The OPTISMILE Podcast 124 - Nutrition for Developing Smiles

IntroductionIn this episode, Dr Clifford Yudelman turns the usual prevention message on its head. Dentistry has spent decades telling people what to avoid, and almost nothing about what actually builds a strong tooth in the first place. He covers the minerals and fat-soluble vitamins behind healthy enamel and dentine, why vitamin K2 has become a talking point in jaw development, and how chewing tougher foods influences jaw width and the odds of needing braces.He also tackles the frequency-versus-quantity question on sugar, whether a vegan diet puts a growing child's teeth at risk, and whether grandmothers were right about cod liver oil. The episode closes on mouth breathing, when an early cavity can be monitored rather than filled, and what modern dentistry does and does not take from Weston Price. The thread running through it all is financial: a well-built jaw and strong enamel in childhood represent decades of restorative dentistry that never has to happen.Questions and AnswersQuestion 1. We know sugar is bad, but what nutrients actively build strong enamel in the first place? (0:55)Enamel and dentine are living structures during development and need calcium and phosphate, plus the fat-soluble vitamins D3 and K2. D3 helps absorb calcium from the gut, and K2 directs that calcium into bones and teeth rather than into muscle. The classic warning sign is a child who brushes perfectly but still develops enamel defects or early decay. Look deeper and you usually find low sun exposure combined with poor dietary fat and a processed diet. In parts of Africa where people are outdoors tending cattle or walking long distances, naturally stronger teeth are common, largely from the vitamin D the skin makes in sunlight. Teeth built well in childhood resist decay and cracking, and that foundation saves decades of fillings, crowns and root canals.Question 2. What is vitamin K2, and why is everyone suddenly talking about it for jaw development? (3:18)Think of K2 as a traffic controller for calcium. Without it, calcium circulates but does not necessarily end up where it is needed. Research increasingly shows K2 activates proteins involved in bone and tooth mineralisation, including the jaw bones, which can influence arch width, tooth spacing and facial development during growth. A telling example is narrow jaws and crowding in children despite genuinely low sugar intake. Nutrition does not override genetics, but it influences how the genes express, and anything that reduces the odds of complicated orthodontics later is a long-term financial win.Question 3. How does vitamin D3 deficiency affect a child's teeth and even their airway? (4:21)D3 deficiency is surprisingly common even in sunny places, because children spend far less time outdoors than they used to. When D3 is low the minerals do not absorb, giving soft brown teeth, delayed eruption and weaker jaw bone. There is growing interest in how D3 affects airway development and muscle tone, so in a child with frequent chest infections, mouth breathing or poor enamel, more sunshine and better D3 can make both the whole body and the mouth more resilient. Oral health, airway health and immunity are all linked.Question 4. Does chewing tougher foods, such as carrots or biltong, actually influence jaw growth and reduce the chance of needing braces later? (5:37)Chewing is exercise for the jaw. Loading bone stimulates bone density and muscle development, so crunchy, tough foods that need real chewing make the jaws grow bigger, as opposed to soft processed foods. It is not about hardness for its own sake but about functional use of the jaw during growth. Children on soft processed diets, junk food or effectively baby food show a marked difference in jaw width and later crowding compared with those eating fibrous vegetables such as celery, carrots and apples along with good proteins. It will not guarantee that braces or Invisalign are avoided, but it plays a bigger part than people realise. For a family with two or three children, putting carrots and celery in the lunchbox instead of something mushy can save considerable time and money.Question 5. Is it how much sugar a child eats, or how often, that really drives cavities? (7:49)Frequency matters more than quantity. Every time sugar is eaten, the plaque on the teeth makes acid and that acid attacks the enamel for about twenty to thirty minutes. A can of Coke drunk with lunch produces one acid episode; the same can poured over ice at ten in the morning and sipped every half hour produces acid attacks all day, and after a few years of that the difference in the teeth is dramatic. The same principle applies to citrus: eat the whole naartjie and get it over with rather than popping a segment every twenty minutes. Grazing all day, including on juice, simply keeps the teeth covered in acid. Anything both sugary and acidic, such as a sour sweet or citrus, is worse again.Question 6. Is a vegan diet safe for developing teeth, or are supplements essential? (10:10)It is not the veganism itself that is the problem, it is the unrecognised deficiencies during critical growth windows. On a vegan diet it is hard to get enough B12, D3, calcium and K2. A well-meaning, ethical vegan family can be completely unaware that a child's poor enamel, and the dental problems that follow for the rest of their life, trace back to a gap in the nutrition. Anyone raising a child vegan should look specifically into foods with high levels of those nutrients. It is much cheaper and better to address that than to deal with enamel problems later.Question 7. Does cod liver oil actually help prevent cavities, or is it just an old wives’ tale? (12:02)Cod liver oil is genuinely very rich in vitamins A and D, both important for enamel and dentine, and its use long predates modern supplements. Grandmothers were not entirely wrong; they had a point, and those practices developed over years of observation. It supports mineralisation alongside good hygiene and low sugar exposure, and it is very low cost, often cheaper than modern supplement ranges. It does not replace brushing and fluoride toothpaste, which remain essential.Question 8. How does mouth breathing tie into all of this, beyond just the airway? (13:54)Mouth breathing usually points to airway obstruction and nasal issues, and it then causes problems in the mouth. It dries the mouth, which changes the oral bacteria, reduces saliva's protective role and makes enamel erosion worse. Sleep quality also suffers, which affects how the body releases growth hormone at night, and that matters for a developing child. A chronic mouth breather with restless sleep can get rapid decay despite a decent diet. Making sure a child is breathing properly, including allergy testing or an ENT referral, helps not only the teeth and the growth but even cognitive development.Question 9. Can nutrition actually reverse small cavities in children, or is that wishful thinking? (15:10)Very early decay, known as white spot lesions, can stabilise or remineralise under the right conditions, with good plaque control, brushing, flossing, fluoride, tooth mousse and nutritional support all working together. It does not mean every cavity will heal, only the ones caught early. A patient of 19 with several cavities visible on x-ray was discussed at the practice's Tuesday case meeting and most were left alone and monitored, because his oral hygiene is now excellent; he was given whitening trays to hold tooth mousse rather than to whiten, with x-rays at regular intervals. Another patient, now 25, has areas that look identical on x-rays taken in 2018, 2023 and today. Not every cavity needs a filling, and it is fair to ask questions when told you need eight.Question 10. What is the Weston Price theory, and does modern dentistry actually support any of it? (17:30)Weston Price held that traditional unprocessed diets correlate with lower decay rates and wider jaws in the populations he studied. His methodology was not perfect by modern research standards, but several of his observations do align with current nutritional science. Modern dentistry does not reject fluoride or preventive tools because of it: nutrition matters, but it works alongside evidence-based dentistry rather than replacing it. The sad cases are the ones where families believe the body can heal any cavity regardless of size; once decay is into the dentine, no theory substitutes for treatment. Dentists worldwide are required by law to earn continuing education points to keep their licence, which is what keeps practice anchored to current evidence, even though nutrition itself is barely taught in dental school.Closing ThoughtsDentistry has spent decades telling people what to avoid and almost nothing about what to actually eat. None of this replaces brushing, fluoride or a proper check-up, but getting the nutrition right early means a family is not fighting an uphill battle for the next fifteen years.As Dr Yudelman puts it, if you build it right the first time, the cheapest orthodontics and the cheapest fillings are the ones you never needed. A well-built jaw and strong enamel in childhood are decades of avoided restorative dentistry. To learn more or to book a full examination, visit OptiSmile.co.za.Further ResourcesPaediatric Dentistry at OptiSmile — child-focused dental care, prevention and first visits: https://optismile.co.za/dental-solutions/paediatric-dentist/Fluoride vs Fluoride-Free Toothpastes: Myths & Facts — the evidence on fluoride, remineralisation and white spot lesions: https://optismile.co.za/blog/fluoride-vs-fluoride-free-toothpastes-myths-facts/Dental Solutions for Snoring and Sleep Apnea — mouth breathing, airway and sleep-disordered breathing: https://optismile.co.za/blog/dental-solutions-for-snoring-and-sleep-apnea/Are All These X-Rays Necessary? — x-ray frequency and monitoring early lesions rather than filling them: https://optismile.co.za/blog/x-rays-dentist-gives-necessary/Secrets of Your Teeth Exposed Through Dental X-Rays — what each type of x-ray reveals, including early decay: https://optismile.co.za/blog/secrets-of-your-teeth-exposed-through-dental-x-rays/The Ultimate Guide to Dental Check-Ups — what a thorough examination includes and how findings are discussed: https://optismile.co.za/blog/the-ultimate-guide-to-dental-check-ups/Pregnancy and Dental Health — nutrition and oral health before the first tooth appears: https://optismile.co.za/blog/pregnancy-and-dental-health/OptiSmile Podcast Series — the full Save Your Money, Save Your Teeth archive: https://optismile.co.za/podcasts/OptiSmile YouTube Channel — video episodes and patient education: https://www.youtube.com/@OptismileZa-dentist-cape-townBook an appointment — contact OptiSmile in Sea Point, Cape Town: https://optismile.co.za/contact-dentist-cape-town/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.