9-15 July is TOFS awareness week! Find out about TOFS and why we’re supporting the work of the charity here at Rhiwbina Dental.

TOF stands for trachea-oesophageal fistula – which is when there is an abnormal connection between the trachea (the breathing tube that connects to our lungs) and the oesophagus (the tube used for swallowing, connecting with the stomach). Along with oesophageal atresia (OA – a condition in which the oesophagus does not develop fully), TOF/OA prevents the ability to swallow.

TOF/OA is a condition that usually becomes apparent at birth – and with increasing awareness, there is a good prognosis for many children born with TOF/OA. However, many adults live with TOF/OA and dental health is one of the many challenges they face. The charity TOFS works to raise awareness and our dentist, Alison Lewis, recently contributed to the TOFS magazine with advice about dental health. Check out her article below – and visit the TOFS website for more information.

Tooth wear in Adult TOFs by Dentist Alison Lewis

This article aims to give an overview of tooth wear, a common condition affecting many Adult TOFs.

What is tooth wear?

Tooth wear is a term used to describe the progressive loss of a tooth’s surface due to actions other than those that cause tooth decay or dental trauma. It is becoming more widespread, as people keep their teeth longer, and because of modern dietary habits. There are three main types: erosion; abrasion; and attrition. Although one type can exacerbate the other, it is erosion, which generally affects TOFs.

How are TOFs affected?

Adult TOFs are at high risk of tooth wear due to the gastro-oesophageal reflux that often goes hand in hand with the TOF condition. Acid from the reflux causes the surface of the tooth enamel to ‘dissolve’. When this happens repeatedly, the damage starts to become noticeable. It can range from a mild 'glassiness’ of the enamel surface to a full-blown stripping-off the enamel down to the dentine, which can then be affected in the same way. It classically affects the back of the upper front teeth (the palatal aspect), as this is the surface that the reflux acid contacts first.

If left unchecked tooth wear can lead to unsightly teeth, chipping and sensitivity. In severe cases, it can result in death of the nerve within the tooth, with the possibility of associated infection.

What you can do to help reduce the likelihood of tooth wear

  • Try to keep reflux under control, with medication if necessary. Your GP will be able to prescribe something appropriate.
  • Avoid foods that makes your reflux worse.
  • Reduce intake of fizzy drinks and fruit juices. Drink plenty of water (but not sparkling!). If you do drink something acidic, use a straw.
  • Avoid tooth brushing for 20 to 30 minutes after consuming acidic food or drink. This gives the saliva time to 'lock down’ the top layer of enamel that has been softened by the acid. Brushing too soon can wash this top layer down the plughole, thus speeding up the effects of the acid erosion.
  • Use a fluoride mouthwash. This will help strengthen susceptible enamel.
  • Use a desensitising toothpaste, eg Sensodyne Repair and Protect, or ProEnamel. This will help reduce any sensitivity.
  • Avoid scrubbing with your toothbrush. Studies have shown electric toothbrushes to be more effective at removing plaque, and can be less damaging if used correctly.
  • Chewing sugar free gum helps stimulate saliva flow – important for washing away and buffering any food acids.

Treatment available if tooth wear is present

The first priority is to address the causes of tooth wear as above. If tooth wear is already present, there is a range of treatments that can help. Sometimes management of sensitivity and addressing dietary habits are all that is needed.

If tooth wear is more severe, it may be possible to rebuild the lost tooth tissue with composite. This is a tooth-coloured filling material, which is bonded to the teeth. It doesn’t involve any drilling or anaesthetic and is thus a 'tooth-friendly’ treatment, not involving the removal of any more precious tooth tissue.

Another option is porcelain crowns. This is a more complicated and expensive treatment. Damage from tooth erosion is usually widespread, and treatment can involve several, if not all of the teeth. This needs to be done with much planning and care by someone with a lot of experience. Many dentists are happy to do this in general practice, though others prefer to refer to a specialist. Certain cases may be available for NHS treatment, but this would need individual assessment. NHS Direct or your Local Health Board may be able to help you find an NHS dentist.

If you live near a Dental Teaching Hospital, it might be possible to get specific treatment there, if your general practice cannot provide it.

There is a lot of information about reflux, diet and teeth online. Being well informed, helps you to make healthy choices that will minimise any damage that TOF-related gastro-oesophageal reflux can cause.

ref: British Health Foundation Ireland

Alison N Lewis BDS DPDS

Alison is a General Dental Practitioner working in a specialist practice in Cardiff. www.rhiwbinadental.com

It’s a summer of sport!

Whether you’re an armchair fan, an active participant or a sucker for the social side of spectator sports, July 2018 has something for everyone. And it’s got us dentists thinking too…

You say: “It’s the World Cup Final on 15 July!”
We say: Have you thought about a sports guard?
Watching the world’s greatest players duck and dive on the pitch is one thing, but if you’re replicating their moves yourself, you’ll need a decent mouth guard. Here at Rhiwbina Dental, we’ll craft a bespoke sports guard for you – far superior to the boil-and-go version you can buy in the chemist. It’s a cost-effective solution to the kinds of injury that can run into thousands (don’t forget, knocked-out front teeth aren’t covered on the NHS!).

You say: “Can’t wait to see Serena and Rapha at Wimbledon!”
We say: “Go easy on the strawberries and Pimm’s!”
There’s no better excuse to get stuck into a jug of Pimm’s and a punnet of strawberries than when Wimbledon rolls around each summer. But did you know that the combination of fruit, liqueur and lemonade wreaks havoc on your teeth? Both Pimm’s and lemonade are packed with sugar, and the fruit adds a lovely hit of acid to the mix. The result? Erosion – which in turn causes teeth to yellow. While we can fix the staining with a professional teeth whitening treatment, you can maintain your smile by opting for lower-sugar lemonade (brands like 7UP and Sprite contain almost three times as much sugar as supermarket bottles).

You say: “Who’s going to take a tumble in the Tour de France?”
We say: “Look! It’s sponsored by a water brand!”

Unlike most official sports sponsors (cigarette brands and junk food anyone?), the Tour de France has found a rather wholesome sponsor in Vittel. And it’s a great reminder of all the benefits drinking water brings – especially in warmer weather. Substituting fruit juices and alcohol with water more often will do wonders not only for your skin and body, but your teeth too – water washes away food that sticks to your teeth and causes plaque, and keeps your mouth feeling fresh.

You say: “Nothing beats the adrenaline buzz of the Grand Prix!”
We say: “Step away from those energy drinks!”

Energy drinks have a huge presence in motor racing – their branding sits well with the fast pace of petrol-head season. But energy drinks are wolves in sheep’s clothing when it comes to oral health – their spurious claims to enhance performance have seen them aligned with sports, yet they are actually extremely unhealthy. Some cans are packed more sugar than you’re meant to consume in a whole day – up to 20 teaspoons!

We’re festival-ready with our amazing Rhiwbina raffle!

Not long to go now until the Rhiwbina Village Festival on 30th June – and following the success of our festival raffle last year, we’re aiming to outdo ourselves at this year’s event!

In-between all the dancing, donkey rides and jam-packed fun, we’ll be selling tickets for our fabulous raffle in aid of FaceUp Cymru – the Head, Neck & Oral Cancer Foundation. We’ve been working really hard amassing a great collection of prizes – and with tickets only £1 a strip, it’s a fantastic chance to win something special.

The prizes revealed!

  • Cut and blow-dry from Michelle George
  • Glass ornament from Froggadog
  • Teeth whitening home kit from Rhiwbina Dental
  • Hygiene appointment at Rhiwbina Dental
  • Electric toothbrush/goody bag from Rhiwbina Dental
  • Flower arrangement from The Florist of Cardiff
  • Microdermabrasion treatment at In Skin Hair & Beauty
  • Blow Dry from In Skin Hair & Beauty
  • Nail treatment from In Skin Hair & Beauty
  • Cricket tickets for a T20 game
  • Rugby Autumn Internationals: Wales V Australia tickets
  • Penderyn whisky
  • Lanson Champagne
  • Rosé wine
  • SlimFit session from Beauty Beyond
  • Beauty treatment vouchers from Sadie’s Hair & Beauty Base
  • WRU replica rugby ball signed by Wales & British and Irish Lions Captain, Sam Warburton
  • Veuve Clicquot Champagne

…and many more prizes to be added!

So why FaceUp Cymru?
FaceUp Cymru supports patients through the journey of head, neck and mouth cancer, helping them to come to terms with their diagnosis and manage their treatment. The charity’s aim is make patients’ lives more comfortable; this might include providing specialist equipment, or funding a dedicated physiotherapist, social worker or clinical nurse who specialises in wound care. It also provides counselling and patient self-help groups to help with confidence building, coping strategies, target setting and coping with disfigurement.
John Hawkins, who established the original Rhiwbina Dental surgery nearly 50 years ago, is a trustee of the charity, having suffered with oral cancer himself. As we still have such a close relationship with John (as do many of our patients), FaceUp Cymru is a charity very close to our hearts.

At the 2016 festival we raised an amazing £1,360.68, and set ourselves a target of beating that last year – and we did it, raising a fantastic £1,420. So spread the word about the Rhiwbina raffle, because we want to outdo ourselves this year!

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