eRadio SA

In this episode of Your Money Maument, Mauritz Oberholzer explores the importance of open and honest communication about money between partners. From discussing spending habits and financial responsibilities to setting shared goals and navigating financial challenges, he explains how couples can build trust, avoid misunderstandings and strengthen their relationship by making personal finances a conversation rather than a source of conflict.

Your Money Maument is aired on eRadio SA every Thursday and available as a podcast afterwards.

For more information visit https://www.mauritzoberholzer.co.za/

Shannon Dougall of SKIN functional discusses what makes the skincare brand unique, the thinking behind its product formulations, and the inspiration behind starting the business.

She also shares her biggest entrepreneurial challenges, what motivates her, her vision for the future of SKIN functional, and the one product she simply cannot live without.

Discover smarter skincare at skinfunctional.com

Want us to shine the spotlight on your business too? Email [email protected] 

Welcome back to Save Your Money, Save Your Teeth. In the previous episode, Eon Engelbrecht and Dr Clifford Yudelman looked at the future of dentistry: robots, artificial intelligence and apps that monitor your teeth from home. This episode comes back down to earth with something every patient needs, a way to protect yourself in the dental chair when the business model, rather than your mouth, starts writing the treatment plan.

They cover what production dentistry is and the buzzwords that come with it, how to recognise a sales script, why a humble repair can beat an Instagram makeover, and why some practices recommend the same big treatment for almost everyone. They also discuss the problem with before and after photos, how to get a genuinely useful second opinion, how to say no politely, what first do no harm means for your bank account, how to check that the person doing your veneers is actually a dentist, and the one rule that protects you most.

10 Questions and Summary Answers

[4:14] What is production dentistry, and what buzzwords should patients watch out for? Dr Yudelman explains that production dentistry, a term common in the United States, is where the business model decides the treatment before your mouth does, with daily turnover targets and a morning search of the schedule for upselling opportunities. It hides behind impressive phrases such as full mouth rehab, smile makeover, your bite is collapsing and you are a ticking time bomb. He describes a long-standing patient in London who was told by an insurer-approved dentist that three teeth needed urgent treatment, with a plan of £1,800 against a £300 co-payment, for cavities he has monitored for years with little change. Teeth do not explode, he says, and crowning every tooth to protect it is the last thing you want.

[9:51] How can a patient tell if a dentist is following a sales script learned at a business seminar? The script has a rhythm: fear first, often a photo of much worse teeth, then a dramatic diagnosis, one big solution such as ceramic on every tooth, and urgency. Other giveaways are that everyone seems to need the same plan, the before and after gallery shows crowns on every tooth, and finance forms appear at the same appointment, sometimes presented by a treatment coordinator known as a closer. A good dentist can still recommend major treatment, but shows the evidence on your own x-rays and scans through co-discovery and explains what happens if you wait. With a script, waiting is never an option and the discount only applies if you start today.

[13:44] Why is patching a tooth sometimes better than the perfect dentistry we see on Instagram? Instagram dentistry is designed for the camera, and Dr Yudelman has never encouraged his dentists to post before and after photos on social media. Every time a tooth is drilled, part of its limited budget is spent and that structure never comes back. Repairing an edge, bonding a chip, or reversing early decay with fluoride and diet changes keeps your options open. The goal is a stable mouth, not perfection, and a makeover belongs at the end of a long story rather than the beginning; even when a full makeover is genuinely needed, it should be done conservatively.

[15:13] Why do some dental philosophies recommend the same big treatment for almost everyone? They sell certainty, and anxious people crave it: fix everything at once and never worry again. Some of these systems suit the right patient, but the problem comes when the philosophy becomes a template and every mild bite issue turns into 28 crowns. Dr Yudelman describes same-day makeover practices that drill every tooth in the morning and fit crowns in the afternoon, when a careful same-day restoration of one tooth takes him two to two and a half hours. Mouths, materials and habits change, and when everything is done together it tends to fail together, which gets very expensive.

[17:08] Why don’t you like using before and after photos to sell treatment? Before and after photos show the result from the front and hide the real price, meaning the biological cost: how much enamel was removed, whether nerves were put at risk, and what it will cost to maintain over 20 years. The real after photo is the one taken ten years later, and nobody posts that. Dr Yudelman does show before and after cases, but only one to one, with the patient’s permission and matched to the person in the chair. He shows how a case was built up conservatively with composite, injection moulding or inlays, how it looks two and four years later, and where it might pick up stain and need a polish.

[19:28] Is it rude to ask for a second opinion, and how do you get one that is genuinely useful? It is not rude at all, and a good dentist welcomes it; Dr Yudelman regularly arranges second and third opinions for his own patients from colleagues in the practice. If a dentist becomes defensive when you mention seeing someone else, that tells you something. Ask for copies of your x-rays and scans, which you are entitled to under POPIA, so you do not pay for them twice. Then ask the second dentist an open question, such as what would you do if this were your tooth, rather than whether they agree. If the second opinion is simply a cheaper quote for the same big plan, get a third.

[21:27] How can you say no to a treatment plan that feels pushed? You need a few calm questions rather than dental knowledge. Say you are not saying no forever, just not today, and ask to be shown the problem on the x-ray and whether the treatment is reversible. If you are told you need five fillings, ask which could be monitored if you floss daily and switch to a fluoride toothpaste, and what happens if things are stabilised and reviewed in three or six months. An ethical dentist will slow down with you. Pressure is not confidence, and if the deal is only good on the day, you are dealing with a salesman.

[22:34] What does first do no harm mean, and does it apply to a patient’s bank account too? First do no harm is the principle behind the Hippocratic Oath, and harm caused by the practitioner is called iatrogenic. Harm is not only pain or infection; it includes a healthy tooth taken away unnecessarily. That tooth then enters a lifetime crown replacement cycle, often leading to further crowns, a root canal and eventually an implant, creating financial stress from treatment that was never needed. Money can be earned again but enamel cannot, and restraint is one of the most valuable and least advertised skills a dentist has.

[24:08] What is the legal position on cheap veneers in South Africa, and how do you check who you are dealing with? Patients can search the HPCSA online register by first and last name to see when a dentist, hygienist or doctor was registered and what they are permitted to do. Dr Yudelman refers to Section 17 of the Health Professions Act and explains that a dental technician may only make what a dentist prescribes and cannot drill, bond or treat your mouth. The HPCSA has been arresting bogus practitioners and dentists whose registration has lapsed. If someone offers veneers at 1,000 rand each when a regular dentist charges 10,000 to 15,000 rand, question their qualifications, because cheap veneers on healthy teeth can start a lifetime of expensive dentistry.

[25:42] If listeners remember just one rule to protect themselves, what should it be? Never agree to anything irreversible until you understand your options. Ask what the treatment commits you to in the long term, what happens if you wait, and whether it can be staged, and ask for the evidence. Unless you have a severe toothache or swelling, time is rarely your enemy in dentistry, but rushing is.

Outro

Eon Engelbrecht and Dr Clifford Yudelman close on the episode’s central message: most dentists are honest, but when the business model writes the plan, the patient pays twice, once in money and once in enamel that never grows back. Ask for the evidence, ask for options, get a second opinion when a plan feels pushed, and never agree to anything irreversible in a hurry.

Dr Yudelman calls this one of the most important episodes he has recorded, and says that having the consumer’s back is the main goal of the podcast. Next week: 4D printing, shape memory aligners and more about aligners.

Further Resources

The Future Is Now: Robots and AI in Dentistry (Episode 128): https://optismile.co.za/blog/robots-and-ai-in-dentistry/

Viral Dental Hacks Debunked: Trends vs Truth (Episode 116, social media dentistry): https://optismile.co.za/blog/viral-dental-hacks-debunked-trends-vs-truth/

Reading Your Dental X-Ray: A Patient’s Guide (Episode 114, co-discovery): https://optismile.co.za/blog/reading-your-dental-x-ray-a-patients-guide/

Bite Collapse, Wear and Early Warning Signs (Episode 88): https://optismile.co.za/blog/preventing-bite-collapse/

Navigating Dental Treatments: What’s Truly Needed (Episode 82, avoiding overtreatment): https://optismile.co.za/blog/avoiding-dental-overtreatment/

Dental Veneers at OptiSmile: https://optismile.co.za/dental-solutions/dental-veneers/

Injection Moulding Technique at OptiSmile: https://optismile.co.za/dental-solutions/injection-moulding-technique/

Dental Inlays and Overlays at OptiSmile: https://optismile.co.za/dental-solutions/dental-inlays-overlays/

Health Professions Council of South Africa (iRegister search): https://www.hpcsa.co.za/

OptiSmile Podcast Series: https://optismile.co.za/podcasts/

OptiSmile YouTube Channel: https://www.youtube.com/@OptismileZa-dentist-cape-town

Contact OptiSmile: https://optismile.co.za/contact-dentist-cape-town/

Disclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.

In this episode of Your Money Maument, Mauritz Oberholzer takes a closer look at the actual cost of credit. From interest rates and fees to the long-term impact on your finances, we explore what borrowing money really costs and what consumers should consider before taking on debt.

Your Money Maument is aired on eRadio SA every Thursday and available as a podcast afterwards.

For more information visit https://www.mauritzoberholzer.co.za/

In this episode, Senior Associate Attorney at Hahn & Hahn, Nirvana Nothnagel explains what a forensic audit means in the context of medical schemes and why practitioners may be subjected to one.

She discusses the issues that can arise during an audit, what practitioners may be asked to provide, and what information they should receive regarding the amounts being claimed. Nirvana also explains what practitioners should do when they receive notice of a forensic audit and the legal support they can expect throughout the process.

An essential conversation for healthcare practitioners who want to understand their rights, responsibilities and options when facing a medical scheme forensic audit.

Legal Talk is aired every Wednesday morning at 10:00 on eRadio SA and available as a podcast thereafter.

In this interview, Nicole Cynkin from the iCAN Audiology Network explains why hearing healthcare is about far more than simply fitting hearing aids. She discusses the role of audiologists as healthcare professionals, the importance of personalised care, patient choice and continuity, and how long-term relationships with the same clinician can improve the hearing healthcare journey.

The conversation also explores the value of independent audiology practices alongside other hearing-care models, without comparing or criticising specific providers.

Nicole explains how independent audiologists can offer personalised, patient-centred care while giving patients greater autonomy and ongoing professional support.

Find out why hearing care works best when patients are known, understood and supported over time.

To find an independent audiologist in your area, visit: www.independentaudiologists.co.za

Welcome back to Save Your Money, Save Your Teeth.

In the previous episode, Eon Engelbrecht and Dr Clifford Yudelman looked at special care dentistry and adapting the dental visit to fit the person. This episode looks ahead, at the tools that are changing what a dental visit even looks like: some genuinely useful right now, some hype, and some still a decade away.

They cover dental robots that shape teeth for veneers and guide implant placement, AI that flags early decay on x-rays, whether to trust a chatbot like ChatGPT with your teeth, and remote monitoring that lets aligner patients send progress photos from their phone.

They also discuss who owns your dental records under POPIA, whether we will really regrow teeth, virtual reality for anxious patients, smart toothbrushes including Dyson's new camera brush, and why the real promise of all this technology is better decisions and less treatment.

10 Questions and Summary Answers

[1:19] Will a robot ever replace a dentist? Not any time soon. Robots now exist that hold the drill and shape a tooth for a veneer or crown, and one that guides implant placement is already in use in Cape Town, but a dentist still plans the work and keeps a hand on the instrument. Robots are brilliant at precision and repetition; the judgement on who to treat, what to treat and when to wait and watch stays with the dentist. Dentists tend to over-prepare teeth for veneers, which is one reason Dr Yudelman rarely recommends them, whereas a robot can remove as little as 0.2 of a millimetre and the veneer can be bonded the same day.

[6:08] How is AI helping dentists find cavities that humans miss? AI does not get tired at four in the afternoon and carries no bias from what it saw yesterday. Trained on hundreds of thousands of x-rays, it flags early shadows, early decay and early bone loss that a dentist might skip past in error. It flags rather than diagnoses, so the dentist still decides what gets treated. Showing patients their early lesions helps them improve diet and cleaning between the teeth, and prevention is the cheapest dentistry there is. New radiation-free 3D imaging that colour codes cracks, cavities, old fillings and plaque looks very promising.

[7:55] Is it a good idea to ask a chatbot like ChatGPT about your teeth, or use it as a second opinion? It is a useful starting point but not the final word. A chatbot can explain what a root canal involves, help you write down questions and translate a treatment plan into plain English, but it cannot see your mouth or feel whether a tooth is loose. General AI can already spot a big cavity on an x-ray, and one patient's ChatGPT simulations of veneers, bonding and orthodontics were surprisingly good, yet it could not tell her how much tooth each option would remove or which was right for her. Use it to get informed, then take your questions to a real dentist, because you do not want to be confident about a wrong answer.

[10:45] What is remote monitoring for aligners like Invisalign, and can you really track your teeth with your phone? Yes. You take photos of your teeth at home, usually once a week, and the software checks that your aligners are fitting properly. The dentist is notified, compares progress with the plan and can send a message such as wear that aligner for another week, or good job. It works very well for yachties, seafarers and patients living elsewhere in South Africa or Africa. There is not much AI in it yet, and it does not replace the dentist, but it beats discovering at a six-week check that an aligner has not been fitting.

[12:55] Are robots actually placing implants now? Guided implant surgery works like a GPS: a 3D scan is used to plan exactly where the implant should go before treatment begins. Most dentists then use a 3D-printed guide that clips over the neighbouring teeth to direct the drill. The robotic system instead guides the dentist's hand to the right angle and tells them when to stop, so a human is still doing the work. The more accurately an implant is placed, the better the crown that goes on it, and the better everything looks five or ten years later.

[14:19] Who actually owns your dental data, and should you worry about privacy? A modern dental record is far more than notes: it includes scans, photos, x-rays and sometimes recordings. In South Africa it is protected under POPIA, the Protection of Personal Information Act, so you are entitled to know how it is stored, who it is shared with, and to ask for a copy. Your x-rays and scans belong to you, and a practice should not withhold them because of an unpaid account. Copying film x-rays once took real time in the darkroom, but now that records are digital, getting a copy of your x-rays or your chart should take a few clicks.

[16:47] Will we ever be able to regrow teeth? Probably, but not tomorrow, and not the way the headlines make it sound. There is exciting work in Japan, initially for people born without some of their teeth, alongside gene editing with CRISPR and stem cell research, which is further off. The real danger is neglecting the teeth you have while waiting for a miracle, which is one of the most expensive bets you can make. With an implant and crown costing around R20,000 to R50,000 in South Africa, a mouth with 23 natural teeth holds at least R460,000 worth of implants, and natural teeth are better than implants.

[19:09] How does virtual reality help anxious patients during treatment? Dr Yudelman has not used it on patients. The headsets he tried in America were impressive but too bulky, and would block the dentist's view of the mouth, especially when working with a microscope. Newer glasses that look more like a pair of sunglasses may solve that, taking your mind to a beach or under the ocean, with good sound as a distraction. VR is already used in burns units and other medical settings, and dentistry is likely to follow.

[21:15] What are smart toothbrushes, and is the data actually useful? Smart brushes measure how hard you press, sense the angle of the brush and show which areas you are missing, often through an app, although much of the premium price is branding. OptiSmile stocks the Oclean, which warns you when you brush too hard. Dyson has just launched a brush overseas at about US$500, roughly R8,200, with a 100,000-pixel camera and AI taking 28 images a second, firing a jet of mouthrinse whenever it sees a gap between teeth. Dr Yudelman is cautious about water flossers, which can cause problems when used at the wrong angle, notes that the Dyson needs its own special toothpaste, and says early reports suggest it has had issues.

[24:10] What excites you most about where dentistry is heading? It is not one gadget but the way everything works together: digital scans, AI on the x-ray, monitoring from home and better materials, such as the injectable composite whose bonding still looks good on patients six years later. At OptiSmile, SmileCloud merges studio photos with a 3D scan to simulate bonding, orthodontics or veneers, and even creates an AI video of the patient speaking with the new smile. That has largely replaced the old trial smile made from a mould filled with tooth-coloured material. Above all, these tools save teeth: it is about better decisions, not more treatment, which is the whole philosophy of the show.

Outro

The closing thought is the one worth holding on to: the best technology in dentistry does not lead to more treatment. It leads to better decisions, and very often to less treatment, done earlier and more precisely. When a practice says it uses AI or robotics, ask whether it helps them catch problems earlier and treat you more conservatively, and look after the teeth you have rather than waiting for tomorrow's miracle.

Looking ten years ahead to 2036, Dr Yudelman expects to still be practising, possibly with a robot doing much of the work under his control. He also floats an idea for the show's future: inviting professors and world experts from Europe, Australia and South Africa to share the very latest research.

Further Resources

Special Care Dentistry for Autism, Anxiety and Dementia (Episode 127): https://optismile.co.za/blog/special-care-dentistry-for-autism-anxiety-and-dementia/

The Brushing Masterclass: Technique, Timing and Tools (Episode 117, smart and electric toothbrushes): https://optismile.co.za/blog/the-brushing-masterclass-technique-timing-tools/

Floss vs Interdental Brushes: What Actually Works? (Episode 119, water flossers): https://optismile.co.za/blog/floss-vs-interdental-brushes-what-actually-works/

Reading Your Dental X-Ray: A Patient's Guide (AI on x-rays): https://optismile.co.za/blog/reading-your-dental-x-ray-a-patients-guide/

iTero 3D Scanner (no impression trays): https://optismile.co.za/dental-technology/itero/

Digital Smile Design at OptiSmile: https://optismile.co.za/dental-technology2/digital-smile-design/

Injection Moulded Composite Bonding at OptiSmile: https://optismile.co.za/dental-solutions/injection-moulding-technique/

Invisalign at OptiSmile: https://optismile.co.za/dental-solutions/invisalign-cape-town/

Dental Implants at OptiSmile: https://optismile.co.za/dental-solutions/dental-implants/

Information Regulator South Africa, Protection of Personal Information Act (POPIA): https://inforegulator.org.za/popia/

Dyson CameraJet launch announcement: https://www.dyson.com/discover/news/latest/introducing-camerajet

OptiSmile Podcast Series: https://optismile.co.za/podcasts/

OptiSmile YouTube Channel: https://www.youtube.com/@OptismileZa-dentist-cape-town

Contact OptiSmile: https://optismile.co.za/contact-dentist-cape-town/

Disclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.

This week on 'Your Money Maument', Mauritz Oberholzer looks at financial goal-setting and how clear, realistic goals can help you take control of your money. From short-term priorities to long-term financial plans, Mauritz shares practical advice on setting goals, staying focused and making smarter financial decisions.

Your Money Maument is aired on eRadio SA every Thursday and available as a podcast afterwards.

For more information visit https://www.mauritzoberholzer.co.za/

The Garden Route is facing a growing wildfire and environmental threat, with invasive alien plants, increasingly dry conditions and the risk of more intense fires placing added pressure on the region’s ecosystems.

Veteran environmental manager Dr Guy Preston recently visited the Garden Route following the region’s extreme weather events and described the extent of invasive alien plants as “among the worst in the country”.

According to Cobus Meiring of the Garden Route Environmental Forum, Preston expressed serious concern about the unchecked spread of invasive vegetation. Dense stands of alien plants not only displace indigenous vegetation and threaten biodiversity, but also create large amounts of combustible material that can fuel intense wildfires. Eon spoke to Meiring about Preston's findings.

Welcome back to Save Your Money, Save Your Teeth. In the previous episode, Eon Engelbrecht and Dr Clifford Yudelman looked at how stress shows up in the mouth before people admit it to themselves. This episode turns to the people for whom a normal dental visit is not just stressful but can be genuinely impossible.

They cover special care dentistry for people with autism, severe ADHD, sensory processing differences, intellectual disabilities, severe anxiety, physical disabilities and dementia: people whose teeth fail not because they do not care, but because the dental chair was never designed with them in mind.

The conversation covers what actually helps with bright lights and loud noises, how to prepare someone for a first visit, what desensitisation looks like in practice, how to manage a strong gag reflex, and how caregivers can brush a mouth that is not their own.

They also discuss silver diamine fluoride, a painless liquid that can stop decay without a drill, when sedation or a general anaesthetic is genuinely the kindest choice, protecting the mouths of people with early dementia, and what a family should check before taking someone in a wheelchair to a dental practice.

10 Questions and Summary Answers

[1:31] What exactly is special care dentistry, and who is it actually for? It is less a specialty than a way of working, for anyone who cannot cope with dentistry the way it is usually delivered. That includes autism, severe ADHD in younger children, sensory processing differences, intellectual disabilities, severe anxiety, physical disability, dementia and people with a traumatic dental history. Some adults arrive having not seen a dentist in 15 years, not because they did not care, but because the visit was a total assault on their senses. Their teeth did not fail them; the system did. Getting proper care early is also far cheaper than an emergency extraction under general anaesthetic ten years later.

[3:02] The lights, the drill and the suction must be overwhelming for someone with autism or sensory processing issues. What genuinely helps? Sensory overload is not bad behaviour; it is a nervous system being flooded, so the answer is to take things away rather than add them. The overhead lights can be dimmed or switched off, and light-sensitive patients can wear dark glasses. Unnecessary beeping, such as the bag sealer in the sterilisation area, is switched off, instruments are kept out of sight rather than waved in front of the face, and the dentist talks quietly about what comes next. The tell-show-do approach used for a four-year-old's first visit works well, and many patients simply bring their own over-ear headphones and disappear into their own music.

[6:11] What can a parent or caregiver do before that first visit to make it go better? Preparation is half the battle, and it starts at home, not in the waiting room. Show the person photos of the practice, the chair and the people they will meet, so nothing is a surprise on the day. Book a quiet slot, such as the first appointment of the morning, and avoid practices where someone will sit for half an hour in a crowded waiting room. Tell the practice about triggers in advance, whether touch, noise, smell or waiting, sometimes through a video consultation with the caregiver. Bring comfort items such as headphones, a favourite teddy bear or a weighted blanket, because a first visit that goes well sets up every visit after it.

[8:21] What does desensitisation actually look like in the dental chair? It is dentistry in small steps at the patient's pace, stopping before it becomes too much. The first visit might just be sitting in the chair, tilting it back and sitting up again; the next might introduce the light, over three or four very short visits. Each time the patient learns that nothing bad happened, and that is how trust is built. Routine matters too: the same person, the same room and the same sequence, because predictability is what makes a person feel safe. It takes longer at the start, but trust replaces a lifetime of crisis dentistry with genuine cooperation.

[9:29] Some people gag the moment anything goes near the back of the mouth. How do you manage a strong gag reflex? A strong gag reflex is often fear-related, and can follow a choking or near-drowning experience. The patient is kept more upright, the dentist goes slower and avoids the back of the tongue, and a 3D scanner replaces messy impressions. Patients are shown that raising a hand stops everything, and they practise it several times until it becomes almost a game and they realise they are in control. Honesty matters as well: many special needs patients are waiting for the surprise jab they have learned to expect from doctors, so the dentist says clearly when there will be no needles. Nose breathing and small distractions such as wiggling the toes or twiddling the thumbs also help.

[12:49] For caregivers brushing someone else's teeth every day, what makes it easier, and are there special toothbrushes that help? Caregivers deserve real credit, and the last thing any of them needs is a lecture, especially in front of the patient. The most useful change is position: brush from behind rather than face to face, with the person's head supported against a chair or headrest, or with a young child lying with their head in your lap. An electric toothbrush can help, and even 20 seconds is better than nothing if two minutes is not tolerated. For people brushing themselves, chunky handles, straps and other aids help with poor dexterity, and there are special sprays and mouthwashes as well.

[15:26] Is it true that there is a liquid that can stop decay without any drilling? Yes. Silver diamine fluoride has been around for a long time and is making a big comeback. It is painted onto the decay, takes seconds, does not hurt and can stop a cavity in its tracks, which makes it one of the most useful tools for people who cannot tolerate a drill. The trade-off is that the treated decay turns black, so it is not ideal on a front tooth, because everybody cares about their appearance. The arrested decay can still be drilled out and filled later if that becomes possible.

[16:51] When is sedation or a general anaesthetic genuinely the kindest option? Choosing sedation is not a failure. When the adaptations have been tried, the decay keeps progressing or the patient is in pain, planned treatment under sedation or a general anaesthetic lets everything be done safely, quickly and well, with no memory of it. It should be planned so that cleaning, fillings and extractions all happen in one session rather than over multiple anaesthetics. OptiSmile does not do theatre cases; this is usually the work of a paediatric dentist, many of whom also treat adults with severe autism or Down syndrome, or an oral surgeon. Long term, it is far safer and cheaper than a string of emergency visits.

[18:42] What about older patients with dementia who can no longer look after their own mouths? It is a sad pattern: a patient with years of good crowns, bridges and implants starts arriving late or lost, and six months later comes in with a carer. Oral hygiene goes downhill as the person forgets how to brush, and a dry mouth lets teeth fail very quickly. When there is an early diagnosis of dementia or Alzheimer's, that is the time to get the mouth into very good shape, treating any teeth or gums likely to cause trouble in the next year or two. Many of these patients are otherwise healthy, and poor oral hygiene is linked to pneumonia in frail older people, so the mouth should not become the next emergency.

[21:12] For someone using a wheelchair or with limited mobility, what should a family look for in a dental practice? Google listings often say whether a practice is wheelchair accessible, but always check, because the listings are not always correct. Look for wide doorways, a lift and no steps; a practice in an old house may have neither. Most patients can transfer into the dental chair with help, and some chairs turn sideways so a short visit can be done with the patient still in their wheelchair, using the chair's headrest. Choose a practice that sets aside extra time and has a caring culture, not a 15-minute slot in a high-volume clinic. Pick up the phone and ask when they last treated someone in a wheelchair, and check the toilet facilities too.

Outro

The closing thought is the one worth holding on to: a difficult patient is almost never the problem; a dental visit that does not fit the person is. Adapt the visit, and most people can be cared for far more gently than their families expect. Call ahead and tell the practice what is hard, whether it is the lights, the noise, the waiting room or the chair.

As Dr Yudelman puts it, this kind of practical guidance is hard to find on a dentist's website, and it will stay just as valid in three or five years' time. Next week: robots, AI and the future of dentistry.

Further Resources

Overcoming Dental Fear: Why Are People Afraid of the Dentist (Episode 51): https://optismile.co.za/blog/overcoming-dental-fear-why-are-people-afraid-of-thedentist/

How to Prepare for a Stress-Free Dental Visit (Episode 53): https://optismile.co.za/blog/how-to-prepare-for-a-stress-free-dental-visit/

Dental Injections Explained (Episode 102): https://optismile.co.za/blog/dental-injections-explained/

The Brushing Masterclass: Technique, Timing and Tools (Episode 117): https://optismile.co.za/blog/the-brushing-masterclass-technique-timing-tools/

Sedation Dentistry at OptiSmile: https://optismile.co.za/sedation-dentistry/

iTero 3D Scanner (no impression trays): https://optismile.co.za/dental-technology/itero/

OptiSmile Podcast Series: https://optismile.co.za/podcasts/

OptiSmile YouTube Channel: https://www.youtube.com/@OptismileZa-dentist-cape-town

Contact OptiSmile: https://optismile.co.za/contact-dentist-cape-town/

Disclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.