Frequently Asked Questions

Cost depends on how many implants are needed, whether bone grafting is required first, and the type of restoration placed on top. Those variables differ enough between patients that any number quoted before an examination would be guesswork.

What we can promise is a written treatment plan with costs before you commit to anything. Many dental plans contribute toward part of implant treatment, and we will help you understand what yours covers. Call (610) 722-5542 to arrange a consultation.

Implant placement is done under local anesthesia and is not painful. Most patients tell us afterward that it was easier than they expected — frequently easier than the extraction that preceded it.

Expect some soreness and swelling for a few days, usually managed with over-the-counter pain relief. Sedation is available if you are anxious about surgery.

Roughly three to six months for a straightforward case. Almost all of that is healing rather than appointments — the bone has to fuse to the implant, and that process cannot be accelerated without risking the result.

Cases needing bone grafting or a sinus lift take longer. Selected cases allow immediate placement at the time of extraction, which is shorter. You will get a realistic timeline for your own situation at the consultation.

Usually not. "Not enough bone" describes the situation today, not the situation after treatment. Bone grafting and sinus augmentation exist precisely to rebuild deficient sites, and they are routine parts of implant practice.

A 3D Cone Beam CT scan measures bone in three dimensions and establishes what is actually possible. A conventional 2D x-ray shows height but not width, and width is frequently the limiting factor — which is why second opinions on this question so often differ.

Implants are intended to be permanent and frequently remain in service for decades. The titanium itself cannot decay.

Longevity depends on the health of the gum and bone around the implant. Implants can develop peri-implantitis — an inflammatory condition comparable to gum disease — if plaque accumulates. Regular hygiene and periodontal maintenance are what protect the investment.

There is no upper age limit. Bone quality and general health matter; age alone does not. We routinely treat patients in their seventies and eighties.

No. Healthy gums do not bleed when brushed — not a little, not occasionally. Bleeding indicates inflammation, and inflammation is the earliest stage of gum disease.

The encouraging part is that this stage, gingivitis, is completely reversible. Once it progresses to periodontitis and bone is lost, that bone does not come back on its own. Bleeding gums are worth acting on precisely because the window for full reversal is open.

Gingivitis affects only the gum tissue. The bone and attachment underneath are intact, and treatment returns the tissue completely to health.

Periodontitis has progressed into the bone. Pockets form between gum and tooth, bacteria colonise them, and the bone supporting the tooth resorbs. It can be stopped and managed — and in selected defects partly rebuilt through regenerative therapy — but it cannot simply be undone. See gingivitis and periodontitis for detail.

A deep cleaning is scaling and root planing — a treatment for existing gum disease, not a longer version of a routine cleaning.

When pockets deepen, hardened deposits sit on root surfaces several millimetres below the gumline, out of reach of a standard cleaning. Scaling removes them and root planing smooths the root so the gum can reattach. It is done under local anesthesia and its success is confirmed by re-measuring pockets weeks afterward.

Frequently it can. Every patient here is treated non-surgically first and re-measured before surgery is even considered. Many people told they need gum surgery turn out not to, once conservative treatment has had a proper chance.

What cannot be avoided is the consequence of leaving deep pockets untreated — they continue losing bone. Declining treatment is a decision to accept that trajectory, so it is worth making with the measurements in front of you.

Research has associated periodontal inflammation with cardiovascular disease, poorer blood sugar control in diabetes, respiratory infections and adverse pregnancy outcomes.

The relationship with diabetes is the best documented and runs both ways: gum disease makes blood sugar harder to control, and poorly controlled blood sugar makes gum disease worse. If you are diabetic, mention it at your visit — it changes how we plan treatment.

No. Gum tissue that has receded does not regenerate on its own. Improving your brushing technique is essential to stop further loss, but it will not restore what has gone.

Gum grafting restores coverage. Dr. Liu offers both traditional grafting and the Pinhole Surgical Technique, which requires no incisions, no sutures and no tissue taken from the palate.

No. Many of our patients are referred by general dentists across the Main Line, but you are welcome to book an evaluation directly. If you already have a dentist, we coordinate with them so your care stays joined up.

A periodontist completes three years of specialty training beyond dental school, focused on the gum and bone that support teeth, and on the surgical placement of dental implants.

Referrals typically happen when gum disease has progressed past what a routine cleaning addresses, when grafting or gum surgery is needed, or when an implant site is not straightforward. Dr. Steven Liu holds specialty certificates in both periodontics and prosthodontics from the University of Pennsylvania.

We work with most major dental plans and will review your specific benefits with you before treatment. You will receive a written estimate showing what your plan is expected to cover and what your portion will be.

Call (610) 722-5542 with your plan details and we can look into it before your visit.

A comprehensive periodontal examination: pocket depths measured at six points around every tooth, along with bleeding, recession and mobility. Imaging as needed, including 3D Cone Beam CT where implants or surgery are being considered.

Dr. Liu then explains what he found — an intraoral camera puts it on a screen so you can see it yourself — and gives you a written plan sequenced from least invasive to most, with the reasoning for each step.

We are at 1257 Lancaster Ave, Berwyn, PA 19312, on the Main Line. Patients travel to us from Berwyn, Wayne, Devon, Paoli, Villanova, Bryn Mawr, Radnor, Malvern, Frazer, Strafford and the surrounding Chester and Delaware County communities.

Office hours are Monday to Thursday 8:00am–5:00pm and Friday 8:00am–2:00pm. See our contact page for directions.

Brush at least twice a day and floss at least once. Flossing is the part most often skipped and it is the part that reaches where gum disease actually starts — the surfaces between teeth, which a brush cannot clean.

Technique matters as much as frequency. Brushing hard is a leading cause of gum recession; a soft-bristled brush used gently along the gumline is more effective and does less damage.

Every six months is the general recommendation for healthy patients.

If you have been treated for periodontal disease, the interval is different — typically every three to four months. That is not upselling: the bacteria associated with gum disease recolonise pockets within roughly that window, and research consistently shows patients who keep to that interval retain their teeth at far higher rates.

In healthy people the most common cause is bacterial deposits on the tongue, particularly toward the back. Brushing or scraping the tongue alone reduces bad breath substantially. Dry mouth, certain foods and smoking all contribute.

Persistent bad breath that does not clear with good hygiene is worth investigating — it is a common sign of periodontal disease, where bacteria and debris sit in pockets beneath inflamed gums.

Frequently the cause is the bite rather than the restoration. Grinding, clenching or an uneven bite generates forces well beyond normal chewing, concentrated on particular teeth.

Replacing a restoration without addressing that just resets the clock. Occlusal therapy looks at how your teeth meet and protects them from the force — usually starting with reversible options such as a custom night guard.

Professionally supervised whitening using established agents does not damage enamel. Temporary sensitivity is common but reverses.

The risks come from unsupervised overuse and from products of unknown composition. Gum health matters too — bleaching inflamed tissue is uncomfortable, and exposed roots will not lighten to match enamel. See teeth whitening.