New “all-natural” pastes promise bright smiles without “chemicals”, while dentists still swear by fluoride. In this fast-paced chat, Dr Clifford Yudelman – OptiSmile clears the fog for host Eon Engelbrecht – E-Radio-SA, revealing when fluoride is essential, when alternatives may help, and how to choose the right tube in under 30 seconds.
[00 : 01 : 25] Is fluoride toothpaste truly necessary for everyone?
- For 99 % of people, yes — fluoride cuts cavity risk by about one-third.
- Opt-outs: those on borehole water naturally >1 ppm fluoride or with proven hypersensitivity.
- Skipping fluoride can cost more in fillings than a lifetime of paste.
- Our preventive Teeth Cleaning visits include a professional fluoride top-up for extra insurance. optismile.co.za
[00 : 02 : 45] How does fluoride prevent cavities at the microscopic level?
- Swaps into enamel as fluorapatite that dissolves only at lower pH.
- Slows the acid-making enzymes in dental plaque.
- Works best in frequent, low doses (toothpaste, varnish).
- Remineralises early white-spot lesions before they turn into holes.
[00 : 04 : 45] Are fluoride-free toothpastes actually effective at cleaning teeth?
- They polish plaque away but can’t rebuild softened enamel.
- Long-term studies show higher decay rates where fluoride is absent.
- Nano-hydroxyapatite offers promise yet lacks the 70-year track record fluoride enjoys.
- See our quick primer on “just enough fluoride” in the blog Dental Health in a Nutshell. optismile.co.za
[00 : 07 : 05] Can daily fluoride swallowing cause systemic health problems?
- A pea-sized dose twice daily is far below levels linked to bone or thyroid issues.
- Supervise under-6s; they naturally swallow more paste.
- Community-water data over 70 years show no credible link to cancer or IQ loss.
- If you’re worried, spit thoroughly and only rinse lightly.
[00 : 08 : 33] Which paste is best for sensitive teeth — fluoride or fluoride-free?
- Choose fluoride plus potassium nitrate or stannous fluoride.
- MI Paste Plus (casein + fluoride) outperforms the fluoride-free version for sensitivity relief.
- Night-time use of high-fluoride prescription paste can seal open dentine tubules.
- More on managing sensitivity in our Tooth Sensitivity & Cost-Saving Care episode notes. optismile.co.za
[00 : 09 : 54] What about patients on high-fluoride well water?
- Use a mild 1 000 ppm paste; avoid supplements and fluoride rinses.
- Regular dental checks will spot early fluorosis before damage sets in.
[00 : 10 : 24] Are “natural” fluoride alternatives like hydroxyapatite proven to work?
- Small trials show similar remineralisation over six weeks.
- Evidence is still limited and often industry-funded.
- Good compromise: a paste with both fluoride (1 350 ppm) and hydroxyapatite.
[00 : 12 : 46] How should parents choose toothpaste for toddlers?
- From the first tooth: a smear of 500–600 ppm kid’s paste.
- At age 3 + and spitting reliably: a pea-sized 1 000 ppm paste.
- Skip “safe-to-swallow” gels with zero fluoride — they protect gums, not enamel.
[00 : 13 : 58] Is fluoride varnish redundant if I already brush twice daily?
- Varnish bonds for up to three months and can cut new-cavity risk by 40 %.
- Essential for brace-wearers, dry-mouth patients, and fizzy-drink fans.
[00 : 15 : 13] What’s the quickest way to pick the right toothpaste in the shop?
- Flip the box: look for 1 350–1 500 ppm fluoride.
- Seek a recognised dental-association seal (SADA, BDA, ADA).
- For sensitivity, check for potassium nitrate or stannous fluoride.
- Ignore “whitening” hype — many are simply more abrasive and can scratch enamel.
Ready to put these tips into action?
- Book a 1.5-hour fully digital consultation (scans, X-rays, personalised plan) at OptiSmile — Book Online
- Still unsure which paste suits your needs? Chat to our hygienists during a routine Teeth Cleaning visit for tailor-made advice.
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Disclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.
