Chapitres
Qu'est-ce que la dentisterie biologique?
[00:00:05 – 00:02:13]
Biological dentistry is not a formally recognised dental specialty — it is a philosophy and an unregulated discipline. At its best, it reflects a genuine interest in how dental treatments affect the whole body. At its worst, it makes claims that are not supported by scientific evidence.
Dentisterie fondée sur des preuves, by contrast, combines high-quality research, clinical expertise, and patient values. It is the standard taught at universities and endorsed by dental organisations worldwide. The key distinction is that evidence-based dentistry follows the research, whereas biological dentistry sometimes starts with a belief and seeks arguments to support it.
Le débat sur le fluorure
[00:02:14 – 00:03:31]
Fluoride is among the most studied substances in public health, with decades of research confirming that it significantly reduces tooth decay when used at appropriate doses. Much of the controversy stems from a misunderstanding of the difference between dose and toxicity — almost any substance, including water, can be harmful at extreme levels.
The fluoride concentrations used in toothpaste and water fluoridation are far below toxic thresholds. Systematic reviews from reputable organisations consistently conclude that fluoride is safe and effective as recommended. Claims linking fluoride to widespread systemic disease are not supported by robust evidence.
Silver Fillings and Amalgam Removal
[00:03:32 – 00:05:53]
Dental amalgam contains mercury in a stable, bound form. Large-scale studies have found no widespread evidence that amalgam fillings cause systemic illness in the general population. Crucially, unnecessary removal can temporarily increase mercury exposure and cause damage to the tooth itself.
There are legitimate reasons to remove amalgam — such as fractures, decay, or a cracking tooth — and these should be handled using proper protocols. However, the claim that routine amalgam removal detoxifies the body is not supported by science. Promising patients that removing their fillings will resolve unrelated conditions such as joint pain or arthritis is where the evidence simply does not follow.
Are Root Canals Toxic?
[00:05:53 – 00:07:28]
Fear-based documentaries claiming that root canals are toxic and cause systemic disease have been thoroughly discredited. The theory originated from poorly designed studies conducted over a century ago and has been repeatedly disproven by modern research.
Traitement canalaire dentaire is one of the most studied procedures in all of dentistry. When performed properly, it removes infection, eliminates pain, and preserves the natural tooth. Advances in microbiology, imaging, and materials have significantly improved outcomes, and reputable dental and medical organisations worldwide support root canal therapy as safe and effective.
What Does Biocompatible Actually Mean?
[00:07:28 – 00:09:43]
Biocompatibility means a material performs its intended function without causing harm to the surrounding tissues. All modern dental materials undergo extensive biocompatibility testing before approval. No material is completely inert, but the goal is predictable performance, durability, and a minimal adverse response.
The term is sometimes misused in marketing to imply superiority without any supporting evidence. Material selection in evidence-based dentistry is guided by clinical indication, longevity, and proven outcomes — not by labels or ideology. Patients who encounter practices heavily promoting exclusive, specially tested materials should approach those claims with healthy scepticism.
Balancing Holistic Health With Scientific Evidence
[00:09:44 – 00:11:21]
Oral health and whole-body health are genuinely interconnected. Maladie des gencives, for example, is well-supported by research as being linked to diabetes and cardiovascular disease. Dentists can and should inform patients of these connections and refer them to appropriate medical professionals when relevant.
However, recognising these links is not the same as overreaching into diagnosis or treatment outside the dental scope. Dentists specialise in the oral cavity, and the appropriate role is to support overall health while working collaboratively with other healthcare providers. An integrative but conservative approach — guided by science and responsive to the individual patient — is the recommended standard.
Does Ozone Therapy Work in Dentistry?
[00:11:21 – 00:13:14]
Ozone has genuine antimicrobial properties and has been studied as an adjunct in dental treatment. Some evidence suggests it can reduce bacteria in certain situations. However, current systematic reviews do not support ozone as a replacement for conventional treatment, such as removing a cavity and placing a filling.
Claims that ozone can heal a cavity without any drilling or restorative work are not well supported by mainstream research. It may have a limited role as an adjunct when no better option is available, but it has not become a mainstream treatment — and practices charging premium fees for ozone as a stand-alone cure should be viewed critically.
Should Patients Be Wary of Metal-Free Claims?
[00:13:14 – 00:16:01]
Modern dentistry has largely moved away from metal-based restorations not for ideological reasons, but because better materials are now available. Options such as lithium disilicate and zirconia offer excellent strength, aesthetics, and tissue compatibility. The absence of metal does not automatically make a restoration safer or healthier — every material has its strengths and limitations.
Titanium, for example, is the most thoroughly researched implant material available and is widely used in orthopaedic surgery. Practices that discourage titanium implants, condemn root-treated teeth, and advocate removing all amalgam fillings — often replacing them with premium-priced alternatives — are not operating from an evidence base. Material selection should be guided by function, longevity, and proven safety, not by documentary-led fear.
Can Dentistry Be Both High-Tech and Holistic?
[00:16:02 – 00:17:45]
La dentisterie moderne can absolutely be both technologically advanced and patient-centred. Comprehensive examinations that incorporate digital imaging, AI-assisted X-ray review, saliva analysis, dietary assessment, sleep health screening, and personalised risk profiling all reflect a genuinely holistic approach — one that is grounded in science.
The difference between this and biological dentistry ideology is that every recommendation must be supported by evidence. A dentist who claims that only their particular approach is valid, or that all conventional treatments are harmful, is not practising holistic care — they are promoting an ideology. Good integrative dentistry supports the whole patient while remaining accountable to the evidence.
Questions to Ask to Avoid Unproven Treatments
[00:19:06 – 00:21:18]
Patients can protect themselves by asking what evidence supports any recommended treatment, and whether that evidence comes from peer-reviewed research. AI tools such as ChatGPT, Gemini, or Claude can help summarise published research when questions are framed correctly. A second opinion is strongly advisable before agreeing to remove teeth with root canals, extract serviceable restorations, or undertake any significant treatment justified primarily by claims of toxicity or systemic disease.
If major dental organisations worldwide recommend a treatment and only one practitioner in town opposes it, that warrants careful scrutiny. Transparency, willingness to explain, and a readiness to acknowledge uncertainty are all signs of ethical, evidence-based care.
Transcription
[Eon Engelbrecht – E-Radio-SA] (0:05 – 0:35)
Welcome back to Save Your Money, Save Your Teeth, the podcast where we help listeners cut through the confusion and make smarter dental decisions. Now today, Dr Clifford Yudelman from OptiSmile joins us again to unpack a topic that can be surprisingly controversial, and that is biological dentistry versus evidence-based dentistry. What is helpful, what is hype, and also how can patients tell the difference?
Dr Yudelman, bon retour.
[Dr Clifford Yudelman – OptiSmile] (0:35 – 0:41)
Thanks, thanks for having me back, and I’m really looking forward to making a few enemies today.
[Eon Engelbrecht – E-Radio-SA] (0:41 – 0:55)
Oh, and I’m looking forward to seeing it happen. No, okay, so let’s start off with the difference between a biological dentist and a traditional dentist. What is that difference?
[Dr Clifford Yudelman – OptiSmile] (0:56 – 2:13)
The term biological dentistry is not a formally recognised specialty. It’s a philosophy, and it’s not a regulated discipline. And in its best form, it reflects an interest in how dental treatments affect the whole body.
But in its worst form, it can drift into claims that are not supported by evidence. So evidence-based dentistry, by contrast, is defined very clearly. It combines the best available scientific research, the clinician’s expertise, and the patient’s values.
And this approach is endorsed by international dental organisations and taught at universities worldwide. And the distinction is this: evidence-based dentistry asks, what does high-quality research show is safe and effective? And biological dentistry sometimes starts with a belief and then looks for supporting arguments.
So, you know, I don’t want to repeat that, but it’s very important to know the difference between the two. And you know, at OptiSmile, the guiding principle is always evidence first, and whole-body health matters very deeply, but the claims must be grounded in science and not ideology.
[Eon Engelbrecht – E-Radio-SA] (2:14 – 2:22)
Now, doctor, why would you say is there so much controversy around fluoride in the biological community?
[Dr Clifford Yudelman – OptiSmile] (2:23 – 3:31)
Well, I knew you were going to just jump right in with the fluoride there. So, you know, fluoride is one of the most studied substances in public health. We’ve done a few podcasts that talk about fluoride, and decades of high-quality research show that fluoride, only in appropriate doses, significantly reduces tooth decay.
And then the controversy arises largely from a misunderstanding of dose versus toxicity. So, almost any substance, including water, can be harmful at extreme levels. And the fluoride concentrations used in water, in toothpaste, and in water fluoridation are far below toxic thresholds.
And systematic reviews from reputable organisations consistently conclude that fluoride is safe and effective when it’s used as recommended. Claims linking fluoride to widespread systemic disease are not supported by any kind of robust evidence. And a scientific approach acknowledges both benefits and risks. It weighs up the evidence, and it avoids any fear-based messaging.
[Eon Engelbrecht – E-Radio-SA] (3:32 – 4:00)
OK, well, my dentist once told me that she had a patient who said she may not touch that silver filling in her mouth under no circumstances. Can she even touch it or remove it? She started screaming at her, actually.
So that brings me to this question. What is the story about silver fillings and removal safety? What is the scientific stance on amalgam or silver?
[Dr Clifford Yudelman – OptiSmile] (4:01 – 5:53)
Dental amalgam contains mercury in a somewhat stable and bound form. And there are large-scale studies that have found no widespread evidence that amalgam fillings cause systemic illness in the general population. That said, unnecessary removal of amalgam can actually increase mercury exposure temporarily and also damage your tooth.
And we’ve spoken about this before. There are a lot of other reasons why we remove silver fillings, like fractures or decay or that the tooth is cracking. But to just routinely remove all of somebody’s fillings and promise them that whatever disease they have is going to get better…
If someone’s got a torn meniscus or arthritis in their hip, to tell them that if I take out all your silver fillings, all of that’s going to miraculously disappear, that’s the issue that I have. If those amalgam fillings are causing cracks or have other reasons to remove them other than the mercury, then I’m all for that, but done the proper way.
And this claim that routine amalgam removal detoxifies the body is not really supported by science. And also preserving tooth structure. So someone who says, no, we’ve got to remove all your fillings and then drill your teeth down and put zirconia crowns or fill your teeth up with some woo-woo biological-tested special composite fillings that won’t give you ovarian cancer, that’s where we’re getting into a bit of a grey area.
[Eon Engelbrecht – E-Radio-SA] (5:53 – 6:21)
OK, I remember watching a documentary once on root canals. And funny enough, I watched it just a couple of days before I had a root canal done on my own tooth. And it scared me, to be honest, because they’re basically saying that these root canals are toxic and they’re slowly but surely poisoning you.
Are these root canals really as toxic as some of these documentaries claim, doctor?
[Dr Clifford Yudelman – OptiSmile] (6:21 – 7:28)
Absolutely not. Those documentaries have been shown to be nonsense. It’s actually been shown that those documentaries are nonsense.
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 your natural teeth. And the theory that they cause systemic disease originated from poorly designed studies over 100 years ago.
And it’s been repeatedly disproven. And modern microbiology, imaging, and materials have dramatically improved outcomes. And reputable medical and dental organisations worldwide support root canal therapy as safe and effective.
And, you know, these fear-based documentaries often rely on outdated and misrepresented data rather than on current science. In my own words, you know, it’s a lot of hogwash.
[Eon Engelbrecht – E-Radio-SA] (7:28 – 7:44)
I wish we had this conversation last year. I was so scared. OK, but now we know.
OK, and what does biocompatible mean, doctor, when you choose your dental materials?
[Dr Clifford Yudelman – OptiSmile] (7:44 – 9:43)
So that’s what I was talking about earlier with this whole biocompatible thing. Biocompatible means the material performs its intended function without causing harm to the surrounding tissues. So all modern dental materials are tested extensively for biocompatibility before approval.
And no material is completely inert. But the goal is predictable performance, durability, and minimal adverse response. And, you know, marketing claims sometimes misuse the term biocompatible to imply a superiority without evidence.
And evidence-based dentistry relies on clinical trials, not labels. And the material choice should be guided by indication, you know, when this should and shouldn’t be used, longevity, which is how long something may last, and proven outcomes. When I talk about these biocompatible composites, I’ve had a patient email me just last week and they copied about 20 other dentists in.
And it was quite funny because people were replying to all and it was interesting to see what other dentists were saying. But basically they asked about, do we use X and Y product that doesn’t have this and that in it? And they were looking specifically for one of these kind of dentists, maybe they’d seen something on TikTok or social media or watched the documentary somewhere.
And a lot of the time, I think these types of practices are just really looking to appeal to people that are a little on the paranoid side when it comes to these types of things. And this episode today is to sort of try and level things out for people that might be walking into a bit of a mismatch.
[Eon Engelbrecht – E-Radio-SA] (9:44 – 9:51)
And then at OptiSmile, how do you balance holistic health with scientific evidence?
[Dr Clifford Yudelman – OptiSmile] (9:51 – 11:21)
So we’ve spoken about this a few times. Whole-body health is inseparable from oral health, and gum disease, for example, is linked to diabetes and cardiovascular disease. And this connection is well supported by research. And the balance lies in respecting these links without overreaching.
We can tell patients about this and we can refer them. I’m often referring people to get a blood test to check for diabetes or sending someone to an ENT or even recommending someone see a cardiologist and discussing their general health. I often send people for sleep studies and they are diagnosed with sleep apnoea.
Every other week, I’m finding someone with sleep apnoea. And we’ve had quite a few podcasts on that as well. And the thing is, it doesn’t replace seeing an actual doctor.
Dentists, we specialise in the oral cavity. And yes, there is an overlap and the whole body is important. And we want to support all of that. And we want to help the person to be healthy. But we can’t now start acting like doctors and start diagnosing all other things. And at OptiSmile, the approach is what we call integrative, but conservative.
And we use science to guide the decisions while recognising each patient as being unique.
[Eon Engelbrecht – E-Radio-SA] (11:21 – 11:28)
And then we come to ozone therapy. What on earth is ozone therapy? And does it actually work for teeth?
[Dr Clifford Yudelman – OptiSmile] (11:28 – 13:14)
So years ago, I went and did a course. The guy was just, ozone will cure anything. You can stick it in your eye. You can stick it in your ear. It’s like a gift to mankind. And it’s got antimicrobial properties.
And it has been studied as an adjunct in dentistry, something that we can use. And some of the evidence shows that it can reduce bacteria in certain situations. But the current systematic reviews don’t support ozone as a replacement for conventional treatment, such as cleaning out a cavity and putting in a filling.
Some of these things where they claim that it can actually heal a cavity without doing any treatment, where you put this little suction cup on the top of the tooth, and you just pump ozone into the tooth for whatever it was, I can’t remember, ten minutes. And then you charge the patient with Australian dollars in those days. You charge him whatever, a hundred dollars for a ten-minute treatment.
Maybe for a hundred and twenty dollars, you could have numbed it and drilled it and put a filling in. And the one has got a lot of research behind it. And the other one is still, even after all these years, it’s still a little bit not mainstream.
And you can use ozone as an adjunct or if you don’t have anything better to use. And again, it’s not mainstream. I haven’t done any research more recently, say in the last six or twelve months.
But since you asked that, as far as I know, currently, we haven’t really found a use for it in our practice.
[Eon Engelbrecht – E-Radio-SA] (13:14 – 13:23)
And doctor, why should patients be wary of metal-free claims if it’s not backed by science?
[Dr Clifford Yudelman – OptiSmile] (13:23 – 16:01)
So metal-free, I don’t see that too much these days. But it was a big thing about that you don’t do amalgam, you only do composite. Or the original crowns were also porcelain fused to gold.
And the gold was very, it’s called high noble gold, and palladium, platinum. They’re very inert materials in the body. And then a lot of copycat porcelain fused to what’s called base metals, where they could be toxic, where they had nickel and so on.
And they did get a bad rap. But almost everything is metal-free these days because we have much better materials. We have lithium disilicate, Emax, that we bond to teeth really well.
We’ve got zirconia, which we bond to teeth that’s very, very strong. And that’s actually zirconia. The gum will actually almost try and glue itself to a zirconia crown.
That’s how inert it is. But the absence of metal doesn’t automatically make a restoration safer or healthier. Every material has got its strengths and limitations.
And that being said, some patients are very well served by chrome cobalt dentures that have been around for years and years. And I don’t think anyone’s died from having a chrome cobalt denture. It’s like a denture that’s got a metal framework, and then you’ve got acrylic or ceramic teeth on top of it.
And this metal-free story, that’s often used where people won’t use titanium implants, which is the most thoroughly researched metal for any kind of hip replacement. Or if you break a bone and they put pins and plates, or someone breaks their jaw, they end up with these titanium screws and titanium plates. And then you get these dentists that are going to pull out all your teeth that have got root canals because they’re giving you cancer, take out all your silver fillings and put in some kind of plastic that might degrade after a couple of years, or even pull your teeth out and then give you a ceramic implant that, yeah, there are some good ones now and so on.
But they charge twice the price of a titanium one, and they badmouth that titanium will kill you. These are the things that I’m trying to warn people about. If you want things that are based on material selection, that’s based on function, how it works, the longevity, how long it’s going to last, the safety, and not just an ideology like, oh, no, we don’t do that, that’s bad.
Watch this documentary that says it’s bad. That’s not evidence-based.
[Eon Engelbrecht – E-Radio-SA] (16:02 – 16:10)
Yes, absolutely. Do you think it’s possible for dentists to be both high-tech and holistic?
[Dr Clifford Yudelman – OptiSmile] (16:11 – 17:45)
Absolutely. In fact, modern dentistry increasingly blends advanced dentistry with preventative and patient-centred care. We’ve spoken a lot about digital imaging, minimally invasive restorations, personalised risk assessment, spending an hour and a half for a new patient exam and going through every little nook and cranny and discussing saliva, discussing forces, discussing diet, discussing oral hygiene, measuring the gums, using AI to check the x-rays, discussing if someone’s had their blood sugar tested, all of these things. I think a lot of good dentists these days support this holistic approach, but only one that’s grounded in science, not some ideology about root canals being bad and titanium being bad. The only thing that’s good is something that I do, and I’m the only one in town that does that.
There’s one in every town. Just like I said, you don’t have to go to Turkey to get Turkey teeth. You don’t have to go to California to find a biologic dentist.
There’s, I’m sure, more than one in Cape Town. There might be one in Jo’burg. I’m not sure.
In Perth, there were two or three, but there’s a biological or biologic dentist everywhere, and if a biologic dentist is listening to this and you don’t like it, then tune out, make your own podcast.
[Eon Engelbrecht – E-Radio-SA] (17:47 – 17:53)
Oh, that was funny.
[Dr Clifford Yudelman – OptiSmile] (17:53 – 18:51)
Talking of which, there is one of these guys on Instagram and TikTok, and there was a guy in one of my WhatsApp groups. There’s about 600 regular dentists, digital and cosmetic dentists on this WhatsApp group, and this one particular guy kept posting. I can’t remember his name.
He’s got like a Czechoslovakian name, and he goes by a different name. He’s got like a stage name, and he posts all the stuff that I’ve been telling you about. That’s one of the things that actually inspired me to do this podcast, and then it just only came to mind now because I wrote the questions for this podcast quite a while ago, and some of the stuff’s only coming back to me now, but yeah, it’s very entertaining.
I won’t mention his name now because I actually can’t remember it, but he goes by Doc Someone or Other, and that’s the kind of stuff people watch. He’s got thousands of followers.
[Eon Engelbrecht – E-Radio-SA] (18:51 – 18:52)
Bien sûr.
[Dr Clifford Yudelman – OptiSmile] (18:52 – 19:04)
As soon as you watch that, he’s very good. I watched that Uri Geller make an airplane disappear, and I believed that. I mean, I saw it with my own eyes.
[Eon Engelbrecht – E-Radio-SA] (19:06 – 19:20)
Oh, you’ve got to be so careful with social media, hey? Just finally, doctor, what questions should patients ask to ensure they aren’t getting, I love saying this word, quackery.
[Dr Clifford Yudelman – OptiSmile] (19:21 – 21:18)
Quackery. Well, that’s your word, not mine. So quackery, that’s an interesting word.
It goes back probably to the days where there were a lot of ducks running around quacking, snake oil salesmen. Quackery is someone that, I think, promises a treatment that’s not grounded in science or evidence-based. So you could ask what evidence supports this treatment.
Is it supported by something that’s called peer-reviewed research? These days, you’ve got something like ChatGPT. You’ve got Gemini.
You’ve got Claude. You can just ask your favourite AI. Make sure you ask the question the correct way.
You could ask, can you give me peer-reviewed journal articles, a summary of why titanium implants may be toxic and why ceramic implants may be better for you, or whatever it is that this dentist is asking. When it comes to things like implants or pulling out teeth that are perfectly good, that have root canals, that people are telling you cause arthritis or heart disease or are going to give you cancer, those are the times where one should really get a second opinion. It can’t all be a big conspiracy.
If every major dental organisation around the world recommends X or Y, and there’s one guy in every town that says, no, everybody else is wrong, I’m the only correct one, then it’s up to you to make your own mistakes. Transparency, willingness to explain, those are things that show if someone’s ethical and if they’re going to do evidence-based care. I think I better shut up before I get into trouble here.
[Eon Engelbrecht – E-Radio-SA] (21:20 – 21:43)
We’ve run out of questions anyway, so it’s all right. I think this was a really important conversation because, you know, patients are often caught between fear-based claims, so often fear-based, and genuine health concerns. A big thank you to you, Dr Clifford Yudelman from OptiSmile for your insights today.
[Dr Clifford Yudelman – OptiSmile] (21:44 – 21:50)
Thank you. Thank you. I appreciate it and looking forward to speaking to you next week.
[Eon Engelbrecht – E-Radio-SA] (21:50 – 22:02)
Absolutely. Looking forward to it. Do join us again next time here on Save Your Money, Save Your Teeth, where we keep helping you protect your smile, your health, and also your wallet.
[Announcer] (22:22 – 23:07)
Découvrez le monde de l’excellence dentaire avec OptiSmile. Rejoignez-nous pour un podcast hebdomadaire mettant en vedette le Dr Clifford Yudelman, un expert chevronné possédant 40 ans d'expérience dentaire sur quatre continents. Obtenez des informations uniques et des conseils dentaires d'experts en visitant OptiSmile.co.za pour des articles qui éclairent le chemin vers une santé bucco-dentaire optimale. Si vous recherchez des soins dentaires inégalés au Cap, contactez OptiSmile ou réservez directement en ligne sur OptiSmile.co.za. OptiSmile, où l'expertise mondiale rencontre les soins locaux.
Avis de non-responsabilité : le contenu fourni dans ce podcast, « Économisez votre argent, économisez vos dents » les lundis médicaux, est uniquement destiné à des fins informatives et éducatives. Il n’est pas destiné à servir de conseil dentaire ou médical. Les idées et opinions exprimées par le Dr Clifford Yudelman et les invités visent à favoriser une meilleure compréhension de la santé dentaire, des mesures préventives et du bien-être général, mais ne doivent pas être interprétées comme des recommandations dentaires ou médicales professionnelles. Clifford Yudelman ne diagnostique, ne traite ni ne propose de stratégies de prévention pour des problèmes de santé directement via ce podcast. Cette plateforme ne remplace pas les soins et conseils personnalisés fournis par un professionnel dentaire ou de santé agréé. Nous encourageons fortement nos auditeurs à consulter leurs propres prestataires de soins dentaires pour répondre aux besoins et préoccupations individuels en matière de santé dentaire. Les informations partagées ici visent à donner aux auditeurs des connaissances sur la santé dentaire, mais ne doivent pas être utilisées comme base pour prendre des décisions liées à la santé sans conseils professionnels. Votre fournisseur de soins dentaires est la meilleure source de conseils sur votre santé dentaire et globale. Veuillez toujours demander conseil à votre dentiste ou à d’autres professionnels de la santé qualifiés pour toute question ou préoccupation concernant votre santé dentaire.
