All posts by Jsgross

Good Oral Health Habits and the Life of Your Teeth

Good Oral Health Habits and the Life of Your Teeth

The health and life of our teeth are in our control. Nothing earth-shattering or profound in that statement. Our oral health habits directly impact the life and use of our teeth. Good habits will extend their life and bad habits will shorten it.

Simple right?

Unfortunately, despite its common sense nature, this is often overlooked and ignored by many people.

In this article, I’d like to explore 5 common sense oral health habits we can and should all adopt to extend the life of our teeth.

What Can I Chew With My New Teeth?

I get this question a lot from patients. This week it came from someone who actually received 3 new teeth. She had been missing them for a while. Having tried various solutions over the years, nothing really worked. She came to me to see if I could help. She was a perfect candidate for new teeth which were a great replacement for what she lost.

After we discussed that she could really eat whatever she desired, she asked me if there were any restrictions. At first, I said “no, you have no restrictions” but then I thought of a news story that I saw recently.

The article was about Hailey Baldwin, known for her modeling and television career, who appeared on late night TV.  Jimmy Fallon, the host of the Tonight Show was interviewing her.

During the interview, she opened two bottles of beer with her teeth. Any dentist hearing about this would cringe. To make matters even worse, the host then commented,”You are the coolest person I’ve ever met.”

I can’t imagine how many of her fans will try this.  The result will be a good number of broken teeth and trips to the dentist. In my world, this is an activity that will lead to many tooth problems. Teeth are for eating food. This is an example of a behavior that will negatively impact our health.

A common sense study with profound implications

In the same vein there, was a study just published by Dr. Frank Hu who is chair of nutrition at the Harvard School of Public Health. Right now the average 50 years old can expect to live approximately 30-33 years according to the US government statistics. However, Dr. Hu found that practicing 5 habits could add approximately a decade to that number.

The habits are not crazy. In fact, you could probably figure these out yourself.  

The 5 Lifestyle Habits to Extend Life:

  1. Not smoking.
  2. Eating in a healthy fashion.
  3. Exercising regularly.
  4. Maintaining a normal weight.
  5. Drinking only in moderation.

Nothing is really earth shattering on this list. What is of great interest to the medical and scientific community is that we have the power and the ability to extend our own lives. Put in another way, we can live out our full lives and not cut it short with bad behaviors. The more great news is that not only are these people living longer, but their quality of life has improved markedly.

I would like to suggest that we could extend the life of our teeth if we follow good oral habits also.

I have my own 5 habits to help our teeth.

The 5 Oral Health Habits to Extend the Life of Our Teeth:

  1. Use your teeth for what they were designed for – eating.
  2. Replace missing teeth.
  3. Fix broken teeth
  4. Get your teeth checked and cleaned regularly.
  5. Brush & floss daily


Using our teeth for things other than eating, like opening beer bottles with one’s teeth is akin to smoking.

Not fixing a broken tooth is akin to excessive drinking.

Not replacing missing teeth is akin to excessive weight.  

Not getting your teeth cleaned on a regular basis is akin to not exercising regularly.

Brushing and flossing are akin to eating in a healthful fashion.

These are all modifiable factors that will either extend or shorten the lifespan of our teeth. In many cases, they will allow us to keep our teeth throughout our entire lives. The health of our teeth is in our control.

If you are a regular reader of this column and have been considering putting emphasis on the care and health of your teeth, now is a great time to start.

Take my 5 Oral Health Habits to heart and call me. I can be reached at 400.951.7856. Talk to Megan and she will start you on the highway to better teeth. I look forward to hearing from you.

Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.


Are Permanent Teeth Right For Me?

Permanent teeth - natural and umplant

Well at first glance that should be an easy one.  Permanent teeth are the best choice for everyone. Isn’t that the way that we were created? We have arms, legs, fingers, and toes that do not come off.

Of course, due to trauma or disease, we could lose some of these permanent extensions of our being, but we know that we need to replace them. We strive for permanent fixes.

What does permanent mean?

Let’s take a moment and define permanent. We tend to think of permanent as being the same as forever.

First of all forever is not really forever. Forever, when used in a human context, usually means as long as I am around. Forever for a 20-year-old is not the same forever as a 75-year-old. So forever can have different meanings depending on the situation.  

So if permanent does not mean forever, what does permanent mean? It usually means that once something is in place, no one has any intention to remove it.

Is it possible to remove it?…yes. It is removed on a consistent basis?…no.

Permanent in the context of dentistry

For example, in dentistry, we refer to a filling as being permanent. There is also a temporary filling. What is the difference? The temporary filling will fall apart relatively quickly and replacement is planned. A permanent filling will last much longer and I have no intention to remove or replace it when I put it into functionality. So it really depends on my thoughts and plans at the outset. Even though permanent is not forever, it implies a long-term solution or a fix to an issue.

The less that I have to deal with a dental appliance, then the more it becomes part of me, so to speak. Framed in the context of what I just mentioned, it is more permanent.

Different types of teeth replacements

For a variety of reasons, we could be forced to lose all of our teeth. If we choose to have them replaced, we need to choose between different approaches.

Full Dentures

Full DenturesThe oldest and “simpler” choice is a full set of teeth that sit in the mouth.  We call this a full denture.

When I need to, I can take out my teeth. Why would I need to take them out? There are a number of reasons. Why do I take off my shoes?  There are a number of reasons. It feels better when they are removed, cleanliness, when in place pain is present, etc….

This is the easiest way to replace missing teeth. The kind that comes in and out at will. They are not permanent because they don’t stay in place all of the time.

Permanent Teeth

The other way to replace missing teeth is with permanent teeth. When we deal with just a few missing teeth, a permanent option can be very simple. We have different types of choices. They could be cemented bridges, bonded bridges or dental implants. They are all good solutions to the problem of replacing missing teeth with a permanent solution. When we are faced with losing all of our teeth, we only have one permanent solution. This is permanent teeth supported by multiple implants.

Dental Implants

There is not a day that goes by that I do not see a commercial talking about this. The approach has been around for a couple of decades but only in the last 10 years or so has it exploded. It is the closest thing that we have to turn back the hands of time for many patients.

The techniques keep on evolving and improving

It is not an invention. It is a technique. As with all techniques, improvement is the constant mantra.

I have done root canals for decades. The way that I do them now is so different than the way that I did them years ago. They are better and faster. The result is a happier patient coupled with great results.

The same is true with permanent teeth. The procedure keeps on evolving. Many times the teeth in a day procedure literally takes a day. There are so many variables and intricacies in the technique that predictability and repeatability have been a challenge.

Underside view of implant procedure

Underside view of implant procedure using Guided Smile Chrome

One of our local laboratories has pioneered a technique which makes the entire process modular. This technique is called Guided Smile Chrome and truly guides the smile. The result is less stress for all of those involved and a reduction in the total procedure time.

Teeth in a (half a) day

Permanent Teeth in half a day

Permanent Teeth in half a day – Next level full mouth teeth replacement with implants

Teeth in a day have now evolved into teeth in a half a day. The technique is computer driven and involves multiple modular pieces that fit together. The result was great and we corrected teeth that were spaced, decayed and broken. We even added teeth to places that were missing teeth for years. Best of all this patient did not have to learn to wear an upper denture. Learning to deal with a set of teeth that come in and out can be a challenge for us as we get older.

If you want to learn more about this breakthrough in permanent solutions to broken and decayed teeth, please call me at 440.951.7856 I look forward to speaking with you.


Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.


Missing a Tooth? You Have Options!

Missing a tooth?

Can I Have New Teeth on The Same Day That I Lose My Teeth?

This question may rank as one of the most sought after requests that I receive.
There are very few people to whom this point does not matter.
Going around missing a tooth is not something that most people want to do.

However, we have to qualify precisely in which situations this is relevant.
It is also true that most people do not mind walking around with a missing tooth.
Didn’t I just contradict myself?
First I said that patients do not want to be seen without a tooth, and then I followed with the opposite statement.

Let us look at these two comments and allow me to explain how they are not contradictory.

When people don’t mind missing a tooth

Let’s start and deal with the second statement.
What do I mean by “most people do not mind walking around with a missing tooth?”
With this latter statement, I am referring to our molars or chewing teeth.
In fact, I have found, not only do people not mind missing these teeth for a short period, but they don’t mind losing a tooth and not replacing it for years!

This is despite the fact that their chewing is either impaired or altered.
To chew food efficiently, they may need to favor one side. Alternatively, the person may spend a long time chewing their food before it is ready to be swallowed.

What’s the big deal? No one can tell!

The rationale for not replacing the tooth follows the thought that eating at some level can still be done. After all, there are still other teeth!
Imagine if we would apply that logic to a finger. One could say, “the loss of a finger would not be so bad as I have nine others.”
Of course, we would never say this but with teeth, since the function is not eliminated entirely and “nobody sees my space,” then what is the big deal?

When it comes to missing a tooth, many put appearance over function

I just touched upon the point which explains my first statement regarding people not wanting to walk around toothless.

Losing a tooth that is obvious to everyone around me is a big deal. In fact, this could affect chewing even less than a back tooth.

The deal breaker is the embarrassment. Walking around missing a tooth that everyone can see, bothers most people.

I remember walking into a store one time and seeing the regular employees walking around with a surgical mask on her face. I thought that she was ill and was contagious.

Being the friendly fellow that I am, I asked if she was okay. She replied that she felt well. Oh… the reason for the mask was that her front tooth broke and she was embarrassed about her appearance.

This is like the old real estate dictum.
As the saying goes, the three most important things in real estate are Location, Location, and Location.

Well, the same applies to losing a tooth in the minds of most people. Our appearance to our friends and neighbors is more important than the loss of chewing function.

With today’s modern dentistry, being toothless is a thing of the past.

I’m not going to focus on the two sides of this discussion.

I want to point out and say that with modern materials, computers and skill of the dentist, being toothless is a thing of the past.
I can either actually create a duplicate of a tooth, that is removed, at the same time that I remove it.
Today, I can also use digital impressions, photographs, and x-rays to convey information to my laboratory to allow them to create a
duplicate of our removed tooth.
This procedure applies to front teeth as well as it pertains to back teeth.
It is applicable when I am doing a permanent bridge to replace a tooth or teeth, or when I am making a removable bridge to replace a tooth or teeth.
This applies to when I remove all of your teeth and make a denture or when I may give you teeth supported on implants.

The point is, with today’s modern dental technologies and techniques, you don’t have to live with missing a tooth.

Whether your concern is appearance, functionality or both, you have options and we can help you!

My goal is to give you options and hope!

If you need to lose a tooth or teeth and are worried about the potential embarrassment, please call me and let’s talk.
My goal is to give you options, and as many people say to me, give you hope.
We can discuss various paths to follow. With your help and input, we can fine tune those options to deliver what you need and what you want.
I can be reached at 440.951.7856. Just call Megan and ask to speak to me or make an appointment for a complimentary consultation.
I look forward to hearing from you.


Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.


The Problem with Snacking with Invisalign Aligners

Snacking with Invisalign Aligners - banana smoothie

Is it wise to be snacking with Invisalign Aligners?

Continuing to chronicle and document my Invisalign® journey from a dentist’s perspective, this week we discuss the possibility and wisdom of snacking with Invisalign Aligners – even if it’s with soft food.

Weeks 4 and 5

These last two weeks continued to be less eventful.

Invisalign does a great job as long as you wear the aligners. This is why we instruct patients to wear them as much as possible except for brushing and eating.
I always get the question concerning the length of time that they really should be worn.
This usually ends up with a question of only wearing them at night. My answer is always “nighttime only is not long enough to create enough movement.”

To snack or not to snack – That is the question

With that in mind, I have the following dilemma. When presented with food and the chance to eat, I needed to decide as to whether to partake and remove the aligners or forgo the food.

I am not referring to meals. I am referring to the numerous opportunities for snacks during the day.
Many times it is easier to leave the aligners in.

This got me thinking as to whether or not I could be snacking with Invisalign® aligners in my mouth.
After all, I have seen patients without any teeth eating. They don’t eat well, but they do eat.
I learned that food that did not require much grinding was a perfect choice. I became adept at bananas, tangerines, yogurt and some other foods.
If you are currently wearing aligners, why don’t you gave it a try?

Its an issue of cleanliness

The only problem that I see is one of cleanliness.
For example, everyone can drink with the aligners in place.

If you head out to Starbucks and order your favorite latte, you will discover that coffee breath will linger longer than usual.
This is because once the liquid gets inside the aligners, the standard mechanical motion of the tongue and lips will not be present.
Saliva does not reach the area as readily as it does without the aligners. Food or liquid behind the aligners lingers.

If we take this concept to sugary foods, the sugar will stay in contact with your teeth much longer. That, of course, spells trouble.

So in the end, I actually ate less frequently than my new found idea allowed me, but still, more than, I had not come across this idea.

The bottom line is that I want to think like a patient, but I can’t get the dentist out of me.


Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

For any questions about Invisalign®  or any of the other dental procedures performed at The Healthy Smile Dental Center please call Megan at 440.951.7856


How Often Should You Replace Your Dentures?

replace your dentures

If you have dentures, you may think that they should last forever.
The truth is, your face, jaw, and gums change over the years, but your prosthesis does not. Your dentures are made of a rigid material and can’t adapt to these physical changes.

In this article, let’s explore some issues that indicate it may be time to replace your dentures.

Will My Front Teeth Look Big?

I thought of this question as I met a new patient this week.
He had a set of dentures that were on their last legs. They had broken over the years and had a number of repairs to try and patch them together.

None of that phased me as I see that sort of thing a lot.

What made an impression on me was how much of his tooth showed when he smiled. The upper front teeth were enormous.

First of all the teeth were very long.

Secondly, when he smiled, the entire tooth was visible as well as a fair amount of pink denture base above the teeth.
This gentleman was in his 60’s, and that look was not at all natural.

We sometimes see that in a very young patient but time takes its toll on the height of teeth.

Dentures or crowns should look natural

Dentures or crowns on front teeth should reflect a natural look on a person.
They should be in consonance with their facial features and general appearance.
A person’s chronological age will affect the size of his teeth. Denture teeth that were made when someone was in their 40’s do not look natural for someone who is twenty or thirty years older.

Front teeth have definite shapes and sizes to create a “natural smile.” They are not all the same length..they are not all the same width..and of course, they are not bright white.

All of that just spells phony when one looks at it.

The makeup of a ‘natural’ smile

I strive to have a natural and comfortable look on the dentures that we make. The very front teeth are the largest and widest of the upper six teeth. They are taller than the tooth that is next to them and definitely wider than that tooth. They do not all line up in a row. The four front teeth as a group are relatively flat looking, whereas the cuspid, or “eye tooth” has a large mid-section. These subtle difference make our smiles look, for lack of a better
word, natural and pleasing.

When you need to replace your dentures

Dentures, like anything else, can be made to last for a long time. However, the larger question is whether or not they should be used for a long time.
First of all, a denture is porous and absorbs odors and bacteria to the point of saturation. This creates a very unsanitary situation in the mouth.
Second of all, the colors and size of teeth change as we get older. Bright white and large teeth are not appropriate for someone as they advance through middle age.
These are reasons that I recommend that your dentures be remade every 5-7 years.
This way our denture stays “in style”.

Just as our faces and bodies change, our artificial teeth should adapt and change. After all, this is the same thing that happens to people with natural teeth. They change in shape and color.

Customized dentures for each patient

During the denture making process in our office, we spend a lot of time getting the front teeth to look appropriate for that particular person.
Many times we use computers to aid us in picking the best size for our mouths.
These teeth are always viewed by the patient and me when the teeth are in wax. This allows me to move the teeth in any direction at will. We may move them up, or push them down, allowing us to see more or less of our teeth.
To create a natural appearance, I may recommend turning a tooth ever so slightly. I may suggest a small space between certain teeth.

All of this is done to duplicate the works of what we often call nature.

It is essential to see how the curve of the edges of your teeth looks against your upper and lower lip.
Do we have a harmonious smile line (a tracing of the teeth edges) or does it look out of place?

I compare pictures of your old teeth and try to make a change for the better, in a very subtle fashion. I use digital photos and videos to
help the patient see themselves as the rest of the world sees them.

The science and art of denture making

Denture making is a science blended into an art. It can’t be rushed and shouldn’t be hurried. After all, you will be wearing these dentures for years.
The least that should be done is spending an appropriate amount of time creating them.

If you think that it is time to make the move to a denture or to update your current denture, please call me. I will listen to you and do my best to help you.

I can be reached at 440.951.7856. Looking forward to meeting you.


Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.


The Added Perk With Invisalign® Treatment

The Invisalign® treatment aligners

The Invisalign® treatment aligners can serve as a tooth whitening tray too!

Continuing to chronicle my Invisalign® journey from a dentist’s perspective, this week we discuss an added benefit that Invisalign® treatment aligners provide that most people don’t realize!

Week 3

Invisalign® aligner trays can serve a second function

Okay, now let’s get to a fun topic.
Do you know that with the Invisalign treatment, there is an extra added perk that very few people discuss?
Please allow me to give you some insider information that many times is lost with all the emphasis, and rightly so, on the alignment and moving of teeth.
What is often forgotten is that the aligner trays can serve a second function. They can act as bleaching devices or trays too!

Two Different Approaches to Teeth Whitening

Bleaching or whitening of teeth has been around for a long time. There are two different approaches to brightening our smiles.

In-Office Laser Whitening

One approach is to sit under a high-intensity light in the dental office with your mouth packed with cotton and gauze while a caustic bleaching solution is put on our teeth. This method works well, though some people have developed a lot of sensitivity either during or after the visit.
These are sometimes hyped as “rapid whitening” or “laser whitening”.  They are all very similar as the manufacturer has come up with some method to accelerate the activity of the bleaching liquid. This kind of jump starts the bleaching process with follow-up care and more whitening done at home.

Take-Home Whitening

Whitening can also be accomplished without supercharging the solution. A unique solution is applied to the teeth and whitening proceeds in a steady, gentle fashion. You might ask, how does the whitening work? Doesn’t it run off the teeth? Dentists need a way to keep the solution on the teeth.

Usually, custom-made holders or trays are made for the patient to keep the liquid on the teeth while it does its magic.

Invisalign® treatment aligners can serve as bleaching trays

Interestingly enough, the trays or holders look like aligners that we use to straighten the teeth during the Invisalign treatment. So now with our aligners, we have the perfect fitting and accurate bleaching trays. This is a perfect opportunity to ask your dentist to provide you with a dentist-quality whitening solution for your teeth. This is something that I offer as a special perk to my patients.

Capitalize on the opportunity

For those of you considering straightening your teeth with the Invisalign treatment and its aligners, I encourage you to also whiten your teeth. Not only will they be straight, but they will sparkle when you are done with treatment.


Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

For any questions about Invisalign®  or any of the other dental procedures performed at The Healthy Smile Dental Center please call Megan at 440.951.7856


Adjusting to Life With Invisalign® – Week 2

Invisalign Lower Aligner - Blue background

Continuing to chronicle my Invisalign journey from a dentist’s perspective, this week we discuss how I’m adjusting to life with Invisalign®

Week 2

Well, I just finished my second week, and it was a lot less eventful than my first.

Learning to place my aligners correctly

I learned how to set the aligners in my mouth without grabbing my lips or cheeks!

The lower set was more of an issue for me as the bottom lip always seemed to wrap forward and get caught in the aligner as I was snapping it into place.
At the same time, the back of the lower aligner would get close to my cheek on both sides. If I wasn’t careful, I would catch my lip and both cheeks at the same time creating a trifecta of sores.

Pro Tip! Using my fingers

I learned to use my fingers to hold back the lips and cheeks and still allow the aligner to seat in to place on my teeth. I needed all of my fingers to multitask.

Being a dentist, this was second nature to me. However, I see how my patients would fight and struggle to learn some of these skills. Some of them never learn those skills and tricks and come in with sores throughout their mouths.

I resolved to make an effort to teach some of these tricks and hacks when I notice sores that are present. Sharing my knowledge of holding back the lips while placing the aligners would really be a nice thing. I’m sure that my patients will appreciate it.

Inspecting the Invisalign® attachments

While I was placing an aligner, I decided to examine the attachments a little closer. One of my lower teeth, the lower right cuspid (eye tooth) had two attachments.
Remember the attachments are the little projections that are bonded to the teeth to help the aligners grip the teeth better and ultimately move the teeth properly.

The attachments are made of tooth-colored filling material and are relatively invisible. At least they are challenging to see.

Great! One of my Invisalign® attachments were missing

So when I looked a little closer, I noticed that only one of the projections was there. That tooth was missing the second attachment. I will assume that it was there and fell off.

The Importance of having two attachments

Whatever the reason the second attachment on that tooth was important. The cuspids have long roots and are difficult to move. This is probably why the Invisalign software that generated the plan placed two attachments. The better the grip, the more predictable the movement.

So I had to go back and have the second attachment replaced on the tooth. This wasn’t a big deal, except for the fact that the device that was used to holding my lips out of the way was really cutting into my upper lip.

After a reasonable amount of time grimacing and wincing, we decided that adding a cotton roll under my lip would help.
This reinforced to me that all retractors are not created equally.
I knew that from my end. Now I know it from the patients’ end as well.

Chronicling how I’m adjusting to life with Invisalign®

I just switched to the third aligner. I’ll see what develops this week.
In the meantime, I’ll just continue chronicling how I’m adjusting to life with Invisalign®.

Stay tuned for my thoughts on week 3 of this Invisalign Patient Experience – Through the Eyes of a Dentist!


Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

For any questions about Invisalign®  or any of the other dental procedures performed at The Healthy Smile Dental Center please call Megan at 440.951.7856


The Invisalign Patient Experience – Through the Eyes of a Dentist

Invisalign Patient Experience

From The Doctor Chair to The Dental Chair – A Unique Perspective

As a dental practitioner administering Invisalign in my practice for nearly 20 years, I know it can be a terrific orthodontic approach to predictably straightening your teeth.
However, I never knew firsthand what an Invisalign patient experience was until now.
Now, as an Invisalign patient myself, I have the unique perspective of knowing what an Invisalign treatment entails from both sides of the equation.
I’m hoping this blog series will help give unique insight and perspective to anyone contemplating this procedure for themselves.

Welcome to The Invisalign Patient Experience – Through the Eyes of a Dentist!

Why Don’t You Practice What You Preach?

When I was in my last year of school, I listened to a physiology lecture from a practicing physician. He was morbidly obese and smoked during the address.
I kept on thinking and wondering. Why wasn’t he picking up and listening to what he was saying?
He knew that his lifestyle was heading him down the road to some serious health problems.
Why didn’t he take his own advice?

Well, some years later, I asked myself the same question.

I had developed a tooth issue which was the result of crowded teeth.
It was more than a tooth issue. It had ramifications to the gum and bone structure around my teeth.

Sure, I am a great brusher and flosser, and disease was less of an issue with me than with other non-dental people.

That being said, I was still beating up certain teeth. I knew that they would begin to chip and crack. The excessive wear was already there. I wanted to stop this.

Crowded lower front teeth

crowded teeth overhead shotI advise my patients all the time about crowded lower front teeth and what happens. I recommend fixing the issue before it becomes a severe problem. I needed to address this in my own mouth.

I finally made time for myself and began orthodontic treatment with Invisalign. As I mentioned earlier, I have used Invisalign treatment in my office for close to 20 years. Now I am on the other end of the treatment so to speak.

I now have aligners (that’s what those plastic things that move your teeth are called) on my top and bottom teeth.

I started to feel what it was like to be sitting in the dental chair, not in the doctor chair.

Sharing my Invisalign patient experience and perspective

So I thought that I would share some of those experiences, feelings, and issues that my patients have.
This time it is coming from a dentist perspective, and I hope to share what is going on and how I cope with those issues.
I hope that this may help some of you who are also going through orthodontic treatment.
For those of you contemplating this treatment, it will give you a glimpse into what lies ahead and how to successfully navigate the path.

Week 1

An appointment for Invisalign® attachments

I have just completed my first week of therapy. Let me tell you how it went for me.
It began last Monday with an appointment in which these little plastic projections were applied to my teeth.
These buttons are designed so the clear plastic aligners effect movement of the teeth.
The size and position of the attachments will control the movements and potentially their timing too.

I sat in the chair and had plastic retractors placed to hold my lips and cheeks away from my teeth.

The technician looked at my teeth and remarked as to how clean my teeth were. I rolled my eyes and thought, “what were you expecting.” Fortunately, I did not verbalize my thoughts.

Applying the Invisalign® attachments

The teeth that had the projections (officially called attachments) were cleaned. They were then dried and bonded in preparation for the attachments.
All of this was done with the cheek retractors in my mouth and cotton stuffed all over to prevent contamination of the teeth with my saliva.
The attachments were connected to the teeth, and I was given my first set of aligners. They snapped into place and really felt weird.

Two facts about wearing the Invisalign® aligners

Invisalign AlignerI knew two essential facts about wearing the aligners.

  1. First of all; wear them all the time except for eating and cleaning of the teeth.
    This should be 22-23 hours a day. They only work when you wear them. Night time wearing alone will not work.
  2. The second fact is never to put them down unless they are in some type of case. The Invisalign aligners are clear and easily lost.

Okay so far so good.

Eating with Invisalign® attachments

A few hours later, I wanted to eat something.

I needed to get these plastic things off of my teeth.

I washed my hands and put my fingers in my mouth trying to find an edge to lift them up.
It is really much easier at first when I am in the dentist role and trying to remove them.
I tried this way and that way until I finally found a spot to start pulling it off. I knew what it felt like to lift an aligner out of the mouth, so I pulled without uneasiness, and it came out.

I spent some time going through the discovery exercise on the other aligner with success.
I ran my tongue over my teeth, and the attachments felt like I found something stuck on my teeth.
I didn’t like that feeling as it was very strange to me.

I then began lunch.

Accidentally biting my lips and cheeks

As I started to chew, my lower left attachment pushed out my lip ever so slightly. This was just enough for me to catch my lip with my upper teeth and bite myself.
I did this once and then again.
I was forced to chew more slowly and deliberately.
This is probably not a bad thing in and of itself.

Of course, once you bite yourself and your lip or cheek swells just a little bit causes you to bite yourself some more.

I can’t tell you how many thousands of times that I have said that to my patients. Now it was more than words. It was a reality to me. I just needed to be more careful.

Putting the aligners back in

Okay, lunch is over.
Time to floss and brush and put the aligners back in.

Firstly I put in the upper set, and that was easy. Just line up the aligner with upper front teeth and snap into place.

The lower set was more of a challenge.
Just when I got it into position and pushed down firmly, my lip folded in and I nailed by the lip.
Of course, now I had a cut and was ready for a mouth sore to develop. Usually, trauma to the lips will result in a sore that takes a few days to heal.
I think that I just discovered a new diet.
Beat yourself up so that eating goes from a pleasure to a negative experience.

The crowning blow came from the inside edge of my lower aligner. I developed a canker sore (a small mouth sore) on the underside of my tongue. So now, not only was eating a pain(literally), so was the simple act of speaking. Every time my tongue moved it sent waves of pain through me.
How many more months do I have to do this?

Stay tuned for my thoughts on week 2 of this Invisalign Patient Experience – Through the Eyes of a Dentist!


Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

For any questions about Invisalign®  or any of the other dental procedures performed at The Healthy Smile Dental Center please call Megan at 440.951.7856


Reduce Added Sugars For Good Oral Health

Reduce Added Sugars

In our last blog post, we discussed five ways to improve your oral health in the coming year. One suggestion was to eliminate one junk food daily. Expounding on that theme, let’s discuss the problem of added sugars and ways to reduce our intake of them.

I Am Addicted To Sugar. What Can I Do?

This question came up at a perfect time. A study just came out showing that sugar-sweetened beverage consumption declined for both children and adults in the United States between 2003 and 2014, according to the Harvard TH Chan School of Public Health.

Despite that reduction, teenagers and young adults still consumed more than the recommended limit for added sugars set by the 2015-2020 Dietary Guidelines for Americans. These guidelines indicate that we should consume less than 10% of our calories from added sugars. Unfortunately, very few of us meet these guidelines.

Added sugars are the real problem

The fact is, sugars are not inherently bad, as they are found in fruits and many healthful foods.
The problem occurs when manufacturers add sugar to a product. You’d be surprised, but it’s not just junk foods, candies, etc. that are the usual suspects. Unfortunately, you can find products with added sugars in many ordinary foods you wouldn’t even think of! Make sure you check the product nutrition labels! It’s your first line of defense!

If we try to cut back on the junk foods, such as limiting ourselves to one less “junk food a day”, we will make progress. Adding fruits will help feed our sugar addiction.

Try reducing added sugars from our diets

The real challenge is identifying and reducing added sugars from our diets. Keeping added sugars under their 10% limit is a process that takes months to get a grip on but is achievable.

Not only will this improve our general health, but it will also help our dental health as well. Remember cavities are caused by bacteria feeding on sugar in our diets. Less sugar translates into fewer cavities.

Taking supplements to aid oral health

CoQ10 to help oral health

The question always comes up regarding taking pills to help our oral health.
Supplements are not one of my favorite things to ingest, as the industry, unlike medicines, have no regulation or supervision.

Despite this fact let’s talk about a couple of compounds which may help with our mouths.

Grape seed extract

Grape seed extract comes naturally loaded with Vitamin C and Vitamin E.
We are not sure, but for whatever reason, this compound will inhibit the formation of what we call “plaque”.
Plaque is the cause of gum disease and cavities. Plaque is essentially a commune of bacteria. These all feed off of sugar and produce destructive acid.
Prevent the plaque and reduce the cavities. Prevent the plaque and prevent gum disease.

Co-enzyme Q10

Another supplement that has many general health benefits is CoQ10 which is short of Co-enzyme Q10.
This nutrient that is made in your body will help us fight infections and other insults by improving our immune system. Poor diet and age can affect its levels.
Japanese dentists are very fond of CoQ10, and many recommend dosages of 60 mg daily as a preventive measure for gum disease. It also has benefits when applied topically to gum tissue. As with many supplements, research may be scarce, and claims abound. That being said, these dosages appear to be safe with the benefits outweighing any risks.

Use proper diet and nutrition for good oral health

These and other therapies in medicine are based on the concept that response to disease attach can be controlled or improved with proper diet and nutrition.
Eating a diet that is primarily plant-based with a reduction or elimination of inflammatory agents such as sugar will help our health in general, and our mouth in particular.

If nutrition and quality of life enthuse you, give me a call and let’s share some thoughts. My passion is good health for you and your family.

Don’t forget that My “Better Than Insurance” program is still in effect until the end of the month.

I am looking forward to hearing from you and can be reached at 440.951.7856 to discuss nutrition or my money saving program with you.


Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.




Resolve to improve your oral health

As the new year approaches, we are all thinking of making resolutions to improve our lives and our health.
As a dentist committed to you and your family’s good health, I’d like to suggest resolving to improve your oral health in 2018.
However, a resolution without a plan is planning to fail.
Read on to make this year’s resolution a successful one.

Can You Make A Suggestion for Mouth Care Priorities for the New Year?

You bet I can!
Before I do, allow me a moment to wish a Happy New Year to everyone. I hope that this year will be filled with wonderful things for everyone.
Now let me get to our topic at hand.

Making a Fresh Start

There is no feeling better than that of making a fresh start. Our lives revolve around a yearly calendar. We get this fantastic opportunity to refresh and recharge ourselves mentally. I can not stress how important this is, to every one of us. As the time goes by, we rarely think of ourselves. The month of January allows us to reflect upon ourselves and look at how we can do things differently than in the past. The guiding motivation is not only “different,” but “better.” It is a well-known fact that memberships in health clubs explode in January. Unfortunately, few people maintain the enthusiasm and commitment as time goes on.

Today, let’s focus on making our goals real and attainable. Specifically, I am going to focus on techniques to improve our oral health. I have spoken at length in this column and face to face in the office about the impact of oral health on our general health. My suggestions will, therefore, have implications that go beyond the mouth. Its ramifications are endless.

One of the reasons that New Year’s Resolutions don’t work is that they are too broad and extensive. This translates into unrealistic goals and expectations. The key to success is to think of a small and incremental change that will impact you and your life. Once you have that thought, then make the change even more modest. Make it something that you can do immediately and simply. Okay, so let’s look at my list.

5 Simple Steps to Improve Your Oral Health.

1. Get a New Toothbrush.

This is so simple.
A builder once told me that “new” is always good. He is absolutely right about this concept.
It applies equally as well in the mouth. Toothbrushes are most efficient when the bristles are fresh. Over time, they do not clean as well. For the short term, our mouths do not feel as fresh with a worn brush. In the long run, they are not doing their job causing problems, and we are wasting our time.

2. Get Your Teeth Cleaned.

Now is a great time to set up a cleaning visit. We all overate during the holiday season and probably didn’t brush as well as we should. The timing is perfect to remove the tartar and stain from our teeth. Seeing freshly cleaned teeth is always a great motivator for oral health.

3. Select One Need and Take Care of It.

Sometimes we are overwhelmed by recommended procedures. It is merely easier to forget everything in the face of multiple needs. For example, you may need four fillings. Rather than just letting things go, pick one filling and get it taken care of.
If you follow that approach, it will be much easier and not be such a burden on you regarding time, effort and possibly finances.

4. Eliminate One Junk Food Daily.

Junk food, in general, and holiday treats specifically, all wreak havoc with our mouths. These sticky foods do not come off of our teeth naturally. It takes work to remove them from our tooth enamel. Usually, the time and place are inconvenient for efficient removal of sticky food products. I recommend that you stock up or carry a sweet fruit with you. It is loaded with fiber, great nutrients and really will satisfy your sweet tooth.

5. Spend Another 30 Seconds Brushing Your Teeth

We all spend too little time brushing. Once we have made an effort to go to a bathroom, haul out the toothbrush and turn on the sink water we have done all of the hard things. It is so easy to spend a little more time brushing and try to reach our goal of debris free teeth. Another half of a minute is time well spent.

In conclusion

These are all goals and techniques that are easy to do. Find one that you like and adopt it. It will stay with you and reward you in the future. If you have any question about my FIVE STEPS, please call me at 440.951.7856. I look forward to hearing from you.

Here’s to a successful New Year’s resolution for a Healthy Smile!

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.