Go paleo: Dental caveman ergonomics

Don't lose heart that your evolutionary DNA did not consult with modern dentists when solidifying your physical structure.

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When you hear the word "paleo," what comes to mind? Probably not ergonomics and probably not dentistry. Most likely you think about diet, CrossFit, gluten-free and dairy-free diets, and consuming lots of meat. Well, I'm not going to discuss food (lovers of pasta, bread, and ice cream, you can keep reading without guilt), but I am going to ask, "What can we learn from our Paleolithic ancestors in terms of ergonomics? What can we gain by referencing the ancestral model when sorting through options to counter musculoskeletal ailments or poor fitness as a consequence of the modern dental work life?"

So let's take a look, and let me take you on a journey that begins 10,000 years ago. At that time, humans subsisted of a culture of hunter-gatherers; we hunted, ran, jumped, and climbed for survival. We were being chased by wild boars and hunting woolly mammoths. We were walking everywhere and those who could not walk (e.g., young children), we carried in our arms. Unfortunately, dentistry probably looked more like the extraction scene from Cast Away in which Tom Hanks, delirious with a toothache, uses a large rock and ice-skate blade to treat his dental pain. Substitute a stone blade for the ice skate, and voilà!

We all have feelings of gratitude, thankfulness, and appreciation that dentistry has advanced. We are truly indebted to science for these changes. I'm not sure about you, but if my dental workday was anything similar to the Cast Away scene, I would just stick to gathering twigs and berries. However, what has not changed significantly since that Paleolithic time is our DNA and our physical structure.

For our Paleolithic ancestors, life was based on survival, and survival was irrefutably linked to physical movement-capturing and gathering our food, getting out of the way of predators, procreating, and caring for and carrying our young. And I really mean carrying our young, as there were no strollers, or kid carriers, or baby joggers. Our genes were selected on how well we could handle vigorous physical work and our bodies survived and thrived on how well we moved. In present day, this type of full-body, varied, and consistent movement is not needed for survival. Our survival and success have different criteria.1,2

So what happens when you put our structure in a specialized, sedentary environment so different than our ancient heritage? What happens when you put our current body in a dental office, when our overall movement is so little in comparison, when our walking consists of moving several feet from operatory to operatory and then sitting down, when our arm motions are mainly in the horizontal plane and hardly ever overhead, and when our lifting mostly consists of maneuvering tiny hand instruments? Then consider doing these same movements eight hours a day for 30 or more years? This hardly constitutes a life of vigorous physical labor. Doesn't it seem logical that many of our aches and pains we develop could stem from this sedentary, repetitive environment? You bet!

Reverting to a full-on Paleolithic lifestyle to combat this conundrum would be ludicrous. Our survival, our success in dentistry and in our modern life, is mostly based on how well we do these sedentary movements and how efficiently we navigate our tech-infused environment. We've got to gracefully merge the dichotomy or, put another way, put some "paleo" into our practice.

In this three-part series titled "Dental caveman ergonomics," I'm going to discuss how we can model some of our native activity patterns in a practical, achievable manner. We are going to tackle some of the "ailments of captivity" that dental professionals suffer and the techniques, technology, and equipment we can use to combat them. In this series, we will cover:

• Sitting: What is the perfect position? Is sitting really the "new smoking," and why is it so lethal?

• Eyes and ears: What are sight cross-training and noise pollution? What can we gain from nature to protect our eyes and ears?

• Attire: Could your dental workday fashion be affecting your health?

As a primer, before we dive into the "meat" of our series, I want to give you a five-item challenge plan to begin merging some "paleo into your practice."

Our genes were selected on how well we could handle vigorous physical work and our bodies basically survived and thrived on how well we moved.

1. Stand up:

Get yourself a stand-up desk or a workstation that can be converted to a sit-stand station. The products available now are numerous. I like the ones from Ergotron; my office computer setup is from Ergotron and is wall-mounted and height- adjustable with articulating arms. The easy way I get more stand-up time is that I eat my lunch standing up and do all my patient notes and computer work standing. I even wrote this article without using a chair! Check out products from Varidesk, Ergotron, Ergohuman, and Focal Upright to get some ideas on some standing or sit-stand stations that may be right for you.

2. Hanging:

Hanging releases back tension and helps postural alignment and grip strength, not to mention that our shoulder joint is constructed for brachiating (a fancy term for swinging via our arms and locomotion). Try hanging with arms overhead from a chin-up bar, with full or partial weight. You can watch me demonstrate this at bit.ly/2clFPvJ.

3. Stretch breaks:

Always use your "toothbrush time" to stretch. Two minutes twice a day adds up to over 24 hours of stretching in a year. That's a lot of moving your body without having to go to a gym. If you brush three times a day, then that number adds up to 36 hours. One of my all-time favorite toothbrush stretches is the calf stretch. Stretching and brushing is a legit twofer-for teeth and body!

4. Walking:

There are countless ways to add more into your day. You can start with parking as far from the office as you can. Let your team members have the closest spots! You can walk on your lunch break (after you finish your lunch standing up, of course) and while you talk on the phone. I do all my conference calls walking, outside if possible. If I can't be outside, I pace in my office.

5. Quiet time:

Let the brain rest and rejuvenate with minimal stimuli. Find a mindfulness practice to help relieve stress, worry, and lack of focus. I use yoga-inspired stretching for my mindfulness practice as well as guided meditation with the app Headspace, which is one of the best learning tools I've found for the beginning meditator.

So get going! Don't lose heart that our evolutionary DNA did not consult with modern dentists (or the modern world, for that matter) when solidifying our physical structure. With a little awareness, we can all add some practical "hunting and gathering" into our workday to make our health and career more vivacious and long-lasting.


Desirée Walker, DDS, is a general dentist and owner of Lumber River Dental, in Lumberton, North Carolina. She graduated from the University of North Carolina at Chapel Hill School of Dentistry in 2008. Outside of her practice and training for her next debut on American Ninja Warrior, she does yoga and gymnastics outdoors with her two cats, Lu and Jones. She can be contacted at drwalker@lumbertondental.com.

References

1. Bowman K. Move your DNA: Restore Your Health Through Natural Movement. Sequim, Washington: Propriometrics Press; 2014.

2. O'Keefe JH, Vogel R, Lavie CJ, Cordain L. Achieving hunter-gatherer fitness in the 21st century: back to the future. Am J Med. 2010;123(12):1082-1086.

Additional Reading

• Bowman K. Don't Just Sit There: Transitioning to a Standing and Dynamic Workstation for Whole-Body Health. Sequim, Washington: Propriometrics Press; 2015.

• Gokhale E, Adams S. 8 Steps to a Pain-Free Back: Natural Posture Solutions for Pain in the Back, Neck, Shoulder, Hip, Knee, and Foot. Pendo Press; 2008.

• O'Keefe JH, Vogel R, Lavie CJ, Cordain L. Exercise like a hunter-gatherer: a prescription for organic physical fitness. Prog Cardiovasc Dis. 2001;53(6):471-479. doi: 10.1016/j.pcad.2011.03.009.

• Vlahos J. Is sitting a lethal activity? New York Times Magazine website. http://nyti.ms/18HoUfZ. Published April 14, 2011. Accessed July 31, 2016.

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