Toothache

Pain felt in the teeth. Toothache is most commonly caused by tooth decay, a rotting away of the teeth, that the ancient Chinese ascribed to the work of worms. Where decay is absent, Chinese medicine attributes toothache to wind-fire, wind-cold, stomach heat, kidney vacuity, or qì vacuity.

Patterns

Wind-fire (风火 fēng huǒ) (wind-heat) toothache is relieved by cold and is associated with painful swelling of the gums. It is exacerbated by exposure to heat or by eating hot spicy foods. Pain may relieved by coolness. The swelling may make eating difficult, and in some cases the cheeks are swollen and hot. Other signs include thirst, a red-tipped tongue with thin white fur or dry yellow fur, and rapid floating pulse.

Medicinal therapy: Oral: Course wind, clear heat, and relieve pain. Use variations of Lonicera and Forsythia Powder (银翘散 yín qiào sǎn). Topical: Apply Mint and Refined Mirabilite Powder (薄荷玄明散 bò hé xuán míng sǎn).

Acumoxatherapy: Base treatment for toothache mainly on ST and LI. Main points: ST-7 (Below the Joint, 下关 xià guān), LI-4 (Union Valley, 合谷 hé gǔ), and ST-6 (Cheek Carriage, 颊车 jiá chē). For wind-fire, add GB-20 (Wind Pool, 风池 fēng chí), TB-5 (Outer Pass, 外关 wài guān), and GV-14 (Great Hammer, 大椎 dà zhuī); needle with drainage. If heat is exuberant, prick LU-11 (Lesser Shang, 少商 shào shāng) and LI-1 (Shang Yáng, 商阳 shāng yáng) to bleed.

Wind-cold (风寒 fēng hán) toothache is characterized by a pulling pain and is exacerbated by cold and relieved by the application of warmth. Other signs include periodic aversion to cold, absence of thirst, a thin white tongue fur, and a tight floating or a slow or moderate pulse.

Medicinal therapy: Oral: Course wind, disperse cold, and relieve pain. Use Perilla Leaf Decoction (苏叶汤 sū yè tāng). Topical: Apply Asarum Powder (细辛散 xì xīn sǎn).

Acumoxatherapy: Add to the main points GB-20 (Wind Pool, 风池 fēng chí), TB-5 (Outer Pass, 外关 wài guān), and LU-7 (Broken Sequence, 列缺 liè quē); needle with drainage and add moxa.

Stomach heat (胃热 wèi rè) toothache is toothache attributable to stomach fire ascending the hand and foot yáng brightness (yáng míng) channels, which pass through the lower and upper jaws respectively. It is characterized by severe pain associated with bad breath, thirst, constipation, yellow tongue fur, and a stringlike pulse.

Medicinal therapy: Clear and discharge stomach fire with Sweet Dew Beverage (甘露饮 gān lù yǐn) or Stomach-Clearing Decoction (清胃汤 qīng wèi tāng).

Acumoxatherapy: Add to the main points ST-44 (Inner Court, 内庭 nèi tíng) and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with drainage.

Kidney vacuity (肾虚 shèn xū) toothache is vacuity fire toothache resulting from insufficiency of kidney yīn with vacuity fire flaming upward. Kidney vacuity toothache is explained by the governing of the bone, and the teeth are the surplus of the bone. It is characterized by dull intermittent pain, absence of bad breath, a red-tipped tongue, and a fine pulse. In some cases, loosening of the teeth is also observed.

Medicinal therapy: Supplement kidney yīn and drain liver fire using formulas such as Supplemented Six-Ingredient Rehmannia Pill (加味六味地黄丸 jiā wèi liù wèi dì huáng wán).

Acumoxatherapy: Needle with even supplementation and drainage or with supplementation at KI-3 (Great Ravine, 太溪 tài xī) and KI-1 (Gushing Spring, 湧泉 yǒng quán); needle with drainage at LR-2 (Moving Between, 行间 xíng jiān) and the main points.

Qì vacuity (气虚 qì xū) usually arises from taxation damage. It is a dull continuous toothache without markedly swollen gums or with swollen gums that are not markedly red. Other signs include bright-white facial complexion, scantness of breath, laziness to speak, faint low voice, fatigue and lack of strength, spontaneous sweating, heart palpitation, dizzy head, tinnitus, frequent voidings of clear urine, pale enlarged tongue with thin white tongue fur, and a weak vacuous or vacuous large pulse.

Medicinal therapy: Supplement qì and relieve pain. Use Center-Supplementing Qì-Boosting Decoction (补中益气汤 bǔ zhōng yì qì tāng) plus cooked rehmannia (Rehmanniae Radix Praeparata, 熟地黄 shú dì huáng), moutan (Moutan Cortex, 牡丹皮 mǔ dān pí), poria (Poria, 茯苓 fú líng), and white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào).

Acumoxatherapy: Add to the main points ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), CV-6 (Sea of Qì, 气海 qì hǎi), BL-20 (Spleen Transport, 脾俞 pí shù), and BL-21 (Stomach Transport, 胃俞 wèi shù); needle with supplementation and add moxa.

Tooth decay (龋齿 qǔ chí) is observed in people who usually eat fat meat, fine grain, and strong flavors or sweet sugary things that get lodged between the teeth and fail to be removed by cleaning. Holes appear in the teeth with local blackening. The holes harbor food, further exacerbating the decay. Cold, hot, sour, and sweet foods can exacerbate the pain, as can inhalation of air.

Medicinal therapy: Clear heat and relieve pain. Topical: Grind zanthoxylum (Zanthoxyli Pericarpium, 花椒 huā jiāo) and limestone (Calx, 石灰 shí huī) to a powder and blend with honey into pills. Apply by forcing pill material into the cavities. Other guidelines for the treatment of toothache are commonly applied.

Acumoxatherapy: Since the hand yáng brightness (yáng míng) large intestine channel runs through the lower teeth, aching among the lower teeth can be treated mainly by large intestine channel points. Since the foot yáng brightness (yáng míng) stomach channel passes through the upper teeth, aching among the upper teeth can be treated by stomach channel points. In addition, The Magic Pivot (灵枢 líng shū, zá bìng piān) states, Toothache without aversion to cold drinks is treated through the foot yáng brightness (yáng míng); with aversion to cold drinks, it is treated through the hand yáng brightness (yáng míng). For toothache without discomfort when taking cold drinks, use ST-44 (Inner Court, 内庭 nèi tíng) and ST-7 (Below the Joint, 下关 xià guān) as the main points; if there is discomfort, use LI-4 (Union Valley, 合谷 hé gǔ).

See tooth decay.