Toothache

SYMPTOMS AND SIGNS: Toothaches are a symptoms which are due to the flaring up of the accumulated heat of the stomach or due to kidney Yin deficiency. It is a very commonly seen among all ages, including the acute and chronic pulpitis, dental caries, peridental abscess and pericoronitis of the dental diagnosis. 

ETIOLOGY AND PATHOLOGY: Generally speaking, toothaches are caused by the interior fire flaring up from the stomach or by kidney Yin deficiency. So the following are the two most commonly seen etiological factors and pathological changes: 

  1. Toothache due to the excessive fire from stomach and intestine: The branch of the large intestine channel of hand - Yang Ming passes through the cheek, and enters the gums of the lower teeth; the stomach channel of the foot - Yang Ming enters the upper gums. A person who excessively drinks alcohol, or has the habit of eating hot and spicy foods can produce stomach or intestinal heat which follows the channels and attacks the gums or tooth causing a toothache. 
  2. Toothache due to the kidney Yin deficiency: The kidney is the organ which nourishes the bone by its function of storing essence. in Chinese medicine, the kidney governs the bone. Since teeth are the continuance of bone, then the kidney has a very close relationship. If there is kidney Yin deficiency, the deficient interior fire will up attack the tooth causing a toothache. 
  3. Toothaches due to unhealthy oral hygiene causes peridontoclasia, dental caris, or peridental abscess, thrush and other oral diseases. 

DIFFERENTIATIONS: 

1. Toothache due to the Excessive Fire: 

Indications: Gingival swelling and pain, alleviated by coldness, thirsty, likes to cold drinks, headache, constipation, scanty yellowish urine, red tongue, thin and yellow coating, wiry and rapid pulse. 

Treatment & Formulas: Clear the interior heat so as to stop the tooth pain. 

Products:

    • Qing Wei San (Coptis and Rehmannia Formula, Item No. 2182): This is a very good formula for toothaches due to excessive fire in the stomach. 
    • Huang Lian Jie Du Tang (Coptis and Scute Formula, Item No. 2212): This can be used for toothaches due to strong interior fire of San Jiao. 
    • San Huang Xie Xin Tang (Coptis and Rhubarb Combination, Item No. 2026): This formula treats the toothache due to the strong interior fire with constipation due to its purgative function and cold nature. 
    • Xiao Cheng Qi Tang (Minor Rhubarb Combination, Item No. 2028): This is only used for toothaches that are caused by strong accumulated heat and constipation in the intestines. 

2. Toothache due to the Kidney Yin Deficiency:

Indications: Slight or no swelling, intermittent dull pain, loose teeth, no thirst, normal stool and urine, red tongue, white coating, deep, thready and rapid pulse.

Treatment & Formulas: Tonify kidney Yin and clear the deficient fire. 

Products:

    • Zhi Po Ba Wei Wan (Anemarrhena, Phellodendron, and Rehmannia Formula, Item No. 2123): This is a typical formula for kidney Yin tonic, at same time, it clears the deficient fire. So it is very often used for toothache due to the deficient fire. 
    • Qi Ju Di Huang Wan (Lycium, Chrysanthemum and Rehmannia Six Formula, Item No. 2290): This is good for toothache due to the kidney Yin deficiency plus interior wind factors. 
    • Liu Wei Di Huang Wan (Rehmannia Six Formula, Item No. 2051 ): This is a typical kidney Yin tonic formula. It can be used for toothaches due to the kidney Yin deficiency without any deficient interior fire. 

COMMENTS: 

  1. Brush teeth regularly and keep healthy oral hygiene.
  2. Avoid fried, spicy and hot foods.
  3. Acupuncture is very effective for toothaches due to the interior stomach or intestine heat. The points are chosen mostly from the large intestine and stomach, or local points, such as Hegu (LI. 4), Jiache (St. 6), Xiaguan (St. 7), Neiting (St. 44), Tianrong (S.I. 17).

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