The OPTISMILE Podcast 110 - Temporary Anchorage Devices (TADs)

The OPTISMILE Podcast 110 - Temporary Anchorage Devices (TADs)

In this episode of Save Your Money, Save Your Teeth, Dr Clifford Yudelman of OptiSmile joins Eon Engelbrecht to unpack one of the quieter revolutions in modern orthodontics: the Temporary Anchorage Device, or TAD. These tiny titanium mini screws sound intimidating, but they have transformed what is possible without resorting to jaw surgery. Across ten questions, the conversation covers how TADs work as a fixed anchor point, the kinds of movements they make achievable, what patients actually experience during placement and removal, and how they pair with both fixed braces and Invisalign. Questions and Answers Question 1  (1:07)  What on earth is a TAD, and why does it sound like a screw in the gum? A TAD is a temporary anchorage device, a small titanium screw placed in the bone to act as a fixed, stable anchor for precise orthodontic movement. It prevents unwanted reciprocal movement of other teeth and makes sophisticated movements possible that were previously difficult or only achievable with jaw surgery. Question 2  (1:43)  How do TADs let orthodontists achieve movements that were once impossible without jaw surgery? They provide what is called absolute anchorage, so a tooth can be moved precisely without causing other teeth to drift. This enables difficult movements such as intrusion, pulling a tooth up into the bone, and bodily movement, physically walking a tooth along the arch. The result is far wider treatment options and, in many cases, no need for surgery. Question 3  (2:24)  Is the procedure to place them painful? No. It is done under local anaesthetic, so the area is numb, and patients feel pressure rather than pain, much like having a small filling. Afterwards the discomfort is minimal, usually settled with Nurofen and Panado, and you get back to normal activities right away. Question 4  (3:08)  How are TADs used to fix a gummy smile? A small screw placed above the upper front teeth lets an elastic intrude those teeth up into the bone, and as they move up the gums follow, reducing gum display. It is a conservative, biologically sound approach that avoids aggressive gum or jaw surgery, applying more controlled force than braces or aligners could manage on their own. Question 5  (4:07)  Can TADs close spaces where teeth have been missing for years? Yes, though it is demanding work, because without anchorage neighbouring teeth simply tilt into old spaces. A TAD allows controlled movement to walk an adjacent tooth back into a long-standing gap, sometimes removing the need for an implant or bridge. Success depends on careful assessment of the bone, the size of the space, and the overall bite. Question 6  (4:56)  Do they stay in permanently, or are they removed? They are removed, often without even needing anaesthetic. The little screw is simply turned out, leaving a tiny hole that heals naturally within a few days to a week. Studies have shown no long-term side effects or adverse outcomes. Question 7  (5:25)  How do you keep them clean while they are in your mouth? Oral hygiene stays normal: you brush around them and can add an antibacterial mouth rinse if needed. They are small, smooth titanium and sit high up, so plaque does not really collect on them. They are also only placed in mouths that are already healthy, which keeps inflammation away. Question 8  (6:02)  Can they be used with Invisalign, not just with metal braces? Yes, they work with both fixed braces and clear aligners like Invisalign. Combining TADs with aligners, all supported by digital planning, allows very sophisticated and controlled movements while keeping the treatment patient-friendly. Question 9  (6:27)  What are the success rates, and can they fall out? Success rates are high, in the region of 80 to 95 per cent, but a TAD can loosen or come out, much like a screw in a piece of wood that is under constant load. If that happens it is easily replaced with a fresh one in a slightly different spot. Question 10  (7:12)  How do TADs save money compared with surgical options? By reducing or eliminating the need for jaw surgery, they dramatically lower cost, risk, and recovery time. They also improve force efficiency and control, which shortens treatment and makes movements possible that simply could not be done before TADs existed. Closing Thoughts What once required jaw surgery, headgear, or compromised results can now often be solved with a quietly placed mini screw and a clear plan. For the right patient that means shorter treatment, lower cost, and avoiding the operating theatre altogether. As always, the theme is biologically intelligent dentistry that does more with less. Further Resources Learn more about orthodontic and aligner treatment at OptiSmile: Orthodontics in Cape Town: https://optismile.co.za/dental-solutions/orthodontics/ [https://optismile.co.za/dental-solutions/orthodontics/] Invisalign in Cape Town: https://optismile.co.za/dental-solutions/invisalign-cape-town/ [https://optismile.co.za/dental-solutions/invisalign-cape-town/] Clear Aligners: https://optismile.co.za/dental-solutions/clear-aligners/ [https://optismile.co.za/dental-solutions/clear-aligners/] Everything You Need to Know About Invisalign: https://optismile.co.za/blog/everything-you-need-to-know-about-invisalign-clear-aligners-in-cape-town/ [https://optismile.co.za/blog/everything-you-need-to-know-about-invisalign-clear-aligners-in-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.

Your Money Maument with Mauritz Oberholzer - RSA Retail Savings Bonds

This week financial advisor Mauritz Oberholzer talks about an RSA Retail Savings Bond, an investment with the Government of South Africa which earns fixed or inflation linked interest for the term of the investment. Your Money Maument is aired on eRadio SA every Thursday and available as a podcast afterwards. For more information visit https://www.mauritzoberholzer.co.za/ [https://www.mauritzoberholzer.co.za/]

LEGAL TALK with Hahn & Hahn Attorneys: PIE Amendment Bill

This week we focus on the PIE Amendment Bill and what it changes in South Africa’s eviction laws. We look at why the Bill is needed, what new offences and penalties it introduces, and how it affects municipalities and state responsibilities. We also examine whether vulnerable occupiers are still protected and what the broader impact will be on property owners, developers, and the economy. Joining Eon is Nirvana Nothnagel of Hahn & Hahn Attorneys. Legal Talk is aired every Wednesday morning at 10:00 on eRadio and available as a podcast thereafter.

The OPTISMILE Podcast 109 - Airway Orthodontics & Palatal Expanders

Introduction A child's upper jaw shapes far more than the alignment of their teeth. It forms the floor of the nasal cavity and directly governs how easily they breathe, how deeply they sleep, and how their face grows over a lifetime. A narrow palate is not simply a cosmetic orthodontic concern — it is a functional one with wide-reaching consequences for health, behaviour, and development. In this episode, Dr Clifford Yudelman of OptiSmile Advanced Dentistry and Implant Centre in Sea Point, Cape Town, explains what palatal expanders are and how they work, the differences between fixed metal and Invisalign-based expansion systems, the critical window for intervention in growing children, and why early expansion can prevent extractions, surgical procedures, and a cascade of harder problems later in life. Topics covered include the relationship between a narrow palate and nasal airway resistance, the surprising link between jaw width and bed wetting in children, what happens to the face profile when teeth are extracted unnecessarily, the current limits of adult expansion, and the specific signs parents should look for at home right now. Episode Questions and Answers Question 1  (1:06) How does a narrow palate affect a child's ability to breathe? The palate forms the floor of the nasal cavity, so a narrow palate directly constricts the nasal passages. Children develop increased nasal resistance, become habitual mouth breathers, and are vulnerable to poor sleep, snoring, behavioural issues, and altered facial growth. Question 2  (2:31) What on earth is a palatal expander, and does it hurt? An orthodontic appliance that widens the upper jaw by separating the mid-palatal suture. In children the suture is still flexible, so expansion is biologic rather than surgical. Most children feel pressure rather than pain, with mild tightness after activation that settles quickly. Question 3  (3:51) What is the Invisalign Palatal Expander and how is it different from metal ones? The traditional metal expander is fixed to the molars and turned daily by a parent. The Invisalign system uses a digitally planned series of removable clear expanders. It is more comfortable, easier to clean, and better accepted by children. Correct diagnosis and timing matter more than the device chosen. Question 4  (5:19) Can expanding the jaw prevent the need for removing teeth later? In most cases, yes. Widening the arch increases both width and perimeter, giving teeth space to erupt naturally. Multiple studies confirm early expansion reduces the need for future extractions. Unnecessary extractions narrow the arch and can flatten the facial profile significantly. Question 5  (7:12) How is bed wetting linked to airway issues and even narrow jaws? Nocturnal enuresis can be linked to sleep-disordered breathing. Poor oxygenation and frequent sleep arousals disrupt the hormonal signals involved in bladder control. Improving airway patency through nasal breathing can help in airway-related cases. Question 6  (8:10) Is there an age limit for expanding the palate? Expansion is most effective in children and early adolescents while the mid-palatal suture is still open. As skeletal maturity increases, non-surgical expansion becomes less predictable. An orthodontic screening at around age seven is the recommended starting point. Question 7  (9:20) How does airway orthodontics improve sleep quality for children? Palatal expansion increases nasal airway volume and reduces airflow resistance. This supports deeper, more stable sleep cycles. Parents typically report reduced snoring and improved daytime focus and behaviour. Sleep studies confirm measurable improvements in airflow after expansion. Question 8  (10:16) Can adults benefit from expansion or is it surgery only for them? Adults can benefit but the fused suture means conventional expansion tends to tip teeth rather than widen the skeleton. Surgery-assisted or TAD-supported expansion can achieve skeletal change. Dr Yudelman cautions that this is being heavily oversold and would not currently refer his own patients for the surgical route. Question 9  (11:18) Does expansion change the shape of the face or even the cheekbones? In growing children, expansion supports more balanced facial development and a broader smile. Changes are gradual and harmonious. Claims of dramatic adult facial transformation should be treated with scepticism. Function is the primary goal; aesthetics are secondary. Question 10  (12:10) What signs should parents look for to know if their child needs this? Watch for chronic mouth breathing, snoring, a narrow smile, crowded teeth, dark circles under the eyes, and frequent fatigue. A simple home check: tilt the child's head back. A flat, wide palate is normal; a deep V-shape is a prompt to see the dentist. Outro Airway orthodontics may be one of the most underappreciated areas in modern dental practice. A child who breathes better sleeps better, learns better, and grows better — and the window for non-surgical palatal expansion is narrow and biologic, which is why early screening matters so much. The dentist who looks at a seven-year-old's crowded smile and sees only teeth is missing most of the picture. Look at the airway. An orthodontic assessment at around age seven allows for the simplest, safest, and most effective interventions — ones that can prevent years of complex and expensive treatment later. Next week's episode covers TADs — temporary anchorage devices — the small titanium screws used in orthodontics to create fixed points that help move teeth predictably. Another essential piece of the modern orthodontic toolkit. To learn more and to book an assessment at OptiSmile, visit the links below. Further Resources Invisalign at OptiSmile https://www.optismile.co.za/invisalign/ [https://www.optismile.co.za/invisalign/] Full overview of Invisalign treatment for adults and teens at OptiSmile, including the Invisalign Palatal Expander system discussed in this episode. Orthodontics at OptiSmile https://www.optismile.co.za/orthodontics/ [https://www.optismile.co.za/orthodontics/] Overview of orthodontic services at OptiSmile including early intervention, palatal expansion, and adult orthodontics. About OptiSmile https://www.optismile.co.za/about-us/ [https://www.optismile.co.za/about-us/] Background on Dr Yudelman's training and the OptiSmile approach. Useful context for patients wanting to understand the practice's evidence-first philosophy and use of digital dentistry. Book an Appointment https://www.optismile.co.za/contact/ [https://www.optismile.co.za/contact/] Book directly online or get in touch with the OptiSmile team in Sea Point, 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.

The OPTISMILE Podcast 108 - Biological vs Evidence-Based Dentistry

Intro The biological dentistry movement is everywhere on social media, with claims that fluoride is toxic, silver fillings poison the body, and root canals cause cancer. None of these claims hold up under scientific scrutiny, yet they continue to drive patients into expensive and often unnecessary treatments. In this episode, Eon Engelbrecht speaks with Dr Clifford Yudelman about the difference between biological dentistry as a philosophy and evidence-based dentistry as a discipline, and how patients can tell them apart. They cover fluoride, amalgam removal, root canals, biocompatibility claims, ozone therapy, metal-free marketing, and the question of whether a modern practice can be both high-tech and genuinely whole-body aware. 10 Questions with Summary Answers 1. [0:41] What is the difference between a biological dentist and a traditional dentist? Biological dentistry is a philosophy, not a formally recognised specialty or regulated discipline. At its best it reflects a genuine interest in how dental treatments affect the whole body; at its worst it drifts into claims unsupported by evidence. Evidence-based dentistry, by contrast, is clearly defined: it combines the best available scientific research with clinical expertise and patient values, and is endorsed by international dental organisations and taught at universities worldwide. The fundamental difference is that evidence-based dentistry asks what high-quality research shows is safe and effective, while biological dentistry sometimes starts with a belief and then looks for supporting arguments. 2. [2:14] Why is there so much controversy around fluoride in the biological community? Fluoride is one of the most studied substances in public health, and decades of high-quality research show that at appropriate doses it significantly reduces tooth decay. The controversy largely stems from a misunderstanding of dose versus toxicity. Almost any substance, including water, can be harmful at extreme levels, but the fluoride concentrations in toothpaste and community water are far below toxic thresholds. Systematic reviews from reputable organisations consistently conclude that fluoride is safe and effective when used as recommended, and claims linking it to widespread systemic disease are not supported by robust evidence. 3. [3:32] What is the scientific stance on amalgam fillings and routine removal? Dental amalgam contains mercury in a stable, bound form, and large-scale studies have found no evidence that amalgam fillings cause systemic illness in the general population. Unnecessary removal can actually increase mercury exposure temporarily and damages otherwise healthy tooth structure. There are valid clinical reasons to replace amalgam fillings such as fractures, decay, or cracking, but routine wholesale removal as a supposed cure for arthritis, joint problems, or other systemic conditions is not supported by science. The clinical principle is straightforward: replace amalgam for a clinical reason, not because of a promise that it will detoxify the body. 4. [5:53] Are root canals really as toxic as some documentaries claim? No, and the documentaries claiming otherwise are based on poorly designed studies from over a century ago that have been repeatedly disproven. 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 the natural tooth. Modern microbiology, imaging, and materials have dramatically improved outcomes. The fear-based content circulating online relies on outdated and misrepresented data rather than current science. 5. [7:28] What does biocompatible actually mean when you choose dental materials? Biocompatible means a material performs its intended function without harming surrounding tissues. All modern dental materials are tested extensively for biocompatibility before approval. No material is completely inert, but the goal is predictable performance, durability, and minimal adverse response. Marketing sometimes misuses the term biocompatible to imply superiority without evidence. Material selection should be guided by clinical indication, longevity, and proven outcomes, not by labels or testimonials. 6. [9:44] At OptiSmile, how do you balance holistic health with scientific evidence? Whole-body health is inseparable from oral health, and the links between gum disease, diabetes, and cardiovascular disease are well supported by research. The balance lies in respecting these links without overreaching. Dr Yudelman regularly refers patients for blood tests, sleep studies, ENT input, or cardiology assessment when warranted, but is clear that dentists specialise in the oral cavity and should not be diagnosing conditions outside it. The approach is integrative but conservative, guided by science and tailored to each individual patient. 7. [11:21] What is ozone therapy, and does it actually work for teeth? Ozone has antimicrobial properties and has been studied as an adjunct in dentistry, with some evidence it can reduce bacteria in certain situations. Current systematic reviews do not support ozone as a replacement for conventional treatment such as cleaning out a cavity and placing a filling. Claims that ozone alone can heal a cavity without restorative work are not mainstream and lack solid research support. Dr Yudelman has not found a useful clinical role for it in his own practice. 8. [13:14] Why should patients be wary of metal-free claims if they are not backed by science? Metal-free marketing capitalises on the genuinely poor reputation of older base metals like nickel-containing alloys, but modern restorative materials are very different. Lithium disilicate (Emax) and zirconia bond well, are extremely strong, and are highly inert; zirconia in particular integrates so well that the gum almost glues itself to a zirconia crown. The absence of metal does not automatically make a restoration safer or healthier — every material has strengths and limitations. The biggest concern is when metal-free messaging extends to discouraging titanium implants, which are the most thoroughly researched implant material in medicine and are routinely used for hip replacements and fracture fixation. 9. [16:02] Is it possible for dentists to be both high-tech and holistic? Yes, and modern dentistry increasingly blends advanced technology with preventive, patient-centred care. A proper new-patient examination at OptiSmile takes around 90 minutes and covers digital imaging, saliva, occlusal forces, diet, oral hygiene, gum measurements, AI-assisted x-ray analysis, and discussion of broader health factors such as blood sugar. The distinction Dr Yudelman draws is between a holistic approach grounded in science and an ideology that rejects established treatments wholesale. Good clinicians can do both; ideologues only do one. 10. [19:06] What questions should patients ask to ensure they are not getting quackery? The most useful question is simply: what evidence supports this treatment, and is it backed by peer-reviewed research? Modern AI tools like ChatGPT, Gemini, and Claude can summarise the published literature on any specific claim, such as whether titanium implants are toxic or whether ceramic implants are genuinely better. A useful sanity check is the global consensus test: if every major dental organisation in the world recommends one approach and a single practitioner in town claims to be the only one who is right, that imbalance is a signal, not a selling point. Transparency and willingness to explain the evidence are the hallmarks of ethical, evidence-based care. Outro This episode draws a clear line between two very different approaches to dentistry. Evidence-based dentistry combines high-quality research with clinical experience and patient values. Biological dentistry, in its more extreme forms, starts with a belief and looks for supporting arguments afterwards. Both can sound caring on the surface, but only one is grounded in science. For any treatment that sounds like a miracle cure, the right questions are simple: what evidence supports this, is it peer-reviewed, and do other major dental organisations agree? If one practitioner is the only one in town claiming to be right, that should be a signal rather than a selling point. Further Resources Unveiling Dental Fillings: Preservation Meets Aesthetics https://optismile.co.za/blog/unveiling-dental-fillings-preservation-meets-aesthetics/ Direct companion for the amalgam discussion. Covers the history of dental amalgam, why white fillings have replaced it in most cases, and when amalgam is or is not the right clinical choice. Root Canal Treatment in Cape Town https://optismile.co.za/dental-solutions/root-canal-treatment-cape-town/ OptiSmile's treatment page on root canal therapy. Explains what the procedure actually involves and why it remains one of the most predictable ways to save a natural tooth. Exposed: The Hidden Dangers of Ignoring Tooth Decay https://optismile.co.za/blog/hidden-dangers-of-ignoring-tooth-decay/ Full podcast episode on root canals, including the anatomy of the tooth, the procedure itself, and why modern endodontics with magnification and 3D imaging produces predictable long-term outcomes. Dental Implants in Cape Town https://optismile.co.za/dental-solutions/dental-implants/ OptiSmile's main implant page. Useful background for the titanium-versus-ceramic discussion and for understanding why titanium remains the gold standard in implant dentistry. Everything You Need to Know About Dental Implants https://optismile.co.za/blog/everything-youd-need-to-know-about-dental-implants/ Full podcast episode on implants. Covers single-tooth implants, full-mouth reconstructions, implant-supported dentures, healing times, and costs. The Oral Microbiome and Your Health https://optismile.co.za/blog/the-oral-microbiome-your-health/ Background for the whole-body health discussion. Explains how the bacteria in your mouth influence cavities, gum disease, and broader systemic conditions including heart and gut health. Chilling Truths: Tooth Sensitivity and Cost-Saving Dental Care https://optismile.co.za/blog/secrets-of-tooth-sensitivity-and-cost-saving-dental-care/ Earlier podcast episode that includes practical discussion of fluoride varnishes and desensitisers as evidence-based ways to protect enamel and reduce sensitivity. About OptiSmile https://optismile.co.za/about-us/ Background on Dr Yudelman's training and the OptiSmile approach. Useful context for patients wanting to understand the practice's evidence-first philosophy and use of digital dentistry. 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.