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recently, a netizen in yongkang city, zhejiang province reported that his father had 23 teeth extracted at one time at a local dental hospital, and 12 teeth were implanted on the same day. he then suffered from constant pain and died of cardiac arrest 13 days later. local health department staff said that since the extraction and death were 13 days apart, the specific cause is still under investigation.

the incident sparked heated discussions among netizens. some expressed shock and confusion about the extraction of so many teeth at one time; others pointed out that the oral diagnosis and treatment industry is in chaos and the elderly are easily deceived, so supervision must be strengthened; others believed that the oral health of the elderly needs urgent attention.

are the claims of some dental clinics that they can "extract teeth in the whole mouth" and "extract and install teeth on the same day" reasonable? how to solve the problem of "tooth loss" among the elderly? with these questions, the reporter conducted an investigation and interview.

dr. liu from a dental hospital in beijing once encountered an elderly patient who came to see him and said that he had severe toothache and wanted to have all his teeth pulled out.the old man has 29 teeth in his mouth.more than 20 of them were opened for nerve treatment, and the treatment has lasted for 3 years. at that time, the doctor who received the patient clearly told the old man,just pull out a tooth.the other teeth can still be used after systematic treatment.

but after a while, when the doctor saw the old man again,it was discovered that all her teeth had been pulled out and she had become so thin that she was completely unrecognizable.upon asking, i learned that she had them removed at a dental clinic when she returned to her hometown. after getting full dentures, she had been feeling unwell and had a loss of appetite, and now she regrets it very much.

"those are more than 20 natural teeth with healthy and strong periodontal conditions. how many people at this age want to have such good periodontal conditions but cannot do so. how could the doctor who extracted her teeth condone and cooperate with an uninformed patient to extract teeth?" dr. liu finds it difficult to agree with the practice of this "colleague".

"implant teeth in the morning and eat meat in the afternoon", "extract teeth, install teeth, and use teeth on the same day", "painless tooth extraction, solve all problems at once", "dental implants cost as low as a hundred yuan"... a recent investigation by a reporter from the legal daily found that some dental clinics use the above slogans in their promotions. some elderly people are eager to seek medical treatment for dental problems, and coupled with information asymmetry, they easily fall into the trap of bad dental institutions.

dental problems affect health

treatment institutions make big promises

mr. wang, 66, who lives in shaoyang city, hunan province, has lost three teeth in a row as he ages. he has consulted a private dental institution about tooth restoration, but gave up because the price was too high. "the other teeth can still be used, but the pain when they get inflamed is life-threatening."

there are many elderly people like mr. wang who suffer from oral diseases.

the results of the fourth national oral health epidemiological survey showed that the problem of tooth loss is serious among the elderly, with an average of 7.5 missing teeth per person and only 18.3% of people having complete dentition. among the elderly aged 65 to 74, the periodontal health rate is only 9.3% and the caries rate of permanent teeth is as high as 98%.

according to dr. xie from the department of stomatology of a tertiary hospital in guangdong province, the most common problems among the elderly seen in his department are bleeding gums, bad breath, and loose and weak teeth, most of which are caused by periodontitis. "some elderly people lack health awareness and have poor oral hygiene. at the same time, tooth defects and wear are also common oral problems among the elderly."

the reporter randomly interviewed several elderly people with periodontitis in beijing and found that most of them believed that "periodontal inflammation can be cured by taking some medicine." however, in the view of dentists, periodontitis is prone to recurrence, which damages the health of the periodontium and causes the teeth to loosen and fall out.

dr. liu told reporters that periodontal disease-related pathogens may invade the aorta and cardiac endothelial cells and cause heart damage. if inhaled into the lungs, it may cause aspiration pneumonia, chronic obstructive pulmonary disease and lower respiratory tract infection.

"another common misunderstanding is that many elderly people think that they will lose teeth as they age, and that this is a normal aging phenomenon. they often do not perform tooth restoration or implantation in a timely manner because they are afraid of trouble." dr. liu said that tooth loss not only damages appearance and affects pronunciation, but also affects chewing function. in the long run, it may interfere with normal digestion and nutrient absorption, accelerate the loosening and shedding of adjacent teeth, and form a vicious cycle. if the chewing function is lost, the benign stimulation of the chewing action to the brain disappears, and it is also easy for the elderly to suffer from alzheimer's disease.

according to industry insiders, extracting teeth that cannot be retained and promptly repairing missing teeth are important ways for the elderly to maintain oral health.

under the huge market demand, some dental institutions have seen business opportunities and have launched various advertisements to attract the elderly to have dental implants, such as "international dental technology", "private customized service", "long-term stability, fast and convenient", "vital bone-friendly, bionic nature", etc.

during the interview, the reporter found that some dental institutions made exaggerated claims in their promotions, claiming "full mouth tooth extraction", "rapid correction in seven days", "a single dental implant can be completed in 10 minutes, teeth can be implanted on the same day, and meals can be eaten on the same day", etc., causing some elderly people to be deceived without knowing it.

tooth extraction requires a thorough evaluation

there are hidden dangers in pulling out multiple

mr. zhang from hebi city, henan province, is 76 years old and has caries in many teeth. he went to a dental institution for consultation. after the face-to-face consultation, the doctor said that the shape of his teeth was not good-looking, "if i pull them all out and get a pair of dentures, they will look good and will not affect my normal eating."

mr. zhang believed the doctor and not only pulled out the decayed teeth, but also the remaining intact teeth, and spent more than 8,000 yuan to install a set of "full-mouth suction dentures". however, the effect was not as good as the doctor advertised. even if he did not chew, he often felt that his gums were worn away, and it was not convenient for him to eat in daily life.

dr. liu told reporters that in modern dentistry, teeth should be retained as much as possible (except for some wisdom teeth), and extraction is only done when absolutely necessary. however, some people still choose to have their entire mouth extracted, and some doctors in dental institutions even encourage patients to have their entire mouth extracted, which is completely irresponsible.

the reporter searched the china market supervision administrative penalty documents network and found that from 2020 to the first half of 2024, there were 1,529 administrative penalty documents on dental institutions, most of which were exaggerated publicity, false publicity, and price fraud by dental institutions. according to incomplete statistics, in the first half of this year, dental medical institutions were involved in more than 200 administrative penalties, among which many dental institutions were punished for violating laws and publishing medical advertisements without authorization, making false or misleading commercial advertisements for products, etc.

for example, a dental hospital in beijing was suspected of price fraud and other illegal activities when promoting dental implant services on online platforms. the beijing municipal market supervision administration issued a warning and fined it 150,000 yuan. however, recently, reporters still saw the dental hospital's advertisement "implant in the morning, eat meat in the afternoon at the earliest" on the social "friend circle". according to professional dentists, dental implants cannot be used immediately after implantation. in the first few days, people mainly eat liquid food. "the saying that you can eat meat on the same day as dental implants is not reliable."

the reporter recently visited several private dental institutions in beijing and found that many institutions promised "full mouth extraction and same-day implantation". some dental institutions put up a lot of advertisements in the hope of attracting more patients to implant teeth, while some institutions took advantage of information asymmetry to persuade patients to extract more teeth and have more types of teeth, thereby charging higher fees.

at a dental hospital in chaoyang district, beijing, when the reporter asked whether full-mouth extraction was possible, the hospital receptionist said: "first of all, it depends on the patient's physical condition. if there is an underlying disease, full-mouth extraction or half-mouth extraction is not suitable. but if there is a real need, all teeth can be extracted and implanted on the same day, which can shorten the repair period."

doctor liu told reporters that when a patient's teeth are loose, residual roots and crowns cannot be retained, and they need to be extracted for full-mouth implant restoration, an immediate tooth extraction and implant restoration method can be adopted. there are currently no specific regulations on the number of teeth to be extracted. generally speaking, the number of teeth extracted at one time is no more than 10, which requires the clinic and the doctor to have certain qualifications and levels, and also needs to consider the patient's physical tolerance. "the more teeth extracted, the more intense the pain the patient feels, and the greater the probability of infection after surgery. patients should be fully evaluated and screened for related underlying diseases to ensure that they are suitable for surgery; during the operation, controlling the infection and pain of the tooth extraction wound is the key; postoperative anti-inflammatory treatment is equally important."

deng liqiang, executive director of the china health law society and deputy director of beijing huawei law firm, believes that some dental institutions advise patients to "extract more and have more types of tissues" for economic benefits rather than for excessive medical treatment according to the actual needs of the patients. if this behavior is true, patients can claim compensation based on actual damages and economic losses.

"if a doctor is at fault, causes damage, or has a causal relationship during diagnosis and treatment, it is a medical accident. in the event of a medical accident, the doctor or clinic may face civil liability, i.e. compensation; or administrative liability, i.e. fines, suspension of practice, or revocation of license. if the patient's death is closely related to the medical practice and the doctor behaves irresponsibly, criminal liability may be constituted," said deng liqiang.

zheng zhongchen, director of beijing lutong law firm, has long been concerned about the medical field. he analyzed that false advertising or fraudulent activities by dental institutions involve multiple legal issues: according to the anti-unfair competition law, if a dental institution engages in false advertising and misleads consumers, it will face corresponding administrative penalties; according to the advertising law, if a dental institution exaggerates the treatment effects, falsely advertises medical technology or doctor qualifications, etc. in its advertisements, it will face administrative penalties such as fines, and serious cases may constitute a crime; according to the "medical institution management regulations", if a dental institution uses deceptive means to gain the trust of patients, induces patients to undergo unnecessary examinations, treatments or use unnecessary medical supplies, or exaggerates the diagnosis and treatment effects and misleads patients, it shall be fined not more than 10,000 yuan.

increase penalties for violations

improve the oral care system

why is there so much chaos in the oral healthcare industry?

in zheng zhongchen's opinion, the oral medical industry is highly market-oriented, some oral medical workers lack professional ethics education, and some medical institutions, in pursuit of profits, ignore medical ethics and the actual needs of patients, leading to excessive or improper treatment; the supervision of oral medical care is relatively weak, resulting in some violations not being discovered and stopped in a timely manner.

"in addition, some elderly patients lack professional medical knowledge and find it difficult to judge the scientificity and necessity of treatment plans. dental institutions take advantage of this information asymmetry to promote more high-profit services. some people lack awareness of the importance of oral health and are easily deceived by false propaganda and receive unnecessary treatments," said zheng zhongchen.

in his opinion, to deal with these chaos, it is necessary to improve medical insurance policies, appropriately expand the coverage of medical insurance for oral medical care, and encourage medical institutions to pay more attention to the scientific nature and necessity of treatment through policy guidance. relevant departments need to strengthen supervision of the oral medical industry, increase penalties for violations, and strictly review the market promotion content of oral institutions to prevent false propaganda from misleading consumers.

"it is urgent to increase transparency and require dental institutions to disclose treatment plans, costs and possible risks so that patients can make informed decisions." zheng zhongchen suggested popularizing oral health knowledge through various channels to enhance the public's awareness of oral health and strengthen their judgment.

deng liqiang believes that the oral medical industry should be encouraged to exercise self-discipline, and the oral medical association should strengthen professional ethics training for doctors to enhance the credibility of medical institutions. administrative agencies should strengthen supervision, take every complaint seriously, and let doctors' behavior return to medical care. patients should listen more, ask more questions, compare prices, and enhance their oral health awareness and self-protection ability.

industry insiders pointed out that it is a very necessary and urgent issue to improve the oral health care level of the elderly, improve the oral health status of the elderly, and reduce the impact of oral health on overall health. oral health education should be deeply integrated into the existing elderly health service system, and a more comprehensive and effective oral health care plan should be formulated, including oral health education, oral disease prevention measures and oral health care. through targeted publicity activities, health education courses and operational health guidance, the elderly's understanding of oral hygiene can be improved, good oral hygiene habits can be cultivated, and the elderly's attention to oral hygiene and health can be strengthened.

"strengthen the construction of professional teams for oral hygiene maintenance and daily care for the elderly. focus on cultivating a special oral hygiene maintenance team, improve the accessibility of oral hygiene diagnosis and treatment for the elderly, and at the same time provide oral professional training for existing elderly health care personnel to improve oral care capabilities and levels." the above-mentioned industry insiders said that at the same time, we can actively explore new models of oral health care for the elderly that empower technology, and reduce manpower input, improve results, and increase efficiency through the development of oral care robots.

during the interview, some elderly people also expressed their expectations of having good teeth and reducing the pain of "tooth loss": "it is inconvenient for us to move around. it would be great if the community could regularly hold oral health lectures and free clinics to help us better understand oral health knowledge." "i hope that more medical insurance policies can cover the field of oral treatment to reduce our financial burden." ...