Episode 120: Disclosing Tablets – See the Plaque You’re Missing

Eon Engelbrecht – E-Radio-SA  (0:04 – 1:18)

Welcome back to Save Your Money, Save Your Teeth, the podcast that looks at what genuinely protects your teeth and also your wallet. Last time we went into the gaps between the teeth and today we’re doing something even more useful. We’re going to make the enemy visible.

Here’s the uncomfortable truth. The plaque that does the most damage is soft, sticky, and almost transparent. You cannot see it, you often cannot feel it, and that is exactly why people who brush twice a day still end up with cavities and gum disease.

They’re not lazy, they are just brushing blind. So today we’re talking about disclosing tablets, a cheap little dye that stains plaque bright and shows you precisely where you are missing every single time. We’ll get into plaque scores, what number you should be aiming for, whether food colouring does the same job, how often you should test yourself at home, and why this might be the single most honest tool in dentistry.

We’re joined as always by Dr Clifford Yudelman from OptiSmile. Dr Yudelman, welcome back. Doctor, what on earth are disclosing tablets and are they just for kids?

Dr Clifford Yudelman – OptiSmile  (1:18 – 2:19)

Thank you. Thanks for having me back.

We use them a lot for kids. They are cheap, effective tools that use a harmless dye to stain the plaque and make it visible to the naked eye, and they work really well for adults as well because the plaque is often transparent and, as you know, it’s what causes cavities and gum disease, and it shows you the bits that you’re missing between your teeth. So these tablets will actually help you check on your brushing and your flossing, and I highly recommend it.

You just chew on them, let them dissolve in your mouth, swish it around and all the plaque that’s on your teeth is visible, so you can remove it. Or you brush and floss as best as you can, and then you do the plaque disclosing, either drops or little tablets, and you can see how well you did and then get the rest of it.

Eon Engelbrecht – E-Radio-SA  (2:20 – 2:26)

Doctor, why do dentists sometimes paint purple or blue dye on teeth during a cleaning?

Dr Clifford Yudelman – OptiSmile  (2:26 – 3:32)

It’s to reveal the invisible plaque. It’s like a pilot that uses instruments or radar, you need to see where you’re going. In our practice, the hygienist always starts off by swabbing your teeth with this special dye and then rinsing your mouth, and then we’ll take a photo for your records, and then may show you in the mirror the areas that you’re missing.

And that’s not to shame you, but just to make you aware of how much plaque there is, because a lot of people have brushed their teeth before they come, they’re hoping for the best. It’s not like someone comes in who hasn’t brushed for two days. So it just shows people where they’re missing and then it makes them more aware.

So when we show them how to brush properly or how to use floss or tell them about interdental brushes, it’s much easier for them to get a visual feedback and to actually do a better job long term. And then they’ve also got a target to aim at, rather than some kind of random motion.

Eon Engelbrecht – E-Radio-SA  (3:32 – 3:38)

Doctor, how can I use these tablets at home to check my own brushing technique?

Dr Clifford Yudelman – OptiSmile  (3:38 – 4:46)

So the tablets are quite big and, to be honest, you really don’t have to use a whole tablet if you manage to break it in half or even into four pieces. You just take a little quarter of one of these tablets and you bite on it a few times and it’s got a nice taste. It dissolves in your mouth.

You don’t swallow it. It turns your whole mouth pink. Depending on the tablet, the fresh plaque shows up as a lighter pink colour.

Then the old plaque that’s been there for more than 24 hours, the more mature and more damaging plaque, shows up in a darker blue or purple. So you swish it around, and it stains your new and your old plaque.

Then you rinse your mouth out. Because the plaque is stained, it doesn’t rinse out. So all that’s left is the plaque on your teeth that’s now visible and you can just brush it away.

So it’s a really good way to make sure you’re doing a good job and to prevent expensive treatment in the future.

Eon Engelbrecht – E-Radio-SA  (4:46 – 4:52)

Doctor, what is a plaque score and what percentage should I be aiming for?

Dr Clifford Yudelman – OptiSmile  (4:52 – 5:47)

So a plaque score quantifies the remaining amount of plaque. So if you’ve got anything under 20 percent, like if you’ve got 10 percent plaque, that’s actually a very good score. Many people start with as much as 50 percent plaque left on their teeth after they’ve brushed.

So this monitors the trend rather than perfection. It’s really great when people have a gum problem or a cavity problem. Some of those patients come in every three or four months and it really keeps up the motivation, because they come in and they ask the hygienist, you know, what’s my score today?

And they know they’re doing a much better job, and the bleeding has gone away, and we can see where they were getting cavities. These cavities are now mineralising. So, like I said earlier, it’s like a pilot flying with radar.

You know where you’re headed, you know what you’re doing.

Eon Engelbrecht – E-Radio-SA  (5:48 – 5:54)

And doctor, I also want to ask you, why does the dye stick more around the gum line and between teeth?

Dr Clifford Yudelman – OptiSmile  (5:55 – 6:30)

So the plaque, or the bacteria, thrives in these sheltered, moist areas where the bristles often miss. It doesn’t mean that your gums are fragile. It means that these spots require better tools and angles.

And instead of brushing harder, which can cause damage, you use gentle, targeted pressure and interdental cleaning. So when you disrupt the plaque there, or you break it up early before it actually matures, that’s the key to preventing decay and bleeding gums.

Eon Engelbrecht – E-Radio-SA  (6:31 – 6:35)

Can I make my own disclosing solution at home with food colouring, doctor?

Dr Clifford Yudelman – OptiSmile  (6:36 – 6:58)

Look, food colouring can stain plaque, but it’s not recommended. The commercial disclosing agents are designed to bind specifically to plaque and rinse away cleanly, whereas food colouring can stain everything and it doesn’t give good feedback. So using proper tablets or liquid is inexpensive and it avoids confusion or the wrong method.

Eon Engelbrecht – E-Radio-SA  (6:59 – 7:04)

If I cannot see the plaque with my naked eye, does it really matter if it is there?

Dr Clifford Yudelman – OptiSmile  (7:04 – 7:48)

Yes, of course it matters. The invisible plaque is often the most biologically active, and this is the plaque that produces acids that cause cavities and produces chemicals that cause your gums to bleed long before any damage is actually visible. So relying on symptoms like that is risky, and sometimes these problems can go on for years, and the disclosing tablets or liquids will expose this hidden phase and allow you to reverse these things before costly treatment becomes necessary, thus saving your money and saving your teeth.

Eon Engelbrecht – E-Radio-SA  (7:49 – 7:53)

And how often should a patient do a plaque test at home to stay on track?

Dr Clifford Yudelman – OptiSmile  (7:54 – 8:43)

I mean, most people only need to do this in the beginning. You can do it every few days, but after that, you only need to do it every two to four weeks. The goal is just to recalibrate your technique, not to get obsessive.

There’s no harm doing it more often. The tablets are not expensive, but they’re not free, and you don’t have to do it all the time. The helpful tactic is to just adjust your brushing and your flossing, your dental cleaning, and then you retest.

So, with kids, you can check them every two or three days when they’re getting into that seven, eight, nine, ten year old period, because then by the time they’re teenagers and they’re not listening to you, they’re already in the habit of doing it properly.

Eon Engelbrecht – E-Radio-SA  (8:44 – 8:49)

Does plaque turn into tartar if I miss these spots for just a few days?

Dr Clifford Yudelman – OptiSmile  (8:50 – 9:49)

Yeah, so plaque actually begins mineralising into tartar surprisingly quickly, especially near your salivary ducts. We’ve spoken a lot about your saliva. There’s a saliva duct underneath your tongue.

That saliva that comes out of there has got a lot of calcium in it. So a lot of people will start building up tartar between the teeth and behind the back teeth. And also on the upper molars, on the outside, there’s a parotid duct, which is the saliva gland in your cheek.

So the concentration of calcium is much higher right near the duct. And once these areas, once the plaque is hardened, you can’t remove it at home and it requires professional help. Staying on top of the soft plaque will save you time and cost, and also sometimes discomfort, when you’re getting the tartar removed.

Eon Engelbrecht – E-Radio-SA  (9:50 – 9:55)

OK, and is this the ultimate tool for co-discovery so that patients can see what you see?

Dr Clifford Yudelman – OptiSmile  (9:55 – 10:25)

Yeah, 100 percent. The disclosing tablets give patients power by providing them visible evidence and replace guesswork with something objective. That gives them ownership and understanding, and it leads them to make better decisions.

It reduces unnecessary treatment and, of course, gives long-term protection of both your teeth and your finances.

Eon Engelbrecht – E-Radio-SA  (10:26 – 10:58)

Dr Yudelman, thank you so much. What I love about today’s topic is that it takes the guesswork out. You do not have to take my word for it, or your dentist’s word for it.

You chew a tablet, you look in the mirror, and the evidence is right there in colour. Dr Yudelman, thank you so much for joining us. And remember, to find out more or book an appointment, you can visit OptiSmile.co.za. Thank you. And this has been Save Your Money, Save Your Teeth. Remember, if you can see it, you can fix it. Until next time.

Announcer – OptiSmile  (11:19 – 12:03)

Discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr Clifford Yudelman, a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting OptiSmile.co.za for articles that illuminate the path to optimal oral health. If you’re seeking unparalleled dental care in Cape Town, get in touch with OptiSmile or book directly online on OptiSmile.co.za. OptiSmile, where global expertise meets local care.