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    1. Dental Hygiene
    2. Clinical Hygiene

    Protecting our children

    March 21, 2014
    With the prevalence of coffee, soft drinks, and energy drinks today, youths have several sources for consuming caffeine. Excessive caffeine consumption can occur with reports of caffeine toxicity and deaths among adolescents and adults. Maria Perno Goldie, RDH, MS, takes a look at ways in which we can educate youth about the effects of caffeine consumption.
    Youths are finding new sources of caffeine, even though general caffeine intake did not increase among kids and teenagers between 1999 and 2010. Coffee and energy drinks became ever more significant contributors of caffeine, while soda intake declined during that period. Between 1999 and 2010, 73% of people ages 2 to 22 consumed at least some caffeine on a given day, including 63% of children ages 2 to 5.(1) The Food and Drug Administration (FDA) states that caffeine is consumed in food or as a medicine.(2) Ninety percent of people in the world use caffeine, and in the U.S., 80 percent of adults consume caffeine every day. The average adult consumes 200 mg per day, the amount in two 5-ounce cups of coffee or four sodas. A study of 7th, 8th, and 9th grade students in Ohio found that students consumed an average of 53 mg of caffeine per day. However, about one-in-five students consumed more than 100 mg of caffeine each day.(2) Caffeine is a central nervous system stimulant, and can affect the brain, spinal cord, and the other nerves in the body. Excess caffeine consumption can increase heart rate and blood pressure, hyperactivity and anxiety. There are reports of caffeine toxicity and deaths among adolescents and adults.
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    A rising number of food products have added caffeine, including waffles, jelly beans, gum and nuts. How these items effect children and adolescents is something the FDA intends to study. The FDA announcement came just as Wrigley's (a subsidiary of Mars) promoted a new pack of gum with eight pieces, each containing as much caffeine as half a cup of coffee.(3) Wrigley decided to stop production, sales and marketing of its new caffeinated gum in May 2013. The company's decision followed meetings with the FDA to discuss the government agency's concerns about the effect the gum has on children and adolescents.(4) In children ages 2 to 5, tea surpassed soda as the largest contributor to caffeine intake.(1) Tea was the second largest contributor to overall caffeine intake for all ages and remained relatively stable over the decade. In 19- to 22-year-olds, coffee intake was greater than soft drinks as the primary source of caffeine, growing from 14% of intake to 34%.(1) Energy drinks went from 0% in 1999-2000 to 10%. Another way we need to protect our children is to teach them healthy lifestyle habits, from nutrition, exercise, no drug use, etc. Pediatric obesity is currently an epidemic, with the prevalence having quadruped over the last 25 years.(5) For children who are obese, a simple fall may lead to more serious elbow injuries and greater complications after surgery than children of a normal weight.(5) These include nerve palsy post-surgery. This is the first study to assess the implications of obesity on this type of a fracture and it substantiates the public health efforts in battling childhood obesity.

    Indoor Tanning Fo
    (7. CDC Press Release) And lastly, female high school students in states with indoor tanning laws, particularly those with parental permission laws and age restrictions, were less likely to engage in indoor tanning compared to students in states without any laws.(6) Skin cancer is the most common type of cancer in the United States. Approximately 3.5 million cases of nonmelanoma skin cancers are treated annually, and over 60,000 melanomas are diagnosed annually. Most cancers have been waning since the 1990s, but fatal melanomas have been increasing, especially in young women. Increased exposure to ultraviolet radiation through indoor tanning may be partially responsible for the continued increase in melanoma.(7)
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    The numbers of states implementing new laws regarding indoor tanning have increased substantially in recent years. At this time, six states (California, Illinois, Nevada, Oregon, Texas, and Vermont), restrict indoor tanning among minors aged younger than 18 years.(7)

    The World Health Organization (WHO) recommends that no one under the age of 18 years use indoor tanning. The FDA has proposed reclassifying indoor tanning devices from low- to moderate-risk devices. The proposed order advises against the use of indoor tanning among minors aged younger than 18 years.

    For information about CDC’s efforts in skin cancer prevention, visit the website.(8)

    References
    1. Branum AM, Rossen LM and Schoendorf KC. Trends in Caffeine Intake Among US Children and Adolescents. Pediatrics 2014;133:386–393. http://pediatrics.aappublications.org/content/early/2014/02/04/peds.2013-2877.full.pdf.
    2. FDA. Medicines in my Home: Caffeine and Your Body. http://www.fda.gov/downloads/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/understandingover-the-countermedicines/ucm205286.pdf.
    3. http://www.fda.gov/forconsumers/consumerupdates/ucm350570.htm.
    4. http://www.cnn.com/2013/05/08/health/wrigley-caffeine-gum-production/.
    5. Mark A. Seeley, Joel J. Gagnier, Ramesh C. Srinivasan, Robert N. Hensinger, Kelly L. VanderHave, Frances A. Farley, Michelle S. Caird. Obesity and Its Effects on Pediatric Supracondylar Humeral Fractures. The Journal of Bone and Joint Surgery(American), 2014; 96 (3): e18 DOI: 10.2106/JBJS.L.01643.
    6. Gery P. Guy Jr, Zahava Berkowitz, Sherry Everett Jones, Emily O’Malley Olsen, Justin N. Miyamoto, Shannon L. Michael, and Mona Saraiya. (2014). State Indoor Tanning Laws and Adolescent Indoor Tanning. American Journal of Public Health. e-View Ahead of Print. doi: 10.2105/AJPH.2013.301850.
    7. http://www.cdc.gov/media/releases/2014/p0213-indoor-tanning.html.
    8. http://www.cdc.gov/cancer/skin.

    Maria Goldie 2013c

    Maria Perno Goldie, RDH, MS

    To read previous RDH eVillage FOCUS articles by Maria Perno Goldie, click here.

    To read more about caffeine and dental hygiene, click here.