Plan: A Practical Guide to Easing Your Autoimmune Disease Symptoms with Nourishing Food

Kale Chips: 1 bunch kale 1 tbsp. olive Oil (EVO) 1 tsp. sea salt/cracked pepper/seasoning 350º oven; cookie sheet lined with parchment paper. Cut into bite size pieces, wash and spin with salad spinner, drizzle with oil, sprinkle seasoning. Bake 10 – 15 minutes until edges begin to brown Great for those of us who CRAVE salt! Green Goddess ½ granny smith apple 1 cup packed chopped kale ¼ cup parsley 1 banana 1 cup coconut water 237 calories of a super-charged vitamin boost Basic Berry ½ cup frozen/fresh black/blue/raspberries 1 cup almond or coconut milk 1 tbsp. Udo’s oil 1 scoop Whey protein powder Option: add kale, spinach etc. as we should aim for 4-5 cups of vegies per day. Detox Smoothie 2 cucumbers 3 stalks celery 1 cup packed chopped kale 1 lemon peeled Ginger 1 cup cilantro 175 calories, boost of anti-inflammatory and antibacterial properties

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Too Rushed to Pack a Lunch in the Morning?

5. Exercise: Getting the Most in Limited Time First of all, setting SMART Goals; Specific, Measurable, Attainable, Relevant and Time-Based

HIIT (High Intensity Interval Training) What is it? HIIT or High Intensity Interval Training is a technique where you give 100% effort through quick, intense bursts of exercise, followed by short recovery periods Historically it was believe that a long, steady paced cardio workout was superior for fat loss. At higher intensities you burn more fat in less time. Athletes have used interval training to build fitness level and muscle strength for many years combining high-intensity bursts of speed with recovery phases 10, 20 and 30 minute HIIT programs available on apps etc. that will burn major calories

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References:

http://www.dentistry.co.uk/2016/10/24/hiit-benefits-to-the-dental-professional/ http://www.livestrong.com/article/1011944-quick-hiit-workout-fire-up-metabolism/?utm_source=newsletter&utm_medium=email&utm_campaign=1201_thurs_curated_f Satcher D. Introduction. In: Seguin RA, Epping JN, Buchner DM, et al. Growing Stronger: Strength Training for Older Adults. Boston, MA and Atlanta, GA: Tufts University Nutrition and the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2002. www.cdc.gov/nccdphp/dnpa/physical/growing_stronger/growing_stronger.pdf Seguin RA, Epping JN, Buchner DM, Growing Stronger: Strength Training for Older Adults. Boston, MA and Atlanta, GA: Tufts University Nutrition and the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2002 - See more at: https://www.uspharmacist.com/article/sarcopenia-loss-of-muscle-mass-in-older-adults#sthash.v4YIcbr0.dpuf

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References:

http://www.health.com/health/article/0,,204

10520,00.html

Viuda-Martos M, Sanchez-Zapata E, Sayas-Barbera E et al. Tomato and Tomato Byproducts. Human Health Benefits of Lycopene and Its Application to Meat Products: A Review. Critical Reviews in Food Science and Nutrition. Vol 54, 2014 – Issue 8.

Heber D. Colorful cancer prevention: α-carotene, lycopene, and lung cancer. Am J Clin Nutr October 2000 vol. 72 no. 4 901-902. Cruz Bojorquez RM, Gonzalez GJ, Sanchez Collado P. Functional properties and health benefits of lycopene. Nutricion Hospitalaria. 2013;28:1.6302. http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/red-wine/art-20048281 Alcohol Intake Associated with Increased Risk of Melanoma. American Association for Cancer Research. News Release. Dec. 1, 2016.

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References: https://www.uspharmacist.com/article/sarcopenia-loss-of-muscle-mass-in-older-adults www.fitstar.com https://www.mayoclinic.org/healthy-lifestyle/womens-health/basics/womens-health/hlv-20049411 Miller MA, Cappuccio FP. Inflammation, Sleep, Obesity and Cardiovascular Disease. Curr Vasc Pharm, 2007, 5, 93-162. Centers for Disease Control and Prevention. Knutson KL, Ryden AM, Mander VA, Van Cauter E. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med 2006;166:1768–1764. Kasasbeh E, Chi DS, Krishnaswamy G. Inflammatory aspects of sleep apnea and their cardiovascular consequences. South Med J 2006;99:58–67. FaceApp: Free Neural Face Transformation Clean Eating Grocery List: http://www.thegraciouspantry.com/clean-eating-shopping-list/ www.goodnessme.ca/recipes www.livestrong.com/recipes 13 Healthy Mason Jar Meals www.livestrong.com www.graciouspantry.com

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Beginner HIIT Workout: 3 rounds, 20 second work, 10 seconds rest

1. Jab, cross, front (right), Jab, cross, front (left) 2. Standing kickback 3. Jumping jacks 4. Sumo squats

6. Hydrate 8 glasses of water a day?

7. Maintain pH Balance Today’s dietary choices are impacting oral health. Healthy saliva should measure no lower than pH of 6.5 Demineralization occurs below a pH of 5.5 Elderly patients or those with exposed dentin need to know that root demineralization can occur when pH levels fall to 6.0.

8. Get Better Sleep – Secret to an Ageless Life • Sleep is a fundamental requirement; changes in sleep reflected through

inflammatory mechanisms may be associated with an increased risk of CVD

• As chronic diseases have assumed an increasingly common role in premature death and illness, interest in the role of sleep health in the development and management of chronic diseases has grown.

• Notably, insufficient sleep has been linked to the development and management of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression.

10 Ways to a Better Sleep 1. Determine your obstacles. 2. Set a sleep schedule. 3. Create a bedtime routine. 4. Remove electronics from the bedroom. 5. Eat dinner earlier and skip the late night snack. 6. Pull the shades. 7. Avoid alcohol, caffeine and exercise before bedtime. 8. Get comfortable. 9. Stress less. 10. Calm and clear your mind. 9. Decompress and Disconnect Disconnect from social media, mobile devices and ‘look up’ Worry less, let go. “I’ve lived through some terrible things in my life, some of which actually happened.” Mark Twain

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References:

Miller MA, Cappuccio FP. Inflammation, Sleep, Obesity and Cardiovascular Disease. Curr Vasc Pharm, 2007, 5, 93-162. Centers for Disease Control and Prevention. Knutson KL, Ryden AM, Mander VA, Van Cauter E. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med 2006;166:1768–1764. Kasasbeh E, Chi DS, Krishnaswamy G. Inflammatory aspects of sleep apnea and their cardiovascular consequences. South Med J 2006;99:58–67. https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/how-many-hours-of-sleep-are-enough/faq-20057898

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10. Cultivate Work/Life Balance Circle true or false to the following statements;

1. I find myself bringing work issues home with me more than I used to.

T F

2. I often feel I don’t have any time for myself -- or for my family and

friends. T F

3. No matter what I do, it seems that often every minute of every day is

always scheduled for something. T F

4. Sometimes I feel as though I've lost sight of who I am and why I chose

this job/career. T F

5. I can’t remember the last time I was able to find the time to take a day

off to do something fun and just for me. T F

6. I feel stressed out most of the time. T F

7. I can’t remember the last time I had a vacation. T F

8. It sometimes feels as though I never even have a chance to

catch my breath before I have to move on to the next issue or crisis.

T F

9. I can’t remember the last time I read -- and finished -- a book that I was

reading purely for pleasure. T F

10. I wish I had more time for some outside interests and hobbies, but I

simply don’t. T F

11. I often feel exhausted -- even early in the week. T F

12. I can’t remember the last time I went to the movies or visited a

museum or attended some other cultural event. T F

13. I do what I do because so many people (children, partners, parents)

depend on me for support. T F

14. I’ve missed many of my family’s important events because of work-

related time pressures and responsibilities. T F

15. I feel like I’m always racing. T F

How Did You Do? Give yourself 1 point for each ‘true’ response. The higher the number, the more critical is may be for you to make some significant changes in your lifestyle. If you scored… 0 – 2: You have your life in pretty decent balance. Identify what is in your life that keeps the balance and strive to maintain it. 3 – 5: Changes need to be made however the good news is that you are now aware. 6 or higher: Your life is out of balance. Time to identify the causes and take action to regain control before it controls you. Take Time For You! If I may assist you with any further information regarding today’s presentation, please don’t hesitate to contact me at jjones@jo-annejones.com On a personal note, thank you for the privilege and honour of spending this time with you.

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Life is an opportunity, benefit from it.

Life is beauty, admire it.

Life is bliss, taste it.

Life is a dream, realize it.

Life is a challenge, meet it.

Life is a duty, complete it.

Life is a game, play it.

Life is a promise, fulfill it.

Life is sorrow, overcome it.

Life is a song, sing it.

Life is a struggle, accept it.

Life is a tragedy, confront it.

Life is an adventure, dare it.

Life is luck, make it.

Life is too precious, do not destroy it.

Life is life, fight for it.

~ Mother Teresa