General FAQ

Why See a Pediatric Dentist?

A: 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.

Are Dental X-Rays Necessary?

A: Radiographs help pediatric dentists diagnose cavities, survey erupting teeth, diagnose bone diseases, evaluate the results of an injury or abscess, or plan orthodontic treatment.

Radiographs allow Dr. Goyal to diagnose and treat 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.

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 a 90% reduction in radiation, no need for processing chemicals, which helps our environment, and instantaneous images, as well as 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 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.

Expectant Mother and Infant Oral Care

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. Mothers 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.
• Follow a proper diet, with the reduction of beverages and foods high in sugar and starch.
• Use a 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.
• Chew xylitol chewing gum (4 pieces per day for the mother) to decrease a child’s caries rate.

Baby Teeth

Why Are Baby Teeth Important?

A: I often get this question and parents usually say these baby teeth will “fall out”. It is true that the vast majority of the time these baby teeth will be replaced by permanent teeth at various ages of the child. However, cavities can and frequently do lead to problems that 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. The proper 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 ages 10-13.

How Do I Prevent Cavities?

A: 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 the below section on “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-sized amount of fluoride toothpaste can be used after the child is old enough not to swallow it. The recommended toothpaste is the one that 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 the toothbrush at a 45-degree angle; start along the gum line with a soft-bristled brush in a gentle circular motion. Brush at least twice a day – in the 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 the breath and remove bacteria and end with flossing.

The American Academy of Pediatric Dentistry recommends six-month visits to the pediatric dentist beginning with 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.

Early Habits

Thumb/Finger Sucking/Tongue Thrust

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, a sock over the hand, positive reinforcement, and a 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.

Mouthguards

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

What to Do if My Child Grinds Their Teeth at Night (Bruxism)?

A: 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.

Dietary Habits

Does My Child Need Fluoride Supplements?

A: Fluoride is an element that 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 a very young child.
• Place only a pea-sized drop of children’s 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.

Preventive Dentistry

What Is Baby Bottle Tooth Decay (Early Childhood Caries)?

A: 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 containing something 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.

What Are Sealants?

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 against food, plaque, and acid, thus protecting the decay-prone areas of the teeth. Placing sealants is one of the easiest ways to prevent tooth decay.

Orthodontics

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 from 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.