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Resources

These are some of the common questions, parents ask Dr. Goyal. These topics vary from early years to adolescence. Please call our office, if you have any additional questions.

Pediatric Dentistry

Dr. Amit Goyal did an extra two years of specialized training at Temple Children’s Hospital after four years of dental school. He specializes in the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. As a pediatric dentist, Dr. Goyal is best qualified to meet these unique needs.

Essentially, pediatric dentists are the pediatricians of dentistry. This pediatric dental office is set up so children feel comfortable when visiting us.

“First visit by First Birthday” is the recommendation by this office, the American Academy of Pediatric Dentistry and the American Academy of Pediatricians. Early examination and preventive care will protect your child’s smile now and in the future.

Parents can make the first visit to Our Office enjoyable and positive. If old enough, your child should be informed of the visit and told that the Dr. Goyal and his staff will explain all procedures and answer any questions.

You and your child will be accompanied by the assistant and shown the office. We encourage going with your child at the first visit. Any necessary x-rays and/or fluoride therapy may be accomplished during this first visit At this visit, we will discuss/perform:

  • An oral cancer assessment
  • Prophylactic cleaning
  • Preventative fluoride application
  • Digital x-rays to diagnose cavities, infection, bone level, and development abnormalities
  • Nutritional counseling and preventive education shall be discussed (thumb, pacifier, finger habits, baby bottle, Sippy cups)
  • Oral hygiene instructions (proper brushing and flossing techniques)
  • Orthodontic evaluation (if braces are necessary)
  • An individualized treatment plan will be performed as part of the comprehensive exam.

We want your child to have a comfortable, fun and positive experience. Dentistry can be scary for children, so our staff and Dr. Goyal will take the time to try to ease your child’s fear and educate them about the dental tools in our office. We are here to answer your questions and show you special techniques to keep your child’s mouth as healthy as possible. We use age appropriate words as well as introduce various dental instruments. This is accomplished by using large, friendly tooth models and stuffed animals. We also offer video games and movies to keep your child engaged and toys are offered at the end of the visit for a great dental checkup or filling appointment. For anxious children, Dr. Goyal is trained in providing laughing gas (nitrous oxide) and can offer sedation dentistry.

We are a preferred/in-network provider for the following major insurance companies. If you do not see your insurance on this list, please call our office as we are continually updating. As a courtesy, we will send the dental claims electronically to your insurance company. We will provide you with an estimate and can help maximize your covered benefits.

No Insurance? No Problem! To help with your dental care, we offer payment plans and accept cash, checks, debit, most major credit cards Flexible Spending and Health Savings plans are accepted. We can work with you to find a payment option that fits your budget and needs. Our office staff will assist you in applying for any dental payment options.

Care Credit can be used to finance your dental treatment. They offer $0 down, no annual membership fees, flexible monthly payment plans to fit your budget needs, and instant credit decisions. Care Credit uses a revolving line of credit so the amount approved can be used for the whole family.

General Questions

We do not use words around your child that may cause unnecessary anxiety, such as “shot”, “needle”, “pull”, “drill” or “hurt”. We ask you to do the same as appropriate words will be used to convey the same message. Our goal is to make each and every visit to our office fun and positive.

In addition to using age appropriate words, we have large models of teeth and stuffed animals to show to your child the instruments we will be using to clean their teeth or little tools to fill a cavity.

We believe in the Tell-Show-Do method, are patient, and provide positive reinforcement to your child to help with fear and anxiety. Additionally, in a children friendly atmosphere, experienced staff, picking out toys from our treasure chest, and watching TV helps your child get accustomed in the new surroundings.

I often get this question many times and parents usually say these baby teeth will fall out. It is true that vast majority of the time these baby teeth will be replaced by the permanent teeth at various ages of the child. However, cavities can and frequently do lead to problems which affect developing permanent teeth. Baby teeth are important for

(1) Proper chewing and eating
(2) Providing space for the permanent teeth and guiding them into the correct position
(3) Allowing normal development of the jaw bones and muscles.
(4) Affect the development of speech

While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

  • The use of a space maintainer is important in maintaining the space for the adult tooth when a baby tooth is lost prematurely. Baby teeth may tilt or drift into the empty causing the permanent teeth to be crowded or rotated. If left untreated, the condition may require extensive orthodontic treatment. At the appropriate time, the spacer can be removed once the permanent tooth begins to erupt into the mouth which may be until age twelve.

    Special Care:
    • Avoid sticky sweets or chewing gum.
    • Don’t tug or push on the space maintainer with your fingers or tongue.
    • Keep it clean with conscientious brushing and flossing.
    • Continue regular dental visits.

Baby Bottle Decay is a form of decay among young children caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause Early Childhood Caries because the sweet liquid gives the bacteria a food source to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. You should talk to your physician or Dr. Goyal about various ways to prevent periodontal disease during pregnancy.

Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother’s should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:

  • Visit your dentist regularly
  • Brush and floss on a daily basis to reduce bacterial plaque.
  • Proper diet, with the reduction of beverages and foods high in sugar & starch.
  • Use fluoridated toothpaste recommended by the ADA and rinse every night with an alcohol-free, over-the-counter mouth rinse with 0.05% sodium fluoride to reduce plaque levels.
  • Don’t share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
  • Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.

If your child loses any primary teeth as a result of trauma, decay or congenital reasons, he/she may benefit from space maintainers (spacers). Space maintainers are appliances made of metal that are custom fitted to your child’s mouth. Most children will adjust to them after the first few days and proper brushing is important. A referral to a certified orthodontist can be made if additional treatment is required.

Good oral hygiene removes bacteria and the left-over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See “Baby Bottle Tooth Decay” for more information. Also, watch the number of snacks containing sugar that you give your children.

Begin daily brushing as soon as the child’s first tooth erupts. A pea size amount of fluoride toothpaste can be used after the child is old enough not to swallow it. The recommended toothpaste is the one which has the American Dental Association seal. If your child is swallowing the toothpaste, then discontinue and use a Baby Toothpaste or training toothpaste that does not contain fluoride.

Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush at least twice a day- morning and before going to bed, the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. If you can, help brush the tongue to freshen breath and remove bacteria and end with flossing. The American Academy of Pediatric Dentistry recommends six month visits to the pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health. In addition to proper oral hygiene, sealants are another great way to protect teeth.


Our office uses the latest technologies in pediatric dentistry. We use digital x-rays and a lead apron when taking x-rays. This new digital technology offers the advantage of 90 % reduction in radiation, no need for processing chemicals which helps our environment, produces an instantaneous image, and the ability to use color contrast in the image. Children are excited when they get to see the picture of their teeth.

We are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. Dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child.

Radiographs help pediatric dentists diagnose cavities, survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, abscess, or plan orthodontic treatment. Radiographs allow Dr. Goyal to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

Sucking or tongue thrust is a natural reflex for infants and children to provide a sense of comfort or security. The use of a Band-Aid, sock over the hand, positive reinforcement, and progress chart may help stop these habits. These habits usually stop by age four but if they continue when the permanent teeth are erupting, a habit appliance may be required. Ask Dr. Goyal if these habits are present on your next visit.

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth, where 80% of cavities in children are found. Children with sealants have 50% less tooth decay after the age of 15. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth. Placing sealants are one of the easiest ways in preventing tooth decay.

Fluoride is an element, which has been shown to be beneficial to teeth. The proper dosage is determined by the amount of fluoride in your drinking water and your child’s age. By ingesting excessive fluoride dental fluorosis can occur to your child’s teeth. Fluorosis is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Parents can take the following steps to decrease the risk of fluorosis in their child’s teeth:
  • Use baby tooth cleanser on the toothbrush of the very young child.
  • Place only a pea sized drop of children toothpaste on the brush when brushing.
  • Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
  • Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
  • Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).
  • Ask your pediatrician or pediatric dentist.

Parents are often concerned about their child grinding at night or notice the teeth getting shorter. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure. The majority of cases of pediatric grinding do not require any treatment because most children outgrow bruxism. The grinding usually stops between ages 9-12. If you suspect bruxism, discuss this with Dr. Goyal.

If you child participates in organized sports, recreational or contact activities, injuries can occur. A mouth guard is great way to protect teeth should injuries to face occur. Mouth guards can help prevent injuries to the lip, teeth, jaws, tongue, and face. We can provide your child with a custom fitted mouth guard. Ask us on your next visit.

Our office treats children with special needs. Dr. Goyal and his staff are trained to take care of children who are mentally and physically disabled. We understand the challenges in taking care of the dental needs of your child and can set up appointments to fit your schedule. The office is designed to be physically accessible to your child. Dr. Goyal will tailor an individual treatment plan and emphasize preventative strategies for your child.

What is Baby Bottle Tooth Decay (Early Childhood Caries)?
Baby Bottle Decay is a form of decay among young children caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause Early Childhood Caries because the sweet liquid gives the bacteria a food source to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

My Child Grinds His Teeth at Night (Bruxism)?
Parents are often concerned about their child grinding at night or notice the teeth getting shorter. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure. The majority of cases of pediatric grinding do not require any treatment because most children outgrow bruxism. The grinding usually stops between ages 9-12. If you suspect bruxism, discuss this with Dr. Goyal.

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