The review examined the
2007-2008 dental records of U.K. children, 211 of whom were Plymouth
five-year-olds. This number was just under the national average of 30.9
percent, but other regions were significantly worse.
The United States had similar
rates. Almost half of children ages 12 to 15 and about one in four American
children aged 2 to 5 is affected by tooth decay. Overall, it affects 4 million
children in the U.S. alone. Americans consumed an average of 23.8 pounds of
candy each in 2008, and with the
holiday season approaching, parents should be on the watch for cavities.
As Halloween approaches,
candy consumption is likely to skyrocket, but there are plenty of ways to
protect trick-or-treaters from tooth decay. Try these five tips to help reduce
the amount of sugar:
1. Choose reduced-sugar or sugar-free candies. Most stores carry equally tasty sugar-free or
reduced-sugar versions of Halloween favorites, including chocolate, peanut
butter cups and various filled or hard candies. These options won’t completely
eliminate the risk of tooth decay, but they can significantly cut sugar intake.
2. Give out unconventional goodies. When it comes to candy, sugar-free gum is your safest
bet. Candies that can melt and/or stick to teeth are the worst. Other ideas
might include stickers, press-on tattoos, plastic rings, or other small toys.
3.
Go to a Halloween program or event.
Choosing alternatives to trick-or-treating significantly cuts the candy haul.
These events are a great place for adults and children to socialize while
enjoying snacks and fun activities.
4. Set a limit. Put a limit on the amount of candy a child is allowed daily. This
helps prevent candy binges while reducing sugar consumption. Candy can also be
used as a reward for good behavior.
5. Donate excess candy. Many communities have programs that will send it to
troops or donate $1 for every pound of candy donated. Candy can also be donated
to fire stations, schools (for rewards), or other offices in the community.
Regularly brushing teeth and
reducing sugar intake can help prevent cavities. Consuming fewer sweets can
also help decrease children’s risk for obesity and diabetes. Dentists and parents
alike recommend that candy be consumed in moderation.

“Although everyone wants to be treated immediately… it is not always best to rush a patient to the OR in the middle of the night,” explains Dr. William M. Ricci MD, Associate Professor of Orthopaedic Surgery at the Washington University School of Medicine.
The study followed 203 patients who underwent orthopaedic surgery—surgery on bones and joints. While there was no significant difference between radiation exposure, healing time or actual treatment, there was a noticeable disparity between operations that occurred between the daytime and nighttime shifts.
All operations used intramedullary nail fixation to mend tibial or femoral fractures. This is a procedure in which a rod, or “nail”, is used to set the bone. The day was divided into two shifts—the morning shift between 6:00 a.m. and 4:00 p.m., and the night shift thereafter.
Second shift patients had shorter operations, but they also had more follow-up operations and more nail removal surgeries—27percent versus 3 percent for patients whose surgeries occurred during regular office hours. Dr. Ricci believes that much of this can be attributed to the long hours many surgeons put in.
“The reality is that the on-call night surgical team may not be well rested as it is likely they had just finished a normal day shift,” Ricci says. Ricci, who is also chief of the Orthopaedic Trauma Service in the Department of Orthopaedic Surgery at W.U., also explains why non-emergency operations should wait.
“We in the healthcare industry don’t have unlimited resources,” Ricci says. “Many hospitals in the U.S. do have a dedicated night team of orthopaedic surgeons who otherwise are without daytime responsibilities. There are surgical teams on-call for those instances when treatment must be immediate.”
Ricci believes giving orthopaedic surgeons more time to operate on trauma patients can help reduce the risk of minor complications from nail fixation surgeries. He encourages patients to wait for surgery if possible, but insists that actions be taken immediately in urgent situations: “Naturally, when the medical condition is emergent and time is a critical factor, immediate surgery should proceed regardless of time of day.”

Vitamin
D deficiency can result in conditions such as rickets in children (usually
<11 ng/mL), and osteomalacia and osteoporosis in adults (typically levels
<25 ng/mL). Low levels of vitamin D also increase the risk of bone and heart
disease, and are also associated with higher blood pressure and lower calcium
and HDL cholesterol levels in later life.
Children classified as
“insufficient” had 15-29 ng/mL, while those who were classified as “deficient”
had levels of 15 ng/mLor less. Normal range, according to the National
Institute of Health, is 30-74 ng/mL.
The study is the largest of
its kind to date, gaining nationwide rather than just regional data. "We
expected the prevalence of vitamin D deficiency would be high,” says lead
author Juhi Kumar, M.D., M.P.H., of the Children's Hospital at Montefiore
Medical Center, “but the magnitude of the problem nationwide was
shocking."
Vitamin D deficiency is more
common for female children, those that are older, obese, drink less than one
glass of milk week, and those who spend four hours or greater on the computer
or watching television per day. African-American and Mexican-American children
also had a greater risk.
Melamed,
co-leader of the study, attributes part of this problem to lifestyle,
recommending parents send their children outdoors. One source of vitamin D is
UV-B sunlight, which converts cholesterol in the skin into vitamin D. She also recommends ditching
the sunscreen for a while: “Just 15 to 20 minutes a day should be enough…don't
put sunscreen on them until they've been out in the sun for 10 minutes, so they
get the good stuff but not sun damage.” Individuals with darker skin and those
who live in northern regions with less sun exposure should spend more time
outdoors.
The American Academy of Pediatrics recommends that children and teens get at least 400 IU per day, double the previous recommendation of 200IU per day. Good sources of vitamin D include fish, milk, eggs, cod liver oil, and fortified foods. Vitamin D levels can also be increased with the use of supplements.
The study's abstract is available online, and will be published in September's issue of Pediatrics.
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