Episode 77: Sensitive Teeth & Erosion The Health Habits Harming Your Enamel

[Eon Engelbrecht – E-Radio-SA] (0:05 – 0:52)
Welcome to Save Your Money, Save Your Teeth. It’s the podcast on eRadio where curiosity meets dentistry and we explore how to keep both your smile and your wallet in great shape. I’m Eon Engelbrecht and every week I sit down with Dr Clifford Yudelman from OptiSmile to unpack the real issues behind dental health.

Now today we’re talking about sensitive teeth and a surprising twist: some of the very healthy habits people swear by – things like hot water with lemon, apple cider vinegar, kombucha and even sparkling water – might actually be harming your enamel. So we’re going to find out why, what the warning signs are and what you can do about it.

Dr Yudelman, welcome back.

[Dr Clifford Yudelman – OptiSmile] (0:53 – 0:58)
Thank you, thanks for having me back and yeah, looking forward to the summer. How about you?

[Eon Engelbrecht – E-Radio-SA] (0:59 – 1:03)
Absolutely, it’s about time now. I think we’ve had enough of the cold.

[Dr Clifford Yudelman – OptiSmile] (1:03 – 1:24)
Yes, for sure. And so yeah, we’ve got a little mini series today and next week, like you said, on sensitivity and things that make it worse and things that we think are healthy. So as usual, I’m ready for your questions.

[Eon Engelbrecht – E-Radio-SA] (1:25 – 1:40)
Let’s fire away. So Dr Yudelman, many healthy morning routines start with hot water and lemon or apple cider vinegar. From a dentist’s view, what does that acid actually do to enamel and roots?

[Dr Clifford Yudelman – OptiSmile] (1:41 – 2:54)
Yeah, so the roots, if you’ve got some recession and your roots are exposed, they’re very susceptible to acid. But let’s just start at the top with this question. So when you drink something acidic like lemon juice or apple cider vinegar, the pH or the acidity in your mouth drops below that critical level we’ve mentioned a number of times before.

And that’s 5.5. So 7, if you remember high school science, 7 is neutral. And you put that little piece of paper that goes purple or orange or green, and you can see. So 5.5 for enamel and then even higher for dentine. So dentine would be your exposed root or any enamel that’s worn away. And at that acidity, minerals like calcium and phosphate, which is what your tooth is made from, literally start dissolving out of your tooth. And the roots, as I said, are more vulnerable, because they don’t have that hard enamel shell, and they only have the softer cementum and dentine.

And once that is softened, it’s far easier for toothbrush bristles or even chewing to wear it away. And that leads to sensitivity.

[Eon Engelbrecht – E-Radio-SA] (2:55 – 3:03)
Now is temperature also part of the problem? You know, like sipping hot acidic drinks first thing, does it make the softening and the sensitivity worse?

[Dr Clifford Yudelman – OptiSmile] (3:03 – 3:33)
Oh yes, 100%. So acid plus heat is a double whammy or double insult. You know, warm lemon water or hot vinegar tea speeds up the chemical reaction, meaning that the acid works faster.

And the heat also makes the enamel expand slightly. So these microscopic surface crystals are even more exposed. And that’s why sipping hot acidic drinks in the morning is one of the worst combos for sensitivity.

[Eon Engelbrecht – E-Radio-SA] (3:34 – 3:45)
Now people swear by these ACV shots for gut health. Is a quick shot better or worse than slowly sipping a diluted drink over an hour, doctor?

[Dr Clifford Yudelman – OptiSmile] (3:45 – 4:28)
Yeah, I mean all this lemon shots and lemon and ginger and apple cider vinegar shots, you know, it’s all a bit of a trade-off. A quick shot exposes the teeth to a very low pH all at once, which is harsh, but then it’s over quickly. But sipping on diluted vinegar or lemon water over an hour keeps your teeth bathed in acid for a long time, which is often worse overall.

Studies show that the time of contact, how long the acid is in contact with your teeth, is one of the biggest predictors of erosion. You know, if people won’t give it up, at least get it over with fast and then rinse with plain water afterwards.

[Eon Engelbrecht – E-Radio-SA] (4:29 – 4:41)
And I know these are also very popular, sparkling water and vitamin waters. Where do they fit in? Does carbonation or added citrus flavouring meaningfully erode teeth?

[Dr Clifford Yudelman – OptiSmile] (4:42 – 5:42)
Yes, 100%. So sparkling water on its own is mildly acidic around, normally around a pH of 5, but some of them that I’ve seen on the shelf can be much lower. People that make their own sparkling water with, where they have the little gas cartridges and they add carbon dioxide that makes carbonic acid, that can be very low pH.

Sparkling mineral waters like a Pellegrino, when there’s minerals, can actually be neutral. But look, adding citrus flavouring or these vitamin boosts, the pH can drop to 2.5 or 3, which is the same as, you know, Coca-Cola and Pepsi and other sodas. And that’s a serious risk for enamel softening.

Many healthy vitamin waters are essentially acidic, you know, sports drinks in disguise. And we have spoken about some of these things before, but today we’re taking a fresh view from the top.

[Eon Engelbrecht – E-Radio-SA] (5:43 – 5:53)
Okay, and what’s the difference between erosion, abrasion and abfraction? And also, how does each uniquely create sensitivity in your teeth?

[Dr Clifford Yudelman – OptiSmile] (5:53 – 7:00)
Yeah, that’s a great question. So erosion is chemical. So that’s where you’ve got acid dissolving the enamel or the dentine, usually on the top of the tooth at the gum line.

Abrasion, so just remember that erosion is chemical erosion. Abrasion is mechanical, which is where your toothbrush bristles or your whitening toothpaste, or holding pins in your mouth, or if you bite your nails, you can abrade your teeth together. So that’s mechanical.

And abfraction, it’s one of my favourite words, I don’t know why we see a lot of abfractions. And that’s more stress related, not, well, yes, from stress when you clench and grind, but also the stress on the teeth. So that’s tiny flexing forces at the neck of the tooth from clenching or grinding, which create a like a V-shaped notch that we see so commonly.

And they often combine, the acid softens the surface, the brushing scrubs it away, and the clenching cracks the tooth at the neck of the tooth, and that’s why sensitivity is so common.

[Eon Engelbrecht – E-Radio-SA] (7:00 – 7:10)
And now we come to intermittent fasting, that’s quite trendy at the moment, you know, that some people drink lots of black coffee on an empty stomach.

[Dr Clifford Yudelman – OptiSmile] (7:10 – 8:15)
Yeah, so black coffee can be quite acidic, a pH of about four to five. And when you drink it on an empty stomach, there’s no food or saliva to buffer the acid. And the fasting also reduces your saliva flow.

If you’re not drinking enough water, we’ve done a few podcasts about medicine and dry mouth and dehydration and so on. That double hit means the enamel is more exposed. And if you brush right after the coffee, then you’re basically polishing away the softened enamel.

So, you know, you’ve got to pick your evils there, pick your poison, as they say. I don’t do intermittent fasting anymore, but I do like my black Americanos. I use an Aeropress, which I think isn’t as acidic as doing like a double espresso with hot water, Americanos.

It seems very popular these days, the cappuccinos and the lattes seem to be falling back a bit. And a lot of people seem to drink Americanos.

[Eon Engelbrecht – E-Radio-SA] (8:15 – 8:16)
Oh, okay.

[Dr Clifford Yudelman – OptiSmile] (8:17 – 8:24)
Right. So that’s in Sea Point anyway. Of course.

[Eon Engelbrecht – E-Radio-SA] (8:25 – 8:36)
And then, Dr Yudelman, you get swish before you swallow. I mean, that’s common with the lemon water and kombucha. Is this swishing actually the hidden villain for sensitivity?

[Dr Clifford Yudelman – OptiSmile] (8:36 – 10:10)
Well, it can be. I had a lot of patients in Australia that were in the wine business because much like here in the Cape, there’s a lot of wine growing and people that do a lot of wine tastings and that actually work with wines, selling them or reps or agents, they do the tastings, they swish it around, and then sacrilegiously spit it out, which is, which I’m not sure that I agree with. But it is better not to drink too much, I guess, especially if it’s on the job.

But swishing these lemon waters or kombuchas, it spreads the acid into every little crevice and it prolongs the contact. And the longer the acid touches the enamel, the deeper the demineralisation. So if you’re swishing kombucha or apple cider vinegar or citrus water, you’re giving your teeth an acid bath, the best is to swallow quickly, don’t swish and chase it with some plain water, especially if you have sensitivity.

There are people that do all these things and they’re like, nah, my teeth never get sensitive. And they’ve got very strong teeth and maybe they don’t have abfractions or some of the other things that also contribute to this. But I must say, the reason why we’re doing these two podcasts again and from a different angle is we just see so much of this being a problem worse than cavities.

We see so much erosion and abfractions, abrasions, people just wearing their teeth away from all of the stuff that we’re speaking about today.

[Eon Engelbrecht – E-Radio-SA] (10:10 – 10:24)
OK, and then, Dr Yudelman, chewable vitamin C’s or ACV gummies or electrolyte powders or pre-workout drinks. Can you rank this by erosive potential and why?

[Dr Clifford Yudelman – OptiSmile] (10:24 – 11:47)
So the worst would be chewable vitamin C tablets because vitamin C has got a pH of about two. That’s ascorbic acid. If you look there, if you look what vitamin C is, it’s basically acid.

And then apple cider vinegar gummies. I did some research that seems to be popular in some places. I’ve never seen them for sale in South Africa, but I put it in there in case people do use apple cider vinegar gummies.

You know, these things, especially any, they’re almost like those sour worms and those grenades. And I forget what some of those things are called. But these things, you know, it sticks to your teeth and prolongs the acid contact.

The next is like pre-workout drinks and electrolyte powders that you mix with water. They often have citric acid there again. You’ve got the word acid in there.

You’ve got ascorbic acid. Citric acid is very detrimental to the teeth. And then a little bit better might be like a pH-balanced sports drink or a flavoured sparkling water that’s more pH neutral.

And the least harmful would be just plain sparkling water as long as you’re not doing it all the time. Obviously the best is just plain good old tap water or filtered water, not necessarily bottled water.

[Eon Engelbrecht – E-Radio-SA] (11:47 – 12:00)
I also want to ask you, Dr Yudelman, how long does enamel stay soft after an acidic drink? And also why does brushing during that window worsen your sensitivity?

[Dr Clifford Yudelman – OptiSmile] (12:00 – 12:34)
So the research shows that your enamel stays softened for up to between 30 and 60 minutes after acid exposure. And if you brush during that soft phase, you scrub away minerals that might have been re-hardened in contact with your saliva. So if you eat something or drink something acidic and your teeth soften a bit, then your saliva has natural abilities to harden it.

Think of it as wet plaster. If you touch it too soon, you’ll gouge it. If you wait, it sits firm again.

[Eon Engelbrecht – E-Radio-SA] (12:35 – 12:50)
Now that’s very, very interesting. I also want to ask you, Dr Yudelman, our final question for today. If someone insists on lemon or ACV for health reasons, what are the damage limiting hacks that can actually work?

[Dr Clifford Yudelman – OptiSmile] (12:51 – 13:29)
So use a straw to try to get it past your teeth. So you sip and you swallow straight down. Rinse with plain water right after.

Don’t brush for at least 30 minutes. You can pair acidic drinks with a meal, not on an empty stomach. And end the day with a fluoride toothpaste to reinforce your enamel.

These don’t make it safe, but it limits the damage. And there are things available from your dentist, fluoride toothpaste or something called MI Paste Plus or Tooth Mousse, things to remineralise and harden your teeth.

[Eon Engelbrecht – E-Radio-SA] (13:29 – 13:46)
And that’s it for today’s episode of Save Your Money, Save Your Teeth. A big thank you to you once again, Dr Yudelman, for explaining why even innocent seeming drinks can lead to erosion and sensitivity. We appreciate it.

[Dr Clifford Yudelman – OptiSmile] (13:46 – 14:24)
Pleasure. Thank you. And I just want to remind the listeners to please subscribe and like and share this with your friends.

We’re getting quite a good following on the Spotify channel, on the eRadio Spotify and also on the OptiSmile YouTube. It’s also on Apple, thanks to Eon and eRadio. So yeah, word’s getting out.

And always wait till the end. Don’t turn off too soon because we always have great tips at the end of every episode. So make sure when you tell your friends about it to tell them to make sure to listen to the whole thing.

[Eon Engelbrecht – E-Radio-SA] (14:25 – 15:04)
And also remember, it’s not about giving up everything you enjoy. It’s about knowing the risks and protecting your teeth with the right strategies. That’s very, very, very important.

Also, thanks to our listeners for joining us. And remember, while we strive to provide valuable insights, always consult with your own dental professional for advice tailored to your personal health. And then do join us again next time for some more fascinating ways of exploring the intersection of dental health and financial savvy.

Until then, keep smiling and taking great care of your teeth.

[Narrator] (15:24 – 16:09)
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 at OptiSmile.co.za. OptiSmile, where global expertise meets local care.