What is the Best Kind of Toothbrush to Use?

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By Celeste Ouyoung, RDH | Dental Hygienist

Need help deciding on the toothbrush that is right for you? We’ve got you covered.

The best kind of toothbrush is one with a soft bristle. Using a soft bristled toothbrush is the safest and most comfortable toothbrush to use. It will minimize the risk of scratching and damaging the tooth surfaces and gums as opposed to a medium or hard bristled toothbrush. There are many toothbrush head design options available. Toothbrushes with multi-level bristles or angled bristles perform better than the traditional flat-level bristles in removing bacterial plaque. The varying sizes of bristles are useful for getting into hard-to-reach areas.

Both manual and powered toothbrushes can be used effectively in removing plaque. Some may find it easier to use a powered toothbrush if they have difficulty with a manual toothbrush, especially those with dexterity issues like the elderly, people with disabilities, or children.

You should change your toothbrush or toothbrush head to a new one every 3 months. Food debris and bacteria can get trapped in the bristles of the toothbrush over time. The bristles of the toothbrush will start to wear down or fray the longer it is used and can reduce effectiveness in removing plaque and food debris from teeth.

Look for toothbrushes with the ADA Seal of Acceptance logo on the package. A product with this seal indicates that it is safe and effective for removal of plaque and reduction of gingivitis. You can also search on the ADA website for products that are listed to ensure you are getting a product that is safe and effective: ADA Seal of Acceptance | American Dental Association

To learn more, visit our NOAH Dental page for helpful videos and tips. If you are ready for you or your child to see a NOAH dentist, schedule an appointment today!

Honoring Black History Month: Dr. Rebecca Lee Crumpler

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Rebecca Lee Crumpler became the first African American female to earn a medical degree in the United States.

Rebecca Lee Crumpler

Born in 1831 in the state of Delaware, Dr. Crumpler worked for 8 years as a nurse before pursuing a degree in medicine. She would then go on to graduate in 1863 from the New England Female Medical College, which later became the Boston University School of Medicine.

Dr. Crumpler practiced in Boston and then moved to Richmond, Virginia after the Civil War ended in 1865. Dr. Crumpler was able to practice with other African American physicians and caring for freed slaves who would otherwise have no access to medical care. She eventually moved back to Massachusetts and retired in the affluent neighborhood of Hyde Park. Where in 1883, she published a book, Book of Medical Discourses based on her journal notes in practice over the years that provided medical advice for women and children.

For more life-saving stories of Black history and healthcare in America, check out these posts:

Understanding the Tuskegee Study

The Lasting Impact of Henrietta Lacks

Enslaved Women and Modern Gynecology

Honoring Black History Month: Dr. Charles Richard Drew

Honoring Black History Month: Dr. Daniel Hale Williams

Honoring Black History Month: Dr. Kizzmekia Corbett

Honoring Black History Month: Dr. Alexa Irene Canady

Honoring Black History Month: Dr. James Durham

Honoring Black History Month: Dr. Rebecca Lee Crumpler

Honoring Black History Month: Dr. Louis T. Wright

Strategies to Live a Heart-Healthy Lifestyle

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By Brandon Bolton, RDN |Registered Dietitian

February is American Heart Month! A time to raise awareness and support for the fight against heart disease. Heart Month is a time when everyone can focus on their cardiovascular health. According to the American Heart Association, heart disease is the number one killer in the United States, and the leading cause of death worldwide.  There are many risk factors that can impact your chances of developing heart disease. The National Institutes of Health (NIH) states that preventing heart disease starts with knowing what your risk factors are and what you can do to lower them.  Some risk factors for heart disease include high blood pressure, high blood cholesterol, obesity, diabetes, smoking, lack of physical activity, and unhealthy eating behaviors. These risk factors can be managed or changed. Some risk factors that cannot be changed include age, sex, and family history of heart disease.

My advice:

Heart disease is often preventable when people make healthy lifestyle changes, including changes to your diet and activity level. Living a heart-healthy life involves understanding your risk factors and making positive choices to protect your heart and stay healthy. Here are some heart healthy nutrition and exercise tips:

  1. Choose heart-healthy foods and eat a diet that is balanced with whole grains, fruits and vegetables, and lean protein sources.
    • Try to have at least 50% of your grain intake come from whole grains such as 100% whole wheat bread, oatmeal, brown rice, and quinoa
    • Aim for 1-2 cups of fruit daily
    • Aim for 1-3 cups of vegetables daily
  • Choose fat-free or low-fat dairy products when having milk, cheese, or yogurt.
  • Eat protein rich foods
  • Lean meats such as 95% lean ground beef or pork tenderloin, skinless chicken or turkey (limit red meats to one time per week)
    • Fish such as salmon and tuna (try to eat fish as least once per week)
    • Eggs
    • Nuts, seeds, tofu, tempeh, edamame
    • Legumes such as beans, lentils, and chickpeas
  • Incorporate foods that are high in monounsaturated and polyunsaturated fats:
    • Olive oil or avocado oil
    • Fish and seafood
    • Nuts and seeds
    • Nut and seed butters
    • Avocados
  • Aim for 30 minutes of moderate physical activity 5 days per week!
    • There are many different types of helpful exercise, but here are the three types that can be most effective for heart health:
  • Aerobic Exercise
    • Walking, running, swimming, playing your favorite sport such as basketball or tennis

2. Resistance Training

  •    Working out with weights, resistance bands, or bodyweight exercises like pushups and pullups

3. Stretching, Flexibility, and Balance

  • Look up a stretching video online, or try yoga

Foods to limit:

  • Limit high sodium foods. Adults and children over the age of 14 should eat less than 2,300 mg of sodium daily.
    • Read food labels and choose foods that are lower in sodium. Look for low sodium, reduced sodium, or no salt added on the food label.
    • Try to choose fresh, whole foods whenever possible and try to avoid processed foods such as frozen meals.
    • Avoid the saltshaker and flavor foods with herbs and spices.
  • Limit saturated fats.
    • Saturated fat is usually found in animal-based proteins such as fatty beef, pork, and chicken skin.
    • It is also found in full-fat dairy products such as whole milk.
    • Butter, lard, coconut, and palm oils also contain saturated fats (replace with olive oil)
  • Avoid trans fats.
    • Trans fats can be found in stick margarine, shortening, processed sweets, baked goods, and some fried foods.
    • Avoid foods with “partially hydrogenated oil” on the ingredient list such as cookies, pastries, baked goods, biscuits, crackers, and frozen dinners.
  • Limit foods that are high in added sugars.
    • Sugar-sweetened drinks such as soda, fruit juice, sweetened coffees, and energy drinks
    • Sweets and desserts
  • Limit Alcohol

If you have any nutrition questions or need help developing a heart healthy diet plan, please reach out to one of the dietitians here at NOAH!

Easy Egg Substitutes That Won’t Cost You The Farm

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People can’t stop talking about the price and availability of eggs and we don’t blame them. 

According to a report from the U.S. Bureau of Labor Statistics, the average price for a dozen eggs increased by 59% last year and doesn’t show signs of coming down anytime soon.  

Luckily, if we’ve learned anything through supply shortages and rising costs in recent years, it’s how to let go of everyday staples and learn to get by with alternatives.  

Finding an alternative to eggs might be easier than you think.  

Aside from being fried, scrambled, poached, deviled, and chopped – a great source of flavor and protein – eggs are most often used as a recipe ingredient to help baked goods rise, thicken sauces and soups, bind dry ingredients together, and add moisture. 

Egg Alternatives – Replaces one egg in a traditional recipe.

Leavening (helps baked goods rise) 

  • ¼ cup of diet soda, seltzer, or carbonated water 
  • 2 tbsp. water, 1 tbsp. vegetable oil, and 2 tsp. baking powder 
  • 1 tsp. baking soda and 1 tbsp. vinegar 

Thickening 

  • 1 tbsp. plain gelatin dissolved in 1 tbsp. cold water, then add 2 tbsp. of boiling water 
  • ¼ cup mashed white or sweet potatoes 
  • 1 tbsp. ground flaxseeds (or chia seeds) and 3 tbsp. water 
  • 3 tbsp. aquafaba (liquid from canned/cooked beans) 

Binding and Moistening  

  • ½ cup bananas, mashed 
  • ¼ cup unsweetened applesauce (replaces eggs, butter, and oil in traditional baking recipes or box mixes) 
  • ¼ cup canned pumpkin or squash 
  • 2 tbsp. tomato paste 
  • ¼ cup soft tofu (pureed)  
  • ¼ cup plain yogurt 
  • 3 tbsp. creamy nut butter 
  • ¼ cup buttermilk 

Take inventory of which of these ingredients are floating around in your pantry or fridge, pair them up with savory or sweet recipes, and see how these egg alternatives measure up to the real thing. It might take some trial and error to find what flavor and texture works in your favorite recipes, but it sure beats the price of eggs. 

Keep in mind that while these substitutions for eggs might make a recipe turn out the same, the nutritional value may differ. Eggs are a great source of protein which is essential to your diet. If you have questions about creating or maintaining a balanced diet, schedule an appointment with one of NOAH’s registered dietitians today. 

Honoring Black History Month: Dr. James Durham

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By Lisa Nails | Patient Navigator

James Durham is noted as the first African American Physician to practice medicine in the United States.

James Durham

Born in 1762 and working most of his life as a slave, he was able to gain knowledge in the field of medicine from his slave owners who were doctors. One of his slave owners, Dr. Robert Dow, who became sort of a mentor to him, trained Dr. Durham as a physician and allowed him to treat and perform procedures on patients of different races under his supervision.

In 1783, Dr. Durham paid for his freedom from his work as a physician and was able to open his own independent practice, despite not obtaining a medical degree. In 1789, his practice is reported to have grossed $3000 annually. From there, he built a reputation for successfully treating patients with yellow fever and his work in diphtheria. Dr. Durham’s success would eventually catch the attention of Dr. Benjamin Rush in Philadelphia, who would later join his practice.

In 1801, Pennsylvania laws restricted anyone from practicing medicine without a formal degree. Dr. Durham continued to practice in secret until 1802, when he mysteriously disappeared. Although his whereabouts remain unknown, it is speculated that he was murdered because of his success as an African American man during that time.

For more life-saving stories of Black history and healthcare in America, check out these posts:

Understanding the Tuskegee Study

The Lasting Impact of Henrietta Lacks

Enslaved Women and Modern Gynecology

Honoring Black History Month: Dr. Charles Richard Drew

Honoring Black History Month: Dr. Daniel Hale Williams

Honoring Black History Month: Dr. Kizzmekia Corbett

Honoring Black History Month: Dr. Alexa Irene Canady

Honoring Black History Month: Dr. James Durham

Honoring Black History Month: Dr. Rebecca Lee Crumpler

Honoring Black History Month: Dr. Louis T. Wright

How to Maximize Your Appetite

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By Maggie Hensley, RD | Registered Dietitian

Appetites, like bodies, are complicated and can be affected by a huge variety of factors. It is inevitable that fluctuations in appetite will happen due to chronic medical conditions, illness, mental health issues, and certain medications. Even when we have little to no appetite, it’s crucial to give our body the energy and nourishment it requires. For short term episodes of poor appetite, here are a few creative tips you may want to check out.

Scent – A somewhat non-conventional way to increase appetite is through the nose. Often fragrant smells can remind our bodies that we haven’t eaten in a while. Popping some popcorn, baking some cookies, or even lighting some food scented candles can help.

Liquids – When low appetite makes it hard to even think about eating anything, liquids are usually the way to go. They are easier to consume, better tolerated, and feel less like we’re forcing ourselves to eat. An added bonus is that protein shakes or fruit smoothies are usually easy to prepare and can be taken on-the-go.

Downsize your meals – Smaller, more frequent meals work in a similar fashion. If you are feeling overwhelmed by the thought of a large meal, having 4-6 quick, easy to eat snacks (granola or protein bars, trail mix, a piece of fruit) can be a more realistic goal.

Enjoy a meal with someone – If possible, eat with others. We tend to eat more when we get together with friends or family.

Consume foods you enjoy – Focusing on preferred foods is another good short-term option. Eating a favorite food can be a good safety net until appetite returns to normal and more variety can be reintroduced. This can be especially helpful during times of grief, depression, and other high stress times. Eating something is always better than not eating at all.

Incorporate higher calorie options – If concerns about unintended weight loss arise, focus on incorporating calories and protein into meals/snacks that are already consumed.  For example, cook with butter, use whole milk instead of skim, or add some unflavored protein powder to soups.

Listen to your body – Lastly, the two strategies that I recommend the most are eating consistently and reconnecting with our own hunger cues. Eating consistently helps our bodies feel safe (that we can be trusted to give it what it needs when it needs it) and keeps our metabolism stable. It is easier said than done as our hunger cues are often subtle. It is all too easy in our culture of busy schedules, social commitments, and lots of distractions to lose touch with the hints that we are hungry. This will usually lead to eating when we feel so hungry that we overeat.

If a low appetite persists for a long time, please check in with your NOAH provider. They can refer you to one of NOAH’s Registered Dietitians, the resident experts in nutrition science and who are conveniently located at all the NOAH clinics.  

How Can I Prevent Cavities?

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By Jane Roots, RDH | Dental Hygienist

“Brush and floss your teeth to avoid cavities.” Sound familiar? 

While we all know we’re supposed to brush and floss to keep our teeth healthy, cavities remain a common problem that we all have to contend with at one point or another, but there are some very important things we can do to prevent cavities from happening.

  • Brush with a Fluoride toothpaste after meals. Brushing regularly and properly with a soft brush gets rid of bacteria/plaque, especially after meals and before bedtime.
  • Flossing gets rid of food lodged between the teeth.
  • Visiting your dentist/hygienist regularly for a comprehensive exam and cleaning.
  • Rinse with mouthwash.
  • Drink plenty of water.
  • Avoid frequent snacking and drinks – cut back on acidic foods and beverages high in sugar.
  • Consider dental Sealants.
  • Consider a Fluoride treatment.
  • Eat healthy foods.
  • Quit smoking – this leads to gum disease, tooth loss and oral cancer.

According to Amy Nowinski of the UIC College of Dentistry, a comprehensive exam and discussion with your dentist/hygienist is the first step in taking control of your oral health. Your dentist/hygienist can inform you of your cavity risk levels, suggested treatment options, and any necessary changes you may need to make. Once you know your risk level, then you can take a more specific, effective approach to improving your oral health.

Honoring Black History Month: Dr. Alexa Irene Canady

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By Lisa Nails | Patient Navigator

Dr. Alexa Irene Canady, 67, is a pioneer in medicine as the first African American female Neurosurgeon in the United States in 1981.

Dr. Alexa Irene Canady

Born in 1950 in Lansing, Michigan to a father who was a dentist and mother who was an educator, Dr. Alexa Canady furthered her pursuit of knowledge and acquired a degree in Zoology in 1971 from the University of Michigan. After almost dropping out during her undergraduate studies, Dr. Canady eventually graduated Cum Laude from the College of Medicine at the University of Michigan, where she became fascinated with Neurosurgery. Although she was discouraged by advisors to stray from pursuing a career in the field, she continued on despite the odds.

Shattering expectations and breaking glass ceilings, Dr. Canady became the first African American female surgical intern at Yale New Haven Hospital in 1975 and would go on to complete her residency at the University of Minnesota in 1981.  Dr. Canady’s hard work eventually paid off, as she became the Chief of Neurosurgery at the Children’s Hospital of Michigan at the young age of 36.

Her research in children includes studies on the effects of hydrocephalus, a condition characterized by the excessive accumulation of fluid in the brain. Dr. Canady retired from medicine in 2012, yet continues to advocate for women in the field of medicine.

NOAH honors Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is to ensure quality healthcare for every member of our community. To do that, we will look at where we have been as a society, what we have accomplished, and how we will collectively achieve this goal.

For more life-saving stories of Black history and healthcare in America, check out these posts:

Understanding the Tuskegee Study

The Lasting Impact of Henrietta Lacks

Enslaved Women and Modern Gynecology

Honoring Black History Month: Dr. Charles Richard Drew

Honoring Black History Month: Dr. Daniel Hale Williams

Honoring Black History Month: Dr. Kizzmekia Corbett

Honoring Black History Month: Dr. Alexa Irene Canady

Honoring Black History Month: Dr. James Durham

Honoring Black History Month: Dr. Rebecca Lee Crumpler

Honoring Black History Month: Dr. Louis T. Wright

Is Your Child Feeling Sick? When is a Cold Not a Cold?

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By Dr. Patricia Avila | Pediatrician

It’s that time of year again! The cooler weather is among us, nights are getting longer, and families are even busier than usual as the holidays approach. It’s also the time of year when children start coming down with symptoms of colds or other respiratory illnesses. While most of these symptoms will turn out to be simple colds and resolve on their own, there are some related illnesses that can be more serious.

The Common Cold: Also Known as an Upper Respiratory Infection

The common cold is caused by several different viruses and is the most common of all the respiratory illnesses. On average, children under the age of two will have three to five colds per year. Children who are in daycare or school-aged children are likely to get sick even more often, because they are exposed to lots of other children on a daily basis. Fortunately, most of these illnesses are just colds and will go away on their own. 

Symptoms of the Common Cold

  • Low fever (101-102 degrees F).
  • Runny nose, nasal congestion, and/or sneezing
  • Sore throat
  • Cough
  • Lack of appetite
  • Fussiness

Symptoms can last up o 14 days but most children feel better within 7-10 days.

When to Worry with the Common Cold

While the majority of children will not need to be see a medical provider for the common cold, you should seek immediate assistance if your child:

  • Is an infant under 3 months old
  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Symptoms last longer than 10-14 days
  • Is dehydrated or not drinking or urinating well
  • Is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Treatment for the Common Cold

  • Antibiotics do not treat the common cold since it is caused by a virus
  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen
  • Nasal saline with suctioning for congestion
  • Honey for cough in a child OLDER than 1 year (NEVER give honey to a child under the age of 1)
  • Use of a humidifier may provide relief

The Flu: Also Called Influenza

The flu is also caused by respiratory viruses called influenza and can present very similar symptoms to the common cold.  However, children with the flu feel much worse and are sicker than with the flu than the common cold.  The flu can have very serious complications including need for hospitalization and sometimes death.   

Symptoms of the Flu

  • Rapid onset of high fever (above 101 degrees F)
  • Chills
  • Headache or other body aches
  • Runny nose, nasal congestion
  • Chest pain and cough
  • Sore throat
  • Poor appetite
  • Feeling tired and weak

Most children will get better after two weeks. Fevers from the flu can last up to seven days. 

When to Worry with the Flu

Flu symptoms can lead to serious complications that require immediate medical treatment. You should seek assistance if your child:

  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Is dehydrated or not drinking or urinating well
  • Is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Young children, infants, and children with high-risk medical conditions who are having flu symptoms should see their pediatrician as soon as possible. High-risk medical conditions may include:

  • Heart defects
  • Chronic lung issues
  • Asthma
  • Weakened immune system
  • Diabetes
  • Cancer

Treatment for the Flu

  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given honey to children under the age of 1)
  • Use of humidifier may provide relief

Outside of supportive care, there is an antiviral medication called Tamiflu which may be prescribed if the flu is diagnosed within the first 1-2 days of onset.

Bronchiolitis

Bronchiolitis is another respiratory illness that is common during the winter months.  There are several viruses that can cause this illness, but RSV, also known as Respiratory Syncytial Virus, is the most common.  RSV is an infection that will affect almost all children under the age of 2 at least once. It usually starts as a cold and within 3-5 days of the onset of the illness is followed by lower respiratory symptoms. For some children the illness can be severe, especially in younger infants, preemies, and those with heart or lung defects.   

Symptoms of Bronchiolitis

  • Cold symptoms with fever, runny nose, nasal congestion, and cough
  • Fussiness
  • Poor appetite
  • Wheezing
  • Difficulty breathing

When to Worry with Bronchiolitis

Bronchiolitis symptoms can lead to serious complications that require immediate medical treatment. You should seek assistance if your child:

  • Has trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath
  • Nails or lips turn blue
  • Is dehydrated or not drinking or urinating well.
  • Child is too sleepy or very fussy and not consolable
  • Has ear pain
  • Has any other symptoms or continues to get worse

Treatment for Bronchiolitis

  • Increased fluids
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given honey to children under the age of 1)
  • Use of humidifier may provide relief

For infants who are high risk there is an injection that is given monthly during the winter months called Synagis that can decrease the risk of severe RSV infection. 

Croup

Croup is another respiratory illness that is common during the fall and winter months and is usually seen in infants and children under 5. Croup is caused by several different viruses including the flu virus and some cold viruses.  The illness is characterized by swelling of the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from croup are usually worse at the beginning of the illness. 

Symptoms of Croup

  • Fever which can be low grade or high
  • Cold symptoms with runny nose and nasal congestion
  • Hoarseness of voice
  • “Barky” or “seal like” cough
  • Noisy breathing called stridor, a high-pitched, turbulent sound when a child inhales or exhales

When to Worry with Croup

The swelling of the airway can sometimes be severe and need immediate medical attention. You should seek assistance if your child:

  • Has trouble breathing – struggles to catch their breath
  • Has noisy breathing that is getting louder and child/infant appears to struggle to breathe
  • Cannot talk because of difficulty breathing
  • Nails or lips turn blue
  • Is drooling and not able to swallow saliva
  • Is dehydrated or not drinking or not urinating well
  • Is too sleepy or very fussy and not consolable

Treatment for Croup

Steroids can decrease the swelling and can be given by mouth, injection, or in a breathing treatment. If given early steroids can help decrease the need for hospitalization and improve breathing.  For severe cases, a breathing treatment with epinephrine may be administered, but this requires careful observation in the emergency department or hospital setting.

Use of cold moist air can help improve mild symptoms as well and can be used at home with a cool mist humidifier.

Tips to Keep Your Child Healthy and Well

  • For all respiratory infections, the best form of prevention is to avoid exposing infants or young children to large crowds or people who are sick.
  • Breastfeeding infants as long as possible (at least 6-12 months) is also an important way to help prevent and fight infections because breastmilk provides antibodies. 
  • Practicing and teaching children good hand hygiene is key.
  • Use soap and water and scrub for at least 20 seconds (sing the ABCs, Baby Shark, or another fun tune).  Another option is the use of an alcohol-based hand sanitizer if hands are not visibly soiled. 
  • Teach children to cover their coughs and sneezes properly by using a tissue or coughing in their arm rather their hands. 
  • Keep children home from daycare or school when they are sick to avoid spreading the illness. 
  • Eating a healthy balanced diet high in fruits and vegetables can help boost the immune system and decrease the chances of getting sick.   

If you have questions about these or other common childhood illnesses, talk to your NOAH provider. If at any time you’re not sure what to do, you can also call our Nurse Triage for immediate advice.