China has entered the aging society, according to the third national oral health epidemiological survey results: 86.1% of the elderly aged 65-74 in China have missing teeth, in order to maintain proper chewing, digestion, language, expression and other functions and physical and mental health, oral restoration is very important and necessary, but at present only nearly 30% of patients accept the restoration of missing teeth. For this reason, the reporter interviewed the director of the Department of Implant Restoration of Jiangsu Provincial Stomatological Hospital, Chunbo Tang, and asked her to talk about the hazards of missing teeth and the restorative options available for the elderly. First, the characteristics and hazards of missing teeth in the elderly? Missing teeth not only hinder chewing and aesthetics, but more importantly, have a great impact on the health of the elderly, summarized in four points: 1, can not chew: without a complete array of healthy teeth, the mouth can not complete the function of chewing, grinding and initial digestion of food. If long-term “swallow dates” type of eating, is bound to increase the gastrointestinal burden and prevent nutrient absorption, causing gastrointestinal diseases and nutritional diseases. 2, dry mouth: because the missing teeth will leak wind, the more missing teeth, the greater the leakage of wind. The elderly originally salivary gland degeneration, saliva secretion is reduced, coupled with the “wind through the hall” caused by missing teeth, natural dry mouth is unbearable. 3, heavy breath: poor digestion is easy to flood the stomach gas, coupled with dry mouth saliva less, the lack of self-cleaning function of the oral cavity, there will be “old people stink”. 4, mucous membrane rotten: If the residual crown and root in the mouth are not removed in time, the sharp-edged residual teeth will stimulate the nearby mucous membrane with long-term chronic abrasion, which may lead to traumatic ulcers, white spots and other mucosal diseases, and even oral cancer. Authoritative report shows that after wearing dentures, the whole body function can be restored to 81-95% of normal, while the whole body function of patients with no teeth will drop 40-60%, so the elderly should be restored in time after missing teeth. Second, the elderly should choose what kind of dentures after missing teeth? Elderly patients with missing teeth can choose movable denture, fixed denture, full denture or implant denture according to the remaining periodontal situation. People who are missing only one tooth have to wear two neighboring teeth to make a fixed bridge in order to get a denture, which is very heartbreaking. If made into movable dentures, there may be poor bite function, food embedding, unsightly, if the denture retention is poor or even accidentally swallowed into the esophagus trachea. Many elderly people who have been fitted with full dentures need a long adaptation period, during which there will be pressure pain, slurred speech, chewing weakness, tasteless diet and other uncomfortable symptoms, some people may even have insomnia, tinnitus, little speech, mental discomfort and other symptoms. The elderly people with long-term total tooth loss will experience shrinkage and resorption of the dental bed and reduction of jawbone height. Dental implants are fixed or semi-fixed dentures that are surgically implanted in the missing tooth area after the artificial root has healed with the tooth bed. Depending on the patient’s jawbone, the surgeon can place two to four implants to solve the stability problem of a full denture and restore the patient’s chewing function and aesthetics. Dental implants are usually placed in two to three steps, starting with a thorough preoperative preparation (oral examination, x-rays, extraction of models, fabrication of guides, etc.) followed by placement of the implants (artificial roots) in the alveolar bone. In the second step, 12 to 16 weeks after the surgery, the impression is taken and the upper crown is created and placed in the patient’s mouth. The average implant placement procedure takes only ten minutes to half an hour to complete. The procedure is performed under local anesthesia, is minimally invasive and painless, requires no hospitalization, and allows you to eat after the procedure with little systemic impact. The implant material is a biomaterial with excellent compatibility with the human body and does not cause any adverse side effects to the human body. Is there an age limit for dental implants for the elderly? Dental implants are available for adults over 18 years old, as long as the toothbed in the missing area has a certain height and width and can tolerate minor surgery like tooth extraction, provided that chronic diseases such as diabetes, hypertension, heart disease and cerebrovascular disease are well controlled and there is no inflammation or mucosal disease in the mouth. In addition, dental bone atrophy in the elderly due to years of wearing dentures or prolonged dental disease may also make implantation difficult. Compared with traditional dentures, dental implants do not need to be taken off and worn, do not need to damage neighboring teeth, and do not feel foreign bodies, and can fully restore chewing efficiency, which has become the most ideal restoration method recognized in the world. 4. How many implants should be placed in elderly people with missing teeth? If the patient has poor jawbone condition, older age and more economic considerations, two implant-assisted overdenture can be chosen, which is less demanding on the patient’s jawbone condition, easy for the patient to clean and maintain, and cost-effective. The disadvantage is that there is a risk of loss of retention on the implants, which requires regular checks and adjustment of retention; because of the small size of the restorative components, intra-oral seating can be difficult if the patient has difficulty with his hands and feet. If conditions allow, four implants can meet the requirements of retention stability and avoid the rotation of the denture caused by two implants, and four implants can be used for overdenture restorations. If the patient has a full jaw, sufficient bone volume, good health and good economic conditions, he can choose a full jaw fixed implant denture. At least 6-8 implants are needed in the upper and lower jaws to create a fixed full denture that is very similar to natural teeth. V. How long is the life expectancy of dental implants? Dental implants can be considered a permanent, non-replacement medical implant, with a typical 10-year survival rate of over 90% in the lower jaw and over 85% in the upper jaw. Its durability is also influenced by a number of factors: the brand of implant used, the level of treatment by the practitioner, daily cleaning care, regular professional care, not smoking, and avoiding excessive stress on the teeth while chewing.