This week we focus on the PIE Amendment Bill and what it changes in South Africa’s eviction laws. We look at why the Bill is needed, what new offences and penalties it introduces, and how it affects municipalities and state responsibilities. We also examine whether vulnerable occupiers are still protected and what the broader impact will be on property owners, developers, and the economy.

Joining Eon is Nirvana Nothnagel of Hahn & Hahn Attorneys.

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

Introduction

A child's upper jaw shapes far more than the alignment of their teeth. It forms the floor of the nasal cavity and directly governs how easily they breathe, how deeply they sleep, and how their face grows over a lifetime. A narrow palate is not simply a cosmetic orthodontic concern — it is a functional one with wide-reaching consequences for health, behaviour, and development.

In this episode, Dr Clifford Yudelman of OptiSmile Advanced Dentistry and Implant Centre in Sea Point, Cape Town, explains what palatal expanders are and how they work, the differences between fixed metal and Invisalign-based expansion systems, the critical window for intervention in growing children, and why early expansion can prevent extractions, surgical procedures, and a cascade of harder problems later in life.

Topics covered include the relationship between a narrow palate and nasal airway resistance, the surprising link between jaw width and bed wetting in children, what happens to the face profile when teeth are extracted unnecessarily, the current limits of adult expansion, and the specific signs parents should look for at home right now.

Episode Questions and Answers

Question 1  (1:06)

How does a narrow palate affect a child's ability to breathe?

The palate forms the floor of the nasal cavity, so a narrow palate directly constricts the nasal passages. Children develop increased nasal resistance, become habitual mouth breathers, and are vulnerable to poor sleep, snoring, behavioural issues, and altered facial growth.

Question 2  (2:31)

What on earth is a palatal expander, and does it hurt?

An orthodontic appliance that widens the upper jaw by separating the mid-palatal suture. In children the suture is still flexible, so expansion is biologic rather than surgical. Most children feel pressure rather than pain, with mild tightness after activation that settles quickly.

Question 3  (3:51)

What is the Invisalign Palatal Expander and how is it different from metal ones?

The traditional metal expander is fixed to the molars and turned daily by a parent. The Invisalign system uses a digitally planned series of removable clear expanders. It is more comfortable, easier to clean, and better accepted by children. Correct diagnosis and timing matter more than the device chosen.

Question 4  (5:19)

Can expanding the jaw prevent the need for removing teeth later?

In most cases, yes. Widening the arch increases both width and perimeter, giving teeth space to erupt naturally. Multiple studies confirm early expansion reduces the need for future extractions. Unnecessary extractions narrow the arch and can flatten the facial profile significantly.

Question 5  (7:12)

How is bed wetting linked to airway issues and even narrow jaws?

Nocturnal enuresis can be linked to sleep-disordered breathing. Poor oxygenation and frequent sleep arousals disrupt the hormonal signals involved in bladder control. Improving airway patency through nasal breathing can help in airway-related cases.

Question 6  (8:10)

Is there an age limit for expanding the palate?

Expansion is most effective in children and early adolescents while the mid-palatal suture is still open. As skeletal maturity increases, non-surgical expansion becomes less predictable. An orthodontic screening at around age seven is the recommended starting point.

Question 7  (9:20)

How does airway orthodontics improve sleep quality for children?

Palatal expansion increases nasal airway volume and reduces airflow resistance. This supports deeper, more stable sleep cycles. Parents typically report reduced snoring and improved daytime focus and behaviour. Sleep studies confirm measurable improvements in airflow after expansion.

Question 8  (10:16)

Can adults benefit from expansion or is it surgery only for them?

Adults can benefit but the fused suture means conventional expansion tends to tip teeth rather than widen the skeleton. Surgery-assisted or TAD-supported expansion can achieve skeletal change. Dr Yudelman cautions that this is being heavily oversold and would not currently refer his own patients for the surgical route.

Question 9  (11:18)

Does expansion change the shape of the face or even the cheekbones?

In growing children, expansion supports more balanced facial development and a broader smile. Changes are gradual and harmonious. Claims of dramatic adult facial transformation should be treated with scepticism. Function is the primary goal; aesthetics are secondary.

Question 10  (12:10)

What signs should parents look for to know if their child needs this?

Watch for chronic mouth breathing, snoring, a narrow smile, crowded teeth, dark circles under the eyes, and frequent fatigue. A simple home check: tilt the child's head back. A flat, wide palate is normal; a deep V-shape is a prompt to see the dentist.

Outro

Airway orthodontics may be one of the most underappreciated areas in modern dental practice. A child who breathes better sleeps better, learns better, and grows better — and the window for non-surgical palatal expansion is narrow and biologic, which is why early screening matters so much.

The dentist who looks at a seven-year-old's crowded smile and sees only teeth is missing most of the picture. Look at the airway. An orthodontic assessment at around age seven allows for the simplest, safest, and most effective interventions — ones that can prevent years of complex and expensive treatment later.

Next week's episode covers TADs — temporary anchorage devices — the small titanium screws used in orthodontics to create fixed points that help move teeth predictably. Another essential piece of the modern orthodontic toolkit.

To learn more and to book an assessment at OptiSmile, visit the links below.

Further Resources

Invisalign at OptiSmile

https://www.optismile.co.za/invisalign/

Full overview of Invisalign treatment for adults and teens at OptiSmile, including the Invisalign Palatal Expander system discussed in this episode.

Orthodontics at OptiSmile

https://www.optismile.co.za/orthodontics/

Overview of orthodontic services at OptiSmile including early intervention, palatal expansion, and adult orthodontics.

About OptiSmile

https://www.optismile.co.za/about-us/

Background on Dr Yudelman's training and the OptiSmile approach. Useful context for patients wanting to understand the practice's evidence-first philosophy and use of digital dentistry.

Book an Appointment

https://www.optismile.co.za/contact/

Book directly online or get in touch with the OptiSmile team in Sea Point, 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.

Intro

The biological dentistry movement is everywhere on social media, with claims that fluoride is toxic, silver fillings poison the body, and root canals cause cancer. None of these claims hold up under scientific scrutiny, yet they continue to drive patients into expensive and often unnecessary treatments.

In this episode, Eon Engelbrecht speaks with Dr Clifford Yudelman about the difference between biological dentistry as a philosophy and evidence-based dentistry as a discipline, and how patients can tell them apart. They cover fluoride, amalgam removal, root canals, biocompatibility claims, ozone therapy, metal-free marketing, and the question of whether a modern practice can be both high-tech and genuinely whole-body aware.

10 Questions with Summary Answers

1. [0:41] What is the difference between a biological dentist and a traditional dentist?

Biological dentistry is a philosophy, not a formally recognised specialty or regulated discipline. At its best it reflects a genuine interest in how dental treatments affect the whole body; at its worst it drifts into claims unsupported by evidence. Evidence-based dentistry, by contrast, is clearly defined: it combines the best available scientific research with clinical expertise and patient values, and is endorsed by international dental organisations and taught at universities worldwide. The fundamental difference is that evidence-based dentistry asks what high-quality research shows is safe and effective, while biological dentistry sometimes starts with a belief and then looks for supporting arguments.

2. [2:14] Why is there so much controversy around fluoride in the biological community?

Fluoride is one of the most studied substances in public health, and decades of high-quality research show that at appropriate doses it significantly reduces tooth decay. The controversy largely stems from a misunderstanding of dose versus toxicity. Almost any substance, including water, can be harmful at extreme levels, but the fluoride concentrations in toothpaste and community water are far below toxic thresholds. Systematic reviews from reputable organisations consistently conclude that fluoride is safe and effective when used as recommended, and claims linking it to widespread systemic disease are not supported by robust evidence.

3. [3:32] What is the scientific stance on amalgam fillings and routine removal?

Dental amalgam contains mercury in a stable, bound form, and large-scale studies have found no evidence that amalgam fillings cause systemic illness in the general population. Unnecessary removal can actually increase mercury exposure temporarily and damages otherwise healthy tooth structure. There are valid clinical reasons to replace amalgam fillings such as fractures, decay, or cracking, but routine wholesale removal as a supposed cure for arthritis, joint problems, or other systemic conditions is not supported by science. The clinical principle is straightforward: replace amalgam for a clinical reason, not because of a promise that it will detoxify the body.

4. [5:53] Are root canals really as toxic as some documentaries claim?

No, and the documentaries claiming otherwise are based on poorly designed studies from over a century ago that have been repeatedly disproven. Root canal treatment is one of the most thoroughly studied procedures in dentistry, and high-quality evidence shows that a properly performed root canal removes infection, eliminates pain, and preserves the natural tooth. Modern microbiology, imaging, and materials have dramatically improved outcomes. The fear-based content circulating online relies on outdated and misrepresented data rather than current science.

5. [7:28] What does biocompatible actually mean when you choose dental materials?

Biocompatible means a material performs its intended function without harming surrounding tissues. All modern dental materials are tested extensively for biocompatibility before approval. No material is completely inert, but the goal is predictable performance, durability, and minimal adverse response. Marketing sometimes misuses the term biocompatible to imply superiority without evidence. Material selection should be guided by clinical indication, longevity, and proven outcomes, not by labels or testimonials.

6. [9:44] At OptiSmile, how do you balance holistic health with scientific evidence?

Whole-body health is inseparable from oral health, and the links between gum disease, diabetes, and cardiovascular disease are well supported by research. The balance lies in respecting these links without overreaching. Dr Yudelman regularly refers patients for blood tests, sleep studies, ENT input, or cardiology assessment when warranted, but is clear that dentists specialise in the oral cavity and should not be diagnosing conditions outside it. The approach is integrative but conservative, guided by science and tailored to each individual patient.

7. [11:21] What is ozone therapy, and does it actually work for teeth?

Ozone has antimicrobial properties and has been studied as an adjunct in dentistry, with some evidence it can reduce bacteria in certain situations. Current systematic reviews do not support ozone as a replacement for conventional treatment such as cleaning out a cavity and placing a filling. Claims that ozone alone can heal a cavity without restorative work are not mainstream and lack solid research support. Dr Yudelman has not found a useful clinical role for it in his own practice.

8. [13:14] Why should patients be wary of metal-free claims if they are not backed by science?

Metal-free marketing capitalises on the genuinely poor reputation of older base metals like nickel-containing alloys, but modern restorative materials are very different. Lithium disilicate (Emax) and zirconia bond well, are extremely strong, and are highly inert; zirconia in particular integrates so well that the gum almost glues itself to a zirconia crown. The absence of metal does not automatically make a restoration safer or healthier — every material has strengths and limitations. The biggest concern is when metal-free messaging extends to discouraging titanium implants, which are the most thoroughly researched implant material in medicine and are routinely used for hip replacements and fracture fixation.

9. [16:02] Is it possible for dentists to be both high-tech and holistic?

Yes, and modern dentistry increasingly blends advanced technology with preventive, patient-centred care. A proper new-patient examination at OptiSmile takes around 90 minutes and covers digital imaging, saliva, occlusal forces, diet, oral hygiene, gum measurements, AI-assisted x-ray analysis, and discussion of broader health factors such as blood sugar. The distinction Dr Yudelman draws is between a holistic approach grounded in science and an ideology that rejects established treatments wholesale. Good clinicians can do both; ideologues only do one.

10. [19:06] What questions should patients ask to ensure they are not getting quackery?

The most useful question is simply: what evidence supports this treatment, and is it backed by peer-reviewed research? Modern AI tools like ChatGPT, Gemini, and Claude can summarise the published literature on any specific claim, such as whether titanium implants are toxic or whether ceramic implants are genuinely better. A useful sanity check is the global consensus test: if every major dental organisation in the world recommends one approach and a single practitioner in town claims to be the only one who is right, that imbalance is a signal, not a selling point. Transparency and willingness to explain the evidence are the hallmarks of ethical, evidence-based care.

Outro

This episode draws a clear line between two very different approaches to dentistry. Evidence-based dentistry combines high-quality research with clinical experience and patient values. Biological dentistry, in its more extreme forms, starts with a belief and looks for supporting arguments afterwards. Both can sound caring on the surface, but only one is grounded in science. For any treatment that sounds like a miracle cure, the right questions are simple: what evidence supports this, is it peer-reviewed, and do other major dental organisations agree? If one practitioner is the only one in town claiming to be right, that should be a signal rather than a selling point.

Further Resources

Unveiling Dental Fillings: Preservation Meets Aesthetics

https://optismile.co.za/blog/unveiling-dental-fillings-preservation-meets-aesthetics/

Direct companion for the amalgam discussion. Covers the history of dental amalgam, why white fillings have replaced it in most cases, and when amalgam is or is not the right clinical choice.

Root Canal Treatment in Cape Town

https://optismile.co.za/dental-solutions/root-canal-treatment-cape-town/

OptiSmile's treatment page on root canal therapy. Explains what the procedure actually involves and why it remains one of the most predictable ways to save a natural tooth.

Exposed: The Hidden Dangers of Ignoring Tooth Decay

https://optismile.co.za/blog/hidden-dangers-of-ignoring-tooth-decay/

Full podcast episode on root canals, including the anatomy of the tooth, the procedure itself, and why modern endodontics with magnification and 3D imaging produces predictable long-term outcomes.

Dental Implants in Cape Town

https://optismile.co.za/dental-solutions/dental-implants/

OptiSmile's main implant page. Useful background for the titanium-versus-ceramic discussion and for understanding why titanium remains the gold standard in implant dentistry.

Everything You Need to Know About Dental Implants

https://optismile.co.za/blog/everything-youd-need-to-know-about-dental-implants/

Full podcast episode on implants. Covers single-tooth implants, full-mouth reconstructions, implant-supported dentures, healing times, and costs.

The Oral Microbiome and Your Health

https://optismile.co.za/blog/the-oral-microbiome-your-health/

Background for the whole-body health discussion. Explains how the bacteria in your mouth influence cavities, gum disease, and broader systemic conditions including heart and gut health.

Chilling Truths: Tooth Sensitivity and Cost-Saving Dental Care

https://optismile.co.za/blog/secrets-of-tooth-sensitivity-and-cost-saving-dental-care/

Earlier podcast episode that includes practical discussion of fluoride varnishes and desensitisers as evidence-based ways to protect enamel and reduce sensitivity.

About OptiSmile

https://optismile.co.za/about-us/

Background on Dr Yudelman's training and the OptiSmile approach. Useful context for patients wanting to understand the practice's evidence-first philosophy and use of digital dentistry.

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 financial advisor Mauritz Oberholzer talks about the hidden price tag- what your bond isn't telling you.

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/

What Happens to a Spouse’s Property During Sequestration? We ask Thabiso Tshukudu of Hahn & Hahn Attorneys,

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

In this episode of Save Your Money, Save Your Teeth, Eon Engelbrecht speaks with Dr Clifford Yudelman from OptiSmile about saliva testing, DNA diagnostics, and the future of personalised dentistry.

While these tests may sound futuristic, the idea is simple: understanding a patient's risk before dental problems become painful, expensive, or difficult to treat. Dr Yudelman explains how saliva can reveal clues about dry mouth, acidity, buffering capacity, bacteria, bad breath, gum disease risk, and even implant risk.

He also takes a balanced view, explaining where these tests can be useful, where they may still be too expensive for the average patient, and why the basics, such as flossing, hydration, professional cleaning, diet, and regular dental care, still matter most.

10 Questions 

1. Why on earth would a dentist want to test my saliva?

Saliva protects the teeth by neutralising acids, washing away bacteria, and delivering minerals such as calcium and phosphate. Testing saliva can help assess flow rate, acidity, buffering capacity, dryness, and potentially bacterial risk. Dr Yudelman explains that while saliva testing can be valuable, he does not currently use it routinely at OptiSmile because, in many cases, clinical signs already reveal the key risks.

2. Can a DNA test tell us if we are genetically more prone to gum disease, and if so, how?

Some people have a stronger inflammatory response to plaque than others. DNA testing can identify genetic variations, such as the IL-1 marker, that may suggest a higher risk of severe gum disease. However, genes are only part of the story. Oral hygiene, smoking, diabetes, professional cleaning, and daily habits still play a major role.

3. Can saliva testing identify the specific bacteria causing bad breath?

Yes, saliva and plaque testing can identify anaerobic bacteria associated with bad breath, especially bacteria on the tongue or in gum pockets. Dr Yudelman explains that this may help guide treatment, but for most patients, the practical basics remain essential: flossing, healthy gums, tongue scraping, professional cleaning, and appropriate antimicrobial products when needed.

4. What is the IL-1 genetic marker and how does it affect implant risk?

The IL-1 marker relates to how strongly the immune system responds to bacterial challenge. In patients with a history of gum disease, this may suggest a higher risk of inflammation and bone loss around dental implants. In such cases, Dr Yudelman may refer patients to a periodontist for more specialised assessment and maintenance planning.

5. How do we test for the acidity or buffering capacity of saliva?

Saliva can be collected in two ways: resting saliva, where the patient simply spits into a container, and stimulated saliva, where the patient chews wax before spitting into a cup. The saliva can then be tested for acidity and buffering capacity. Low buffering capacity means saliva is less able to neutralise acid, increasing the risk of tooth erosion and cavities.

6. Can saliva testing help us choose the right antibiotic for an infection?

In specific periodontal cases, specialists can test fluid from gum pockets, known as crevicular fluid, to identify bacteria and guide antibiotic choice. This is not usually a general saliva test for everyday dental infections, but it may be valuable in selected gum disease cases where targeted treatment is needed.

7. Is this testing expensive, and is it worth it for the average patient?

Dr Yudelman explains that saliva and DNA testing can be expensive, especially when paid for privately in rands. For the average patient, it may not always be necessary. However, in selected cases, such as unusual gum disease, implant risk, or persistent bacterial problems, targeted testing may be worthwhile if it changes the treatment plan.

8. How does this all fit into personalised medicine in dentistry?

Personalised dentistry means using more information to tailor prevention and treatment to the individual patient. Saliva testing, DNA markers, bacterial testing, AI-assisted x-ray analysis, and digital diagnostics may all help motivate patients and guide more specific care. Dr Yudelman believes these tools will become more common as they become faster, cheaper, and easier to use.

9. Can saliva testing detect diseases like diabetes or even cancer?

There is research into saliva-based detection for systemic diseases such as diabetes and cancer, but Dr Yudelman stresses that this is not yet routine dental practice. He mentions future possibilities such as small sensors that could monitor glucose from saliva, but explains that this episode is more future-looking than a guide to what patients should expect at the dentist tomorrow.

10. How do you perform the test? Is it just spitting in a tube?

Most saliva tests are non-invasive. Patients may chew a piece of wax and spit into a small cup or tube. DNA testing may involve saliva or a cheek swab. There are no needles, no finger-pricks, and no major discomfort. The sample is then analysed depending on the type of information being tested.

Key Takeaways

Saliva is not just spit. It is one of the body's most important protective systems for the mouth. Good saliva flow helps neutralise acid, protect enamel, control bacteria, support remineralisation, and reduce the risk of decay, erosion, dry mouth problems, bad breath, and gum disease.

Saliva and DNA testing may become more common in dentistry as the technology becomes quicker and more affordable. These tests may help identify patients at higher risk of gum disease, implant inflammation, dry mouth complications, acid erosion, bad breath, or bacterial imbalance.

However, Dr Yudelman's message is practical and balanced. Testing may be useful in selected cases, but it does not replace the fundamentals: flossing, tongue cleaning, regular professional cleaning, hydration, a sensible diet, managing dry mouth, avoiding smoking and vaping, and seeing a dentist before small problems become expensive ones.

Further Resources

1. The Oral Microbiome and Your Health - A highly relevant companion episode on oral bacteria, dysbiosis, gum disease, and links between oral health and general health.

2. Dry Mouth Dilemmas: Causes, Consequences and Relief Strategies - Useful for listeners who want to understand how reduced saliva flow increases the risk of cavities, infections, sensitivity, and dry mouth complications.

3. Medicines and Mouth Health: What You Need to Know - Explains how common medicines can reduce saliva flow, contribute to dry mouth, and increase the risk of cavities and gum problems.

4. Dental Implants at OptiSmile Cape Town - Relevant to the discussion about implant risk, gum health, inflammation, and long-term implant maintenance.

5. OptiSmile Dental Solutions - A useful starting point for patients exploring dental check-ups, teeth cleaning, implants, cosmetic dentistry, and preventive dental care at OptiSmile.

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 we’re unpacking a question that comes up every year in the construction industry: When exactly is the builders’ break?

To help us navigate this, we are joined by Jaco Hamman, a specialist in construction law at Hahn & Hahn Attorneys,

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

Eating disorders often reveal themselves in the mouth before anyone else notices. In this episode, Dr Clifford Yudelman from OptiSmile discusses the dental signs associated with bulimia and anorexia, explains why stomach acid can erode enamel far more rapidly than dietary acids, and outlines what dentists look for during an examination.

He also talks about compassionate communication, protective home care during recovery, and minimally invasive ways of restoring teeth damaged by acid exposure. The conversation is reassuring for anyone who has worried about the state of their teeth after struggling with disordered eating, and useful for parents, siblings, and friends who want to understand what oral signs to be aware of.

10 Questions with Summary Answers

1. [1:25] How does bulimia specifically damage the teeth compared to regular acid reflux?

Stomach acid has a pH close to 1, far more acidic than lemon juice or cola. Unlike reflux, which tends to affect the back of the throat intermittently, bulimic vomiting brings acid forcefully and repeatedly into contact with the teeth themselves. The result is a distinctive smooth, glassy erosion on the inside surfaces of the upper front teeth, with thinning enamel and increasing translucency. Over time it can expose dentine, cause sensitivity, and lead to fractures. Dr Yudelman also notes that in many patients the perceived damage is worse than the actual damage, so there is no need to avoid the dentist out of shame.

2. [5:04] What is perimolysis, and why does it appear on the back of the upper teeth?

Perimolysis is the specific pattern of enamel erosion on the back surfaces of the upper front teeth caused by stomach acid. Because the tongue tends to protect the lower teeth during vomiting, the upper teeth take the brunt of the acid. Under magnification, perimolysis looks like enamel that has been polished away, as though someone has filed the back of the teeth down.

3. [5:43] Why should patients never brush their teeth immediately after vomiting?

Acid softens the enamel temporarily, and brushing a softened surface wears it away rather than cleaning it. The same principle applies to morning sickness during pregnancy. Instead, rinse gently with water, or water with a little bicarbonate of soda to neutralise the acid, and wait 30 to 60 minutes before brushing. Chewing sugar-free gum in the meantime helps saliva remineralise the surface.

4. [6:51] How can a dentist spot the signs of an eating disorder before anyone else does?

Dentists often see the physical signs before a doctor, a parent, or even before the patient has talked to anyone about it. The pattern of perimolysis, rapid enamel thinning, unusual sensitivity, and a high cavity rate in someone with otherwise good oral hygiene are strong clues. The dentist's role is not to diagnose the eating disorder itself, but to recognise the oral signs and open a compassionate conversation that may lead to the patient seeking help.

5. [8:36] What are the oral signs of anorexia, such as vitamin deficiency or dry mouth?

Anorexia and bulimia are very different conditions, and anorexia tends to be more medically serious. Common oral signs include dry mouth, dehydration, increased cavity risk, gum inflammation, delayed healing, ulceration, and vitamin B and C deficiencies producing sore or bleeding gums. Low bone density can also affect the jawbone. The mouth often reflects what is happening systemically, which also applies to people who are not clinically anorexic but who eat very restrictively and exercise excessively.

6. [10:52] How do you restore teeth that have become thin and translucent from acid?

The priority is preserving whatever enamel remains. The first-line treatment is typically adhesive composite bonding, especially injection-moulded composite bonding, which restores thickness, protects the dentine, and improves appearance without drilling. On back teeth, overlays may be needed in some cases. Veneers and crowns are rarely the first choice because they require removing more tooth. If the disorder is still active, stabilising protection always comes before cosmetic restoration.

7. [12:11] Is it safe to do cosmetic work while an eating disorder is still active?

Generally no, because ongoing acid exposure compromises bonding and accelerates the breakdown of restorations. In this situation the focus should be on protection and stabilisation. Temporary and protective materials such as glass ionomer, which contains fluoride and bonds naturally to the teeth, can be painted on to reduce further damage. These are less cosmetic than composite, but they buy time until the underlying condition is resolved.

8. [13:09] How do you approach this sensitive topic with patients compassionately?

By focusing on clinical findings rather than assumptions. Saying something like, "I'm seeing a pattern of acid damage that we usually see with frequent acid exposure," opens the conversation without judgement. Compassionate, non-judgemental communication builds trust. Dentistry should feel like a safe space. Letting a patient leave the practice without raising a clear clinical observation is a missed opportunity to help.

9. [14:55] What home care routines can protect enamel during recovery?

Neutralise acid after exposure with water or a small amount of bicarbonate of soda, use a high-fluoride toothpaste, and brush and spit without rinsing so the fluoride stays on the teeth. Tooth Mousse applied in a tray helps remineralise. Sugar-free chewing gum supports saliva flow. Fluoride varnishes and glass ionomer applied by the dentist add extra protection. Cheese and other dairy foods help neutralise acid in the diet.

10. [16:27] Can salivary glands swell up, causing so-called chipmunk cheeks?

Repeated vomiting can enlarge the parotid salivary glands in the lower cheeks, causing noticeable facial swelling from glandular irritation and altered salivary flow. Swelling may reduce when the behaviour stops, but chronic changes are possible. Dr Yudelman notes that while he has read extensively about it, he has not personally seen this in more than four decades of practice, suggesting that it tends to occur in more advanced cases than he typically treats.

Outro

The biggest message from this conversation is that the mouth often reflects what is happening in the rest of the body, and a dentist can sometimes be the first person to notice what is going on. Dental care for people who have struggled with disordered eating should always be approached with compassion and without judgement. It is also worth knowing that many patients worry more about the state of their teeth than is actually warranted, and that even when damage has occurred, modern minimally invasive dentistry can usually restore function and appearance without aggressive treatment. If you are unsure about the condition of your teeth, a confidential checkup is always a good place to start. To learn more or to book an appointment, visit OptiSmile.co.za.

Further Resources

Episode 73: Acid Reflux and Tooth Erosion (Podcast)

https://optismile.co.za/blog/acid-reflux-tooth-erosion/

The closest companion episode to this one, covering how stomach acid reaches the teeth and what it does to enamel over time.

Episode 10: The Secrets of Tooth Sensitivity (Podcast)

https://optismile.co.za/blog/secrets-of-tooth-sensitivity-and-cost-saving-dental-care/

Useful follow-up listening on why teeth become sensitive when enamel thins and dentine is exposed, and what can be done about it.

Injection Moulded Composite Bonding and Veneers

https://optismile.co.za/dental-solutions/injection-moulding-technique/

The minimally invasive, no-drill technique Dr Yudelman describes as the first-line approach for rebuilding teeth worn thin by acid erosion.

What You Need to Know About Dental Bonding

https://optismile.co.za/blog/what-you-need-to-know-about-dental-bonding/

Background on how composite bonding works in practice, including how it can restore the appearance and function of eroded front teeth.

Dental Checkups in Cape Town

https://optismile.co.za/dental-solutions/dental-checkup/

What to expect at a confidential OptiSmile dental checkup, including how enamel erosion and early damage are identified.

Book a Confidential Consultation at OptiSmile

https://optismile.co.za/

If you have concerns about your teeth, a no-judgement assessment is the first step to protecting what enamel remains and planning for gradual restoration.

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.

When a primary earner passes away without a safety net, the family doesn't just lose a loved one, they lose a lifestyle. This week financial advisor Mauritz Oberholzer talks about the importance of Life Insurance.

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/

WhatsApp is part of everyday life on construction sites - but could it be putting contractors at serious contractual risk under the JBCC? Today we unpack why informal messages can have costly consequences.

Jaco Hamman of Hahn & Hahn Attorneys joins us.

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