Recently, a netizen in Yongkang City, Zhejiang Province reported that his father extracted 23 teeth at one time in a local dental hospital and implanted 12 teeth on the same day. The pain continued, and he died of cardiac arrest 13 days later. The staff of the local health department said that because the time of tooth extraction and death was 13 days apart, the specific cause is still being investigated.
The incident sparked heated discussions among netizens, and some people expressed shock and puzzlement at the removal of so many teeth at one time; Some people also pointed out that the oral diagnosis and treatment industry is frequent, and the elderly are easy to be deceived, so supervision must be strengthened; There are also those who believe that the oral health of the elderly needs to be paid attention to.
Are the claims of some dental clinics as "full mouth tooth extraction" and "same-day extraction" reasonable? How to solve the problem of "old teeth" for the elderly? With questions, the reporter launched an investigative interview.
Dr. Liu from a dental hospital in Beijing once came into contact with such an elderly patient: when he came to the doctor, he said that he had a terrible toothache and wanted to pull it all out. After taking the film, it was found that more than 20 of the 29 teeth in the old man's mouth had been opened for neurotherapy and had been treated for 3 years. At that time, the attending doctor clearly told the old man that just one tooth can be extracted, and the other teeth can be used after systematic treatment.
But after some time, when the attending doctor saw the old man again, he found that all her teeth had been extracted, and she was so thin that she was completely out of shape. When asked, I learned that she went to a dental clinic to have it removed when she returned to her hometown, and she has been uncomfortable and lost her appetite after being fitted with full dentures, and now she regrets it.
"That's more than 20 natural teeth with very healthy and strong periodontals, and how many people can't have such good periodontal conditions at this age. How can the doctor who extracted her tooth condone and cooperate with the unwitting patient to say that the tooth was extracted? Dr. Liu disagrees with this "colleague's" approach.
"Implant teeth in the morning and eat meat in the afternoon", "Pull on the same day, install on the same day, and use on the same day", "Painless tooth extraction, solve all problems at one time", "The price of dental implants is as low as 100 yuan", ...... "Rule of Law Daily" reporter recently investigated and found that some dental clinics played the above advertising slogans when publicizing, and some elderly people sought medical treatment because of oral problems, coupled with information asymmetry, it is easy to fall into the trap of bad oral institutions.
Dental problems affect health
Treatment institutions boast of Haikou
Mr. Wang, a 66-year-old man who lives in Shaoyang City, Hunan Province, has lost three teeth in a row as he gets older. He once went to a private dental institution to consult for the restoration of missing teeth, but gave up because the price was too high, "other teeth can still be used, but when it is inflamed, it hurts and kills."
There are many elderly people like Mr. Wang who are plagued by oral diseases.
The results of the Fourth National Oral Health Epidemiological Survey showed that the elderly had serious problems with missing teeth, with 7.5 missing teeth per capita, and only 18.3% of them had complete dentition. Among people aged 65 to 74 years, the rate of periodontal health is only 9.3%, and the rate of caries in permanent teeth is 98%.
According to a doctor surnamed Xie in the Department of Stomatology of a tertiary hospital in Guangdong Province, the most common among the elderly treated in his department are bleeding gums, bad oral odor, and loose and weak teeth, most of which are caused by periodontitis. "Some older people lack health awareness and poor oral hygiene. At the same time, tooth loss and wear are also common oral problems in the elderly. ”
The reporter randomly interviewed a number of elderly people with periodontitis in Beijing and found that most of them thought that "periodontal inflammation, take some medicine and be fine". However, in the eyes of dentists, periodontitis is prone to recurrence, which damages the health of the periodontal and can lead to loose teeth loss.
Dr. Liu told reporters that periodontal disease-related pathogenic bacteria may invade the aorta and heart endothelial cells to involve the heart, and if inhaled into the lungs, they may cause aspiration pneumonia, chronic obstructive pulmonary disease and lower respiratory tract infection.
"There is also a common misconception that many older people think that toothlessness is natural when they get older, and that this is a normal part of aging. They often do not have a tooth restoration or implant in time because they are afraid of trouble. Dr. Lau says that tooth loss not only damages appearance and affects pronunciation, but also affects chewing function, which can interfere with the normal digestion and nutrient absorption process in the long run, accelerating the loosening and loss of adjacent teeth, creating a vicious cycle. If the chewing function is lost, the benign stimulation of the brain by the chewing action disappears, and the elderly are prone to Alzheimer's disease.
According to industry insiders, extracting teeth that cannot be retained and repairing missing teeth in time is an important means for the elderly to maintain oral health.
Under the huge market demand, some dental institutions have seen business opportunities and have put out various advertisements to attract dental implants for the elderly, such as "international dental technology", "private customized services", "long-term stability, fast and convenient", "vitality and bone-kissing, bionic nature" and so on.
In the interview, the reporter found that some dental institutions boasted about Haikou during the publicity, claiming that "full mouth tooth extraction", "seven days of rapid correction", "a single dental implant is completed in 10 minutes, dental implants on the same day, and meals on the same day", etc., resulting in some elderly people not knowing that they were fooled.
Tooth extraction requires a thorough evaluation
There are many hidden dangers in pulling more
Uncle Zhang, a 76-year-old man from Hebi City, Henan Province, who suffers from tooth decay in many teeth, went to a dental institution for consultation, and the doctor said that his teeth were not in good shape, "If they are all pulled out and a pair of dentures are installed, they will look good and will not affect normal eating."
Uncle Zhang listened to it, not only extracted the caries, but also extracted the rest of the intact teeth, and spent more than 8,000 yuan to install a pair of "full-mouth adsorption dentures". However, the effect is not as advertised by the doctor, even without chewing, he often feels that his gums are worn out, and it is not convenient to eat daily.
Dr. Liu told reporters that in modern stomatology, teeth can be retained as much as possible (except for some wisdom teeth), and only as a last resort will they choose to extract, but there are still some people who choose to extract teeth in the whole mouth, and even doctors in oral institutions encourage patients to extract teeth in the whole mouth, which is completely irresponsible.
The reporter searched on the China Market Supervision Administrative Punishment Document Network and found that from 2020 to the first half of 2024, there are 1,529 administrative punishment documents on dental institutions, most of which are exaggerated publicity, false publicity, and price fraud by dental institutions. According to incomplete statistics, in the first half of this year, there were more than 200 administrative penalties in dental medical institutions, many of which were punished for illegal and unauthorized publication of medical advertisements, false or misleading commercial promotion of goods, etc.
For example, a dental hospital in Beijing was warned and fined 150,000 yuan by the Beijing Municipal Administration for Market Regulation for suspected price fraud and other illegal acts when carrying out oral implant service promotions on an online platform. However, recently, the reporter can still see the advertisement of "dental implants in the morning and meat in the afternoon at the earliest" in the social "circle of friends". According to professional dentists, it is generally not possible to use it immediately after dental implantation, and most of the first few days are mainly based on liquid food, "the statement of eating meat with dental implants on the same day is very unreliable."
The reporter recently visited a number of private dental institutions in Beijing and found that there are not a few institutions that promise to "full mouth tooth extraction and same-day implantation". Some dental institutions put a lot of advertisements in the hope of attracting more patients to implant teeth, and some institutions take advantage of information asymmetry to persuade patients to extract more teeth and multiple teeth, so as to charge higher fees.
In a dental hospital in Chaoyang District, Beijing, when the reporter asked if it was possible to extract a tooth from the whole mouth, the reception staff of the hospital introduced: "First of all, it depends on the patient's physical condition. But if you really need it, you can also pull it all out and plant it on the same day, which can shorten the repair period. ”
Dr. Liu told reporters that when the patient has loose teeth, the residual root and crown cannot be retained, and the patient needs to be extracted for full-mouth implant restoration, the tooth restoration method can be adopted as a pull-out and planting. At present, there is no specific regulation on the number of tooth extractions, generally speaking, the maximum number of teeth extracted at one time is more than 10, which requires the clinic and the doctor to have a certain qualification and level, and also needs to consider the patient's physical capacity. "The greater the number of teeth extracted, the more intense the pain the patient will feel and the greater the probability of infection after surgery. Patients should be thoroughly evaluated and screened for underlying diseases to ensure that they are suitable for surgery; During the procedure, it is key to control the infection and pain of the extraction wound; Anti-inflammatory treatment after surgery 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 persuade patients to "pull out more and more" for the sake of economic interests rather than the actual needs of patients.
"If the doctor is at fault, has a harmful result, and has a causal relationship in the diagnosis and treatment activities, it is medical malpractice. In the event of medical malpractice, the doctor or clinic may face civil liability, i.e., compensation; or administrative liability, i.e., fines, suspension of practice, or revocation of licenses. If the patient's death is closely related to the medical practice, and the doctor acted irresponsibly, it may constitute criminal liability. Deng Liqiang said.
Zheng Zhongchen, director of Beijing Lutong Law Firm, has long been concerned about the medical field, and he analyzed that false publicity or fraud by dental institutions involves many legal issues: according to the Anti-Unfair Competition Law, if dental institutions carry out false publicity and mislead consumers, they will face corresponding administrative penalties; According to the Advertising Law, if dental institutions exaggerate the treatment effect or falsely advertise medical technology or doctors' qualifications in advertisements, they will face administrative penalties such as fines, and in serious cases, they may also constitute a crime. According to the Regulations on the Administration of Medical Institutions, dental institutions that use deception to gain the trust of patients, induce patients to accept unnecessary examinations and treatments, or use unnecessary medical supplies, or exaggerate the results of diagnosis and treatment and mislead patients, shall be fined less than 10,000 yuan.
Increase penalties for violations
Improve the oral care system
Why is there frequent chaos in the oral health care industry?
In Zheng Zhongchen's view, the oral medical industry has a high degree of marketization, some oral medical workers lack professional ethics education, and some medical institutions ignore medical ethics and the actual needs of patients in order to pursue profits, resulting in overtreatment or improper treatment; The supervision of oral medicine is relatively weak, resulting in some violations not being detected and stopped in time.
In addition, some elderly patients lack professional medical knowledge and find it difficult to judge the scientificity and necessity of treatment options, and dental institutions use this information asymmetry to promote more high-profit services. There are also some people who do not have a good understanding of the importance of oral health, and are prone to false claims and unnecessary treatment. Zheng Zhongchen said.
In his view, to control these chaos, it is necessary to improve the medical insurance policy, appropriately expand the coverage of the oral medical part of the medical insurance, and promote medical institutions to pay more attention to the scientificity and necessity of treatment through policy guidance. It is necessary for relevant departments to strengthen the supervision of the oral medical industry, increase the punishment for violations, and strictly review the market publicity content of dental institutions to prevent false propaganda from misleading consumers.
"There is also an urgent need for transparency to require dental institutions to disclose treatment options, costs, and possible risks, so that patients can make informed decisions." Zheng Zhongchen suggested that oral health knowledge should be popularized through various channels to improve the public's awareness of oral health and enhance their judgment.
Deng Liqiang believes that the self-discipline of the oral medical industry should be encouraged, and the dental medical association should strengthen the professional ethics training of doctors to enhance the credibility of medical institutions. Administrative organs should strengthen supervision, take every complaint seriously, and let doctors' behavior return to medical treatment. Patients should listen more and ask more questions, shop around, and enhance their oral health awareness and self-protection ability.
Some people in the industry pointed out that it is a very necessary and urgent topic to improve the level of oral health care for the elderly, improve the oral health status of the elderly, and reduce the impact of oral health on the 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 program 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 should be given an awareness of oral hygiene, develop good oral hygiene habits, and strengthen their attention to oral hygiene.
"Strengthen the construction of professional teams for oral health maintenance and daily care of the elderly. Focus on cultivating a specialized oral health maintenance team, improve the accessibility of oral health diagnosis and treatment for the elderly, and at the same time carry out professional oral training for the existing health care personnel of the elderly to improve the ability and level of oral care. At the same time, we can actively explore a new model of oral health care for the elderly empowered by science and technology, and reduce manpower investment, improve effect and improve efficiency through the research and development of oral care robots.
During the interview, some elderly people also expressed their expectations for having good teeth and reducing the pain of "old teeth": "It is inconvenient for us to walk back and forth, if only the community could regularly carry out oral health lectures and free clinic activities to help us better understand the knowledge of oral health", "I hope that more medical insurance policies will cover the field of oral treatment and reduce our financial burden"......
Source: Rule of Law Daily K25