Episode 03: The Link Between Your Teeth, Heart Disease, Diabetes & Alzheimer’s

Chapter 1: Introduction

 
[00:00:00] 

Introduction to Medical Monday on eRadio by Eon
Engelbrecht, featuring Dr Clifford Yudelman from OptiSmile,
focusing on oral health’s significant impact on overall systemic
health.

Chapter 2: The Significance of Oral Health

[00:00:16]

Dr Yudelman expresses his anticipation for the
discussion, emphasising the underestimated importance of oral
health and its broader implications beyond just dental issues.

Chapter 3: Oral Health and Systemic Diseases

[00:01:15]

Dr Yudelman explains how oral health is crucial in
preventing systemic diseases like heart disease, stroke, and diabetes
and its potential links to Alzheimer’s and mental health, highlighting
OptiSmile’s comprehensive approach to dental care.

Chapter 4: Diabetes and Oral Health Connection

[00:02:26]

Discussion on the epidemic of Type 2 diabetes and its
direct relation to oral health. Dr Yudelman shares personal insights
and stresses the importance of dental hygiene in managing diabetes.

Chapter 5: Heart Disease and Oral Bacteria

[00:04:28] 

Dr Yudelman delves into the genetic evidence linking
specific oral bacteria to heart disease, showcasing OptiSmile’s
advanced understanding of oral-systemic health connections.

Chapter 6: Osteoporosis and Dental Health

[00:06:20]

The conversation shifts to how oral health affects and is
affected by osteoporosis, underlining the importance of
comprehensive health care provided by OptiSmile.

Chapter 7: Identifying Oral Health Problems

[00:07:45]

Key indicators of oral health issues affecting overall
health, including the impact of cavities and bad breath, are discussed,
highlighting OptiSmile’s patient-centred diagnostic approach.

Chapter 8: Medications and Their Impact on Oral Health

[00:10:16]

Dr Yudelman discusses how certain medications can
compromise oral health, stressing OptiSmile’s thorough patient
assessment for personalised dental care.

Chapter 9: The Importance of Dental Care During Pregnancy

[00:13:51]

The critical role of dental health during pregnancy and its
impact on preterm deliveries is discussed, reflecting OptiSmile’s
holistic approach to dental wellness.

Chapter 10: Stress, Grinding, and TMJ

[00:15:49]

Exploring the relationship between stress, teeth grinding,
and TMJ, and the comprehensive solutions OptiSmile offers,
including the assessment for sleep apnea and the provision of night
guards.

Chapter 11: Contacting OptiSmile

[00:19:31]

Dr Yudelman shares how to contact OptiSmile for expert
dental care, emphasising their innovative free video consultation
service, designed to offer personalised advice and facilitate access to
their top-tier dental services.

Chapter 12: Conclusion

[00:21:26]

Closing remarks, thanking Dr Yudelman for his insights
into the critical link between oral and overall health, and a reminder
of OptiSmile’s commitment to enhancing oral health and overall wellbeing

[00:00:00] Eon Engelbrecht E-Radio-SA: This is Medical Monday on the eRadio, and
joining us again today is Dr Clifford Yudelman from OptiSmile today, talking about the
link between oral health and overall health. Dr Yudelman, welcome back.
[00:00:16] Dr Clifford Yudelman OptiSmile: Thanks so much for having me on again.
after last week’s episode on general dentistry and preventive care and our Valentine’s
episode about bad breath. so today is actually the one that I’ve been waiting for the
most. And because a lot of people that don’t really, maybe they don’t care so much if
they lose another tooth or if they have a bit of bad breath, or their gums are bleeding
and they they’re not that interested in oral health. They’re, they’ve maybe it’s something
that they learned from their parents. Like, it’s just a tooth. Pull it out, you know? So I’m
not going to argue or try and change someone’s mind. But hopefully, today’s episode
will make people think twice about what’s going on in their mouths. So, hope you got
some good questions for me. And I’m going to stay on track today and answer your
questions. So thanks very much.
[00:01:15] Eon Engelbrecht E-Radio-SA: Absolutely. how can oral health impact your
overall health and well-being?
[00:01:23] Dr Clifford Yudelman OptiSmile: That’s a fantastic question because your
oral health can really affect the risk of heart disease and stroke. I’ll get into the
mechanism because some of these things are all very similar. Diabetes and controlling
your blood sugar and pregnancy. And now they even talking about things like
Alzheimer’s and mental health. Ten or 20 years ago, there were indications that this was
the case, and there were quotes from the Mayo Clinic that people with their natural
teeth live ten years longer than people who don’t have their natural teeth and so on. But
it’s really in the last, in the last five, ten years that there’s just study after study after
study that links your oral health directly with these things that we just spoke about. I
think we can maybe carry on, and you can ask me specifically about each of these.
[00:02:26] Eon Engelbrecht E-Radio-SA: What are some systemic diseases linked to
poor oral health?
[00:02:32] Dr Clifford Yudelman OptiSmile: Okay. So let’s start off with one that you
can’t argue with, and that is these days, diabetes, especially in the US and, I believe, in
South Africa as well. Type 2 diabetes is an epidemic. We eat way too many carbs, me
included. although some people think Professor Tim Noakes is controversial, I can say
from a personal point of view that two years ago, I was pre-diabetic. I was on diabetic
medication, and I felt ill from the medication. I discovered Tim Noakes’s videos, and I
did some Banting for two months. I lost 16kg, and I went off all medications, including
blood pressure medication, diabetes medication and cholesterol medication. So I think
there are some things out there that can help people who’ve got type two diabetes
rather than medication. And the thing one of the things is brushing and flossing and
going to the dentist and making sure that your teeth and gums are healthy because
they’ve shown without any doubt that when your gums are bleeding, and you’ve got
gum disease, your blood sugar will be almost impossible to control. And vice versa. If
you’ve got diabetes, you’re more prone to things like skin infections and gum infections.
So diabetes. I think we’ve got that covered. And you can just Google it. You’ll see
there’s study after study after study. The other one is heart disease. So interestingly,
when someone gets a bypass, and they remove a clogged artery from your from your
heart, the cholesterol builds up in the, in that layer in the, in the wall of the artery they
send it for genetic testing.
[00:04:28] Dr Clifford Yudelman OptiSmile: And it’s only since we, we’ve been doing
all this genome stuff for the last ten, 20 years. They can also do a scraping of your
particular flora. There are eight main bacteria in your mouth that are responsible for
gum disease. And in each of those, they’ve got long names. I won’t mention them here
and try and show them off to other dentists, but they’ve got abbreviations like AA.
Actually, let me tell you, that’s Actinomycetes Actinomycetemcomitans: That’s one. One
word. Sorry. Two words. AA, so if you’ve got AA in your gums, there’s there’s different
genotypes of AA. And so maybe there’s like 50 different types of this particular one. And
if they do a DNA test of the little bit of your artery that they remove from your heart after
a heart attack, they, they will actually find the DNA of that bacteria that’s in your mouth,
in your heart. So that was the last time I checked. I haven’t read any further papers in
the last in the in more recently, but there are hundreds of other papers about how oral
health causes heart disease. And now there’s also about Alzheimer’s. I think people
must actually look after their health and Google the stuff I use, Perplexity.AI, or I go to
Scholar.google.com and you find things that are in medical journals. Don’t believe
everything you see on the internet, on a regular website. You go, if you can, you can go
to something like Mayo Clinic, heart disease, gum disease, and you’ll probably find
something more reliable.
[00:06:08] Eon Engelbrecht E-Radio-SA: And then I’m sure the web MD website will
obviously say something again that will make you believe 100% that you are busy dying
because that’s what they do with that website. And most of the time.
[00:06:20] Dr Clifford Yudelman OptiSmile: Yes, yes. Oh, and the other thing is, is
osteoporosis. So it’s very important that, especially in females or even in males that
cycle, if you don’t do any load-bearing exercise and you just cycle every day and you
don’t actually get any upper body exercise, that’s a big risk for osteoporosis, especially
as you get into your 60s. And then people who have osteoporosis go on this medication.
It’s called a it’s a type. The type of medication is bisphosphonates. I don’t actually know
all of the different drug names, but once you go on that, you can never get a dental
extraction. So you have to make sure that A that you don’t get osteoporosis in the first
place. And there’s a lot of information out there how to avoid it. It is pretty much
avoidable. hormone replacement in women is controversial in South Africa, but it’s a
very it’s something definitely to look into. It’s not just about the hot flashes. The hormone
replacement will actually protect your bones. I’ve been very interested in this recently
because I get a lot of female patients who are on these bisphosphonates. And so I’ve
really looked into it. And you can’t get a dental implant if you’ve got osteoporosis. And
yeah, your bone health is very important, and it can affect what goes on in your mouth.
So that’s just going in the opposite direction.
[00:07:45] Eon Engelbrecht E-Radio-SA: Doctor, what are the signs that your oral
health is actually busy affecting your general health? Do we get symptoms? How do we
know?
[00:07:54] Dr Clifford Yudelman OptiSmile: Let’s put cavities aside. well, actually, let’s
talk about cavities. If your teeth you got cavities between the teeth and when you’re
eating, food gets stuck, and you can’t eat your protein, you can’t eat your fish or your
meat or your veg, your carrots are getting stuck, and you just eat a lot of mushy, like,
mashed potatoes and a lot of carbs, crisps and chips. your diet is affected by how you
are able to to chew and bite if you’re missing a lot of teeth. Or maybe you have loose
dentures. You’ve lost your teeth. And we know that diet is very much related to our
systemic health. So that’s from a point of view of cavities. they’re getting teeth fixed
early before the cavities go into the nerve. Once the cavity goes into the nerve, you can
get an abscess in the bone. You can get a severe infection. It can cause fevers,
swelling, and pain. I think people listening to this have maybe had those problems
before. And it can actually give you flu-like symptoms, and it can cause quite a bad
infection. But I think your question maybe has more to do with how do we even know
these are the obvious things that we want to avoid? but what about just, someone with
bad breath? if you’ve got bad breath if your wife or husband tells you you’ve got bad
breath, or maybe your kids.
[00:09:18] Dr Clifford Yudelman OptiSmile: Something to do. If you listen to our
Valentine’s Day podcast, if you look at the back of your tongue, if there’s a lot of tongue
coating, you go out and you buy some dental floss and a tongue scraper. You scrape
your tongue when you floss or you brush, if you see any. It’s called pink toothbrush. You
brush your teeth without toothpaste for a minute with a dry toothbrush and spit in the
base. And if you see blood, that’s bacteria that are living under your gum line. And they
are going to your into your bloodstream and they’re going to your heart, they’re going to
cause high cholesterol. I mean, I’m sounding quite alarmist, but I mean, this is the case.
And if you’ve got other health issues, those bacteria going into your bloodstream are not
going to help your heart or your brain or any other part of your body, having really good
oral hygiene is is very important. I think it is back to the bad breath or the bleeding
gums. That’s key.
[00:10:16] Eon Engelbrecht E-Radio-SA: So, doctor, if I’m on medications currently,
how would I know it’s affecting my oral health?
[00:10:24] Dr Clifford Yudelman OptiSmile: So yeah. And that’s a really good
question. I’m so pleased that you asked that because I come to the dentist, and they
wonder why we delve into their medical history. And I think we’ve covered some of the
things. If someone already knows they have diabetes or they know they have heart
disease or high blood pressure, we know that we can motivate them to improve their
oral hygiene. But knowing what medications you, or a patient that’s coming to me today
or tomorrow, is on, really helps us because there are so many medications; if you
Google dry mouth, the technical terms are zero, like a Xerox xerostomia s t o m I a or
just medication and dry mouth. There’s a list of literally maybe 200 medications. The
common ones would be some of them, the psychology psychiatric medications and
some medications like antihistamines. There are a lot of medications that dry your
mouth. And when you’ve got a dry mouth, the acid will attack your teeth more. You’re
going to get more erosion. You’re going to get, more cavities, and it’s going to be
difficult to eat and speak. And if you do suffer from a dry mouth, we could actually do a
whole episode about dry mouth. That’s another systemic condition as generally caused
by medications. There are things like arthritis in people with rheumatoid arthritis, where
arthritis also knocks out the salivary glands, and also your tears, and you have very dry
eyes or, or dry mouth or radiation treatment that’s caused dry mouth. But also people
who have gone through a bout of depression, and depression is not something to be
embarrassed about.
[00:12:19] Dr Clifford Yudelman OptiSmile: People should reach out for help if they if
they have thoughts of suicide or they’re depressed or they have no one to speak to. I
know it’s a bit off subject, but if someone is depressed, they don’t brush, they don’t floss,
they don’t care. They don’t care about their oral health. And people can go through this
period of neglect. And, and then there’s, there’s some embarrassment about the
damage that’s been done. And it’s a bit of a vicious cycle. I think I’ve gone off subject
there, but I just wanted to get that across because it’s a very I think it’s it fits into this
episode how how your, your, your general health can actually affect your mouth. And
also as people get older or if you’ve had an injury or if someone’s got, some kind of
paraplegia or, or you need a carer to help you brush your teeth, not being able to
actually physically brush or floss is another thing. So there’s there are things where
medications and or systemic problems can cause oral problems. And, and your dentist
is the best person to help you with this. And I think at this point, I should say that
anything I’m saying here, any advice? it’s not advice, it’s general information. And you
should always check with your dentist. if your dentist says Dr Yudelman doesn’t know
what he’s talking about, I’m fine with that. Go and Google it or ask your your dentist for
advice. Please don’t follow everything I’m telling you here blindly, doctor.
[00:13:51] Eon Engelbrecht E-Radio-SA: I never realized how important it is for dental
care, especially during pregnancy and oral health and how they interconnect. Why is
dental care so important during pregnancy?
[00:14:05] Dr Clifford Yudelman OptiSmile: And I’m so pleased you asked that
because, I clean forgot to actually mention that earlier in that because we don’t think of
pregnancy as sort of part of systemic health. It’s a natural it’s a natural thing. And we
think our bodies know what to do. And we don’t think of it like heart disease and
diabetes. However, there are many studies that have shown that a lady in a female who
is pregnant has severe gum infections and poor oral health. And of course, if you’ve got
cavities and like I mentioned earlier, poor diet because of, your problems with not being
able to eat the correct diet. that’s good for the kid. you could have a, you could have a
malnourished baby and so on. But the main thing is, gum disease has been proven to
be one of the causes of preterm deliveries, and if a baby is born a week or 2 or 3 weeks
early, it causes a lifetime of problems, or it can take a long time before the baby is
healthy. Sometimes the baby has to go into an incubator. And so, getting your mouth
nice and healthy is not only good for your relationship, but it’s also good for your baby.
Your drinking alcohol during pregnancy or smoking during pregnancy. I think most
people know about that. If you go and you, you’re drinking, and you and you’re showing
like six months pregnancy, and you’re smoking, I think every other person is going to
come up to you and wag their finger in your face and say, you’re harming your baby, but
who’s going to tell you about flossing and brushing?
[00:15:49] Eon Engelbrecht E-Radio-SA: True. And then, lastly, our final question for
today: how does stress affect oral health? And let’s look at some of the strategies to
reduce its impact on our dental well-being.
[00:16:03] Dr Clifford Yudelman OptiSmile: OK, so that’s a fantastic question because
we mentioned I mentioned a little bit about depression and psychiatric or psychological
problems. And some people are very tough, and they’re able to withstand a huge
amount of pressure, whether it’s financial pressure or relationship pressure or, or,
teenagers acting up and they, they very good at, one thing is, they say biting your
tongue and not and not actually reaching out or lashing out, but it comes across as
grinding. A lot of people we find grind their teeth at work or during the day as well as at
night. And so there are exercises one can do, meditation, yoga, walking, all things to
reduce stress are very important, but in some patients, they’ve developed their muscles
really well. And they they become professional grinders. And people grind away their
teeth. this is on top of any kind of acid erosion. And or they keep cracking, you put a
filling in and they crack the, the tooth, and then you put a, you put a crown in and they
crack the crown. And they are things we can make for patients called night guards. like
a piece of plastic that you wear over your teeth. I find that people don’t wear them
unless they’ve got jaw problems. So grinding your teeth stress can cause TMJ, which is
your temporomandibular joint. It’s just a long word for that joint there near your ear. If
you’re getting headaches, earaches, things like that. you go to the ENT because you
think you’ve got an ear infection. your dentist is the right person to consult. And
personally, I don’t make a night guard or a bite guard for a patient that’s grinding unless
I also question them about snoring and sleep apnea.
[00:17:53] Dr Clifford Yudelman OptiSmile: Because so many people, if you’ve had
extractions for orthodontics, if you’ve got a small mouth and a big tongue, if you’re
overweight or if you’ve got a large neck or other risk factors for sleep apnea, if you’re if
you wake up with bruised ribs because your husband or wife keeps hitting you in the
ribs every time you snore, that’s a sign of sleep apnea and snoring. There’s an app
called SnoreLab, where you can record any sounds that you’re making at night. And the
snoring, it sounds like an airplane. And then you’ll hear yourself choking and coughing.
And then after that, you’re very quiet because then you’re cracking your teeth, you
grinding your teeth like crazy. And so just giving someone a night guard for grinding,
you might actually be making the sleep apnea worse. So. So I send all my patients for a
home sleep study. it used to be that medical aid covers it. I don’t know if they cover it.
It’s about 2000 rand. You do not have to go and have a hospital sleep study, a home
sleep study where you take home a special machine and then you bring it back. You go
to sleep you don’t necessarily need. most dentists won’t be able to help you with a
sleep study, but if you grinding your teeth and this sounds like you, then please get it
checked out. Because if you think gum disease affects your heart disease and your
diabetes and your psychiatric and all of that, sleep apnea is way worse. And it’s tied into
the gum disease and everything we’ve spoken about. We could actually do, do an
episode just on sleep apnea. maybe, maybe in a in a month or two.
[00:19:31] Eon Engelbrecht E-Radio-SA: Looking forward to that. as always, amazing
advice. doctor Yudelman, thank you so much for your time. just to tell us quickly, how
do we get in touch with you and also your website and your socials?
[00:19:45] Dr Clifford Yudelman OptiSmile: So it’s OptiSmile OptiSmile e we call it
OptiSmile because we optimize your oral health and we optimize your. Confidence. We
enable you to smile with confidence and vitality. That’s how we came up with OptiSmile.
You go to OptiSmile.co.za; you can WhatsApp us from there. You can phone us from
there. I won’t repeat my phone number or my WhatsApp number. you can just Google
OptiSmile or Google. Best dentist in Cape Town. And hopefully, we show up
somewhere on the first page. I’m not saying we are the best dentist, but we’ve got over
310 five-star reviews. Read our reviews and see if it’s something where we can help
you. We’re in Sea Point and we also offer free video consultations for patients that are
intending to actually come to Sea Point. And they can book it. You have to fill in. There’s
a health history and a dental history that you have to fill in before we actually set up that
half an hour appointment for you. And we’re able to give you all kinds of personalized
advice at that point. It is personal advice, and even though we don’t charge, it is
considered a doctor-patient relationship. And for anyone that’s thinking about coming to
see us, I would. And you’re coming from far away. I would encourage you to book a
video consult straight from our website, where it says Book Online. It’s one of the first
options when you go into that under New Patient.
[00:21:26] Eon Engelbrecht E-Radio-SA: That’s a very great initiative there, doctor.
Thank you so much, as always. And until next week.
[00:21:33] Dr Clifford Yudelman OptiSmile: Thank you so much. Bye