Objective: To investigate the status of tooth loss and denture restoration in Chinese adults, analyse the changing trend and provide fundamental data for oral health policy. Methods: According to the protocol of the 4th National Oral Health Survey, a multistage stratified random cluster-sampling method was used to enrol adult subjects aged 35 to 44, 55 to 64 and 65 to 74 years in all 31 provinces, municipalities and autonomous regions of the mainland of China. The status of tooth loss and denture restoration was investigated. SPSS20.0 software was used for statistics analysis. Results: Among the 13,464 subjects investigated, 13.8% had complete dentition, 84.4% had dentition defects, and 1.8% was edentulous. Urban subjects showed a significantly higher proportion of complete dentition than those in rural (P = 0.02), and males showed the statistically higher proportion of complete dentition than females (P = 0.01). The mean of remaining teeth was 26.1 ± 6.90, which in urban areas was significantly higher than in rural areas (P 0.01). The means of remaining teeth were 29.6 ± 2.3, 26.3 ± 6.1, and 22.5 ± 8.7 in the 35 to 44, 55 to 64 and 65 to 74 age groups, respectively. The detection rate of fixed partial dentures (FPD) was statistically higher in urban than in rural areas and in males than that in females (P 0.01). The detection rate of removable partial dentures (RPD) was statistically higher in urban areas than in rural locations (P 0.01). However, the detection rates of irregular denture and unrepair of tooth loss were both significantly lower in urban than in rural areas (P 0.01). The rate of restoration of tooth loss was 41.6% in Chinese adults. Conclusion: Although the tooth loss and denture restoration status recorded in the survey was improved compared with the results of 10 years ago, more efforts need to be made on strengthening oral health promotion, particularly for elderly people and those living in rural areas. Keywords: Chinese adults, denture restoration, oral health survey, tooth loss, the 4th National Oral Health Survey