Episode 65: Hydration & Oral Health – The Surprising Connection

(0:05 – 0:55)

Welcome again to Save Your Money, Save Your Teeth, the go-to podcast where curiosity meets dentistry straight from the experts. I’ve got our expert here with us as per usual, Dr Clifford Yudelman from OptiSmile, ready to take a deep dive into the world of dental care, especially from a consumer’s perspective. So, whether you’re looking to brighten your smile or protect your wallet, this podcast’s got you covered with practical advice and the latest insights.

So stick around with us for the next half-hour or so as we uncover the secrets to maintaining both your dental health and your finances. Today, we are talking about hydration and oral health. Apparently, there’s a surprising connection between the two, and Dr Yudelman is going to tell us all about it. Dr Yudelman, welcome back.

Dr Clifford Yudelman – OptiSmile (0:56 – 1:20)

Thanks, Eon. Great to be back and great to hear your voice once again. I’m looking forward to today’s podcast and also next week’s, which is along a similar line. We’re starting to look at health aspects of sports and hydration—things like that.

Fire away.

Eon Engelbrecht – E-Radio-SA (1:20 – 1:27)

It sounds very, very interesting. I want to ask you firstly: how does plain water directly help prevent tooth decay?

Dr Clifford Yudelman – OptiSmile (1:28 – 3:39)

We’ve had some podcasts early on in the series about diet, tooth decay and pH in your mouth, and so on. Basically, when you drink plain water—still water or even tap water—it dilutes and washes away any dietary sugars or acids before bacteria can ferment them. It’s the bacteria that sit in the plaque, eat the sugars and produce acids; that’s what causes cavities.

Every time you sip on water, it stimulates more saliva flow, and your saliva has natural minerals, especially calcium and phosphate, which harden any early enamel cavities you may be getting. Not all areas of Cape Town have fluoride in the tap water, and even some still waters that you get—say, from Kauai—sometimes come straight from a spring. They’ve usually got some naturally occurring fluoride (they obviously check it’s not too high), so you get a micro-dose that also helps harden your teeth.

A well-hydrated mouth maintains a neutral pH—around seven—and that cuts down the time that acid can attack your teeth. Remember the critical pH: 5.5. Above seven is alkaline; below seven is acidic. Something like pH 6 isn’t going to harm your teeth; a lot of drinks are around pH 6 and just have a slight flavour. If you add a hint of lemon to water, it may drop to pH 6—unlike pure lemon juice at pH 3. So let’s remember that threshold of 5.5, because we’ll come back to it shortly.

Eon Engelbrecht – E-Radio-SA (3:40 – 3:45)

Okay. And sparkling water—could that be eroding my enamel without me knowing it?

Dr Clifford Yudelman – OptiSmile (3:46 – 6:31)

Hundred per cent. Unflavoured carbonated water is mildly acidic—often right on pH 5.5—and has no sugar, so the risk is lower than juices or sodas. But, for example, if you’ve got expensive taste and buy something naturally carbonated like Pellegrino, its minerals push the pH up to about seven, which is fine for teeth.

Some supermarket sparkling waters have surprisingly low pHs—below 5.5. Valpré, for instance, is one I’ve measured. If you’re sipping sparkling water all day, you can literally melt your teeth. We’ve spoken about erosion before. When I was in Australia, SodaStream machines were popular. SodaStream water sits around pH 3.5–4. These numbers are logarithmic: drop from 5.5 to 4.5 and it’s roughly a hundred times more acidic. Go to pH 3 and it’s hundreds of times more corrosive.

Damage comes mainly from frequency. Drinking a bottle with a meal is fine; nursing one all day is not. Flavoured versions are worse—citric acid plunges the pH below 3. Drink promptly so saliva can rebound the pH, rather than bathing enamel in acid for hours.

Eon Engelbrecht – E-Radio-SA (6:32 – 6:43)

Obviously, we know hydration is important. Does overall hydration status affect your gum health too, or is it just your teeth?

Dr Clifford Yudelman – OptiSmile (6:44 – 8:21)

One hundred per cent. When I practised in America, people walked around with two-litre Evian bottles, sipping water constantly; the moment they lay back in the chair their mouths were full of saliva. In Australia and South Africa, we drink far less—lots of coffee instead—and mouths tend to be drier.

Adequate water intake means more saliva. Saliva contains immunoglobulins and antimicrobial peptides that suppress gum-disease bacteria. Chronic dry mouth breeds a thicker, stickier biofilm and accelerates gingivitis. Being hydrated also improves blood flow, helping gums heal quickly, and studies show low salivary flow correlates with higher inflammatory markers in the fluid between gum and tooth. So: drink plain water.

Eon Engelbrecht – E-Radio-SA (8:21 – 8:26)

How much water is ideal for healthy teeth and gums? We don’t want to overdo it.

Dr Clifford Yudelman – OptiSmile (8:27 – 10:08)

Most sources recommend around two litres a day for adults at sea level, adjusted upwards in hot climates or during strenuous exercise—far more than most people drink. Personally, I struggle to hit even a litre.

The simplest check: your urine should be very pale or straw-coloured. Dark yellow or orange means drink more. Steady sips are better than downing it in one go. Because coffee and alcohol are diuretics, have an equal amount of plain water for every cup of coffee or alcoholic drink.

Eon Engelbrecht – E-Radio-SA (10:08 – 10:16)

Is it true that staying hydrated can actually reduce bad breath?

Dr Clifford Yudelman – OptiSmile (10:17 – 11:30)

Yes. Our very first podcast, before Valentine’s Day 2024, covered this. Dry mouth allows volatile sulphur compounds—think rotten eggs—to build up. Morning breath happens because saliva flow switches off at night. Moist tissues deter the anaerobic bacteria that thrive without oxygen. Saliva also physically washes food particles away, and a lubricated tongue avoids the thick coating that smells. Patients with medication-induced dry mouth often develop dramatic halitosis; upping water intake or using saliva substitutes helps immediately.

Eon Engelbrecht – E-Radio-SA (11:30 – 11:36)

Why do some patients experience dry mouth even when they drink plenty?

Dr Clifford Yudelman – OptiSmile (11:37 – 13:21)

First thing I ask is about medication. Classic antihistamines dry up nose, eyes and mouth. Many antidepressants list dry mouth as a side-effect. Beta-blockers and other blood-pressure meds reduce salivary output. Mouth-breathing, especially during sleep or exercise, contributes too. Systemic conditions—diabetes, thyroid imbalance, autoimmune disease—can play a role, and, of course, excess coffee or alcohol.

Eon Engelbrecht – E-Radio-SA (13:21 – 13:26)

Herbal teas or coffee—are these acceptable substitutes for water?

Dr Clifford Yudelman – OptiSmile (13:27 – 15:25)

Decaffeinated herbal tea counts one-for-one. Black coffee technically hydrates but is mildly acidic; problems arise when you add sugar and nurse it for hours. Green tea’s polyphenols even inhibit Streptococcus mutans, the main cavity-causing bacterium. Sweetened iced teas are a disaster: sucrose plus citric acid. Same for “healthy” sports drinks—watch out for hidden sugars and acids.

Eon Engelbrecht – E-Radio-SA (15:26 – 15:28)

So I suppose Coca-Cola is out of the question?

Dr Clifford Yudelman – OptiSmile (15:29 – 16:15)

Even Diet Coke is very acidic (phosphoric acid). An occasional can with a meal is fine—as long as you follow it with water—but don’t sip it from 5 p.m. until bedtime. Everything in moderation, including moderation itself, as my late dad liked to say.

Eon Engelbrecht – E-Radio-SA (16:16 – 16:22)

Dr Yudelman, what role do electrolytes play in maintaining oral moisture balance?

Dr Clifford Yudelman – OptiSmile (16:22 – 17:53)

Salivary glands rely on sodium–potassium pumps to secrete fluid, so an extremely low-salt diet can reduce flow. Athletes lose sodium through sweat; sipping an isotonic (sugar-free, citric-acid-free) electrolyte solution helps. When I used to cycle for five or six hours, I’d keep one bottle of plain water and one with electrolytes—always rinse with the plain water afterwards.

Eon Engelbrecht – E-Radio-SA (17:53 – 18:00)

Can fluoride mouth rinses replace the need for regular water intake?

Dr Clifford Yudelman – OptiSmile (18:00 – 18:50)

No. Rinses may add minerals, but they don’t provide mechanical cleansing or continuous buffering. Over-using strong mouthwashes can cause dry mouth; many strip the saliva. Prescription fluoride rinses or Tooth Mousse before bed offer an extra layer of protection, but plain water is still the frontline defence.

Eon Engelbrecht – E-Radio-SA (18:50 – 18:52)

Tooth Mousse—that’s quite a name.

Dr Clifford Yudelman – OptiSmile (18:54 – 18:59)

Yes—think of it as conditioner for your teeth.

Eon Engelbrecht – E-Radio-SA (18:59 – 19:09)

Finally, what hydration hack would you give a busy professional on the go?

Dr Clifford Yudelman – OptiSmile (19:09 – 21:12)

Keep a reusable 500 ml bottle—nothing ridiculous like a two-litre sling. Drink half or all of it after every call or meeting, then refill. In the afternoon, swap fizzy drinks for iced rooibos (no caffeine, no acid). Set phone reminders: “Drink water, don’t snack.” And remember, filtered tap water is perfectly fine—no need for expensive imports.

Eon Engelbrecht – E-Radio-SA (21:13 – 21:26)

That concludes today’s podcast on the surprising connection between hydration and oral health. As always, a big thanks to you, Dr Yudelman, for sharing your expertise.

Dr Clifford Yudelman – OptiSmile (21:26 – 21:39)

Pleasure. Next week’s episode—Athletes & Oral Health: How Your Teeth Affect Performance—should be fascinating.

Eon Engelbrecht – E-Radio-SA (21:40 – 22:20)

Indeed. Thanks to our listeners for tuning in. Remember, while we strive to provide valuable insights, always consult your own dental professional for personalised advice. Subscribe for more enlightening discussions and join us next time as we explore the intersection of dental health and financial savvy. Until then, keep smiling and take great care of your teeth.

Narrator (22:41 – 23:26)

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 experience across four continents. Gain unique insights and expert advice at OptiSmile.co.za, or book directly online. OptiSmile: where global expertise meets local care.