Toothache

Introduction

Toothache is a common ailment. It may be due to wind fire, stomach fire, asthenic fire, and dental caries.

 

Etiology and Pathogenesis

The Hand and Foot Yangming Meridians go into the upper and lower gums respectively. Toothache may be due to flaring up along the meridians of the pathogenic fire transformed from pathogenic heat in the large intestine and stomach, or from exogenous pathogenic wind that attacks and accumulates in the Yangming Meridians. The kidney controls bones and the teeth are the odds and ends of the bones. Deficiency of the kidney yin with flaring up of the asthenic fire may also give rise to toothache. Sometimes toothache is due to dental caries caused by over intake of sour and sweet food.

 

Differentiation

a) Toothache due lo stomach fire:

Main manifestations: Severe toothache accompanied by foul breath, thirst, constipation, yellow tongue coating, forceful and rapid pulse.

Analysis: Accumulated heat in the stomach and intestines results in constipation. Up surging of the stomach heat causes yellow tongue coating and foul breath. Thirst is due to the exhaustion of body fluid by heat. Severe toothache is due to the stomach heat flaring up along the meridians. Forceful and rapid pulse also indicates the stomach fire.

b) Toothache caused by wind fire:

Main manifestations: Acute toothache with gingival swelling accompanied by chills and fever, superficial and rapid pulse. Analysis: The exogenous pathogenic wind invades the Yangming Meridians and turns into fire. Then occurs the toothache with gingival swelling. When the exogenous pathogenic factors struggle against the body resistance in the muscles and skins, there are chills and fever as exterior symptoms. Superficial and rapid pulse is a sign of wind - fire.

c) Toothache caused by deficiency of the kidney yin:

Main manifestations: Dull pain off and on, loose teeth, absence of foul breath, reddened tongue, thready and rapid pulse.

Analysis: The kidney controls bones and the teeth are the odds and ends of the bones. The kidney in deficiency state fails to keep the teeth strong, so they are loose. Flaring up of the asthenic fire leads to dull pain. Since nothing is accumulated in the stomach, there is no foul breath. Thready, rapid pulse and reddened tongue are due to heat caused by yin deficiency.

 

Treatment

a) Toothache due to stomach fire:

Method: The reducing method is applied to eliminate heat and stop pain. Points of Hand - Yangming Meridian are selected.

Prescription: [LI4 - ST6 - ST44 - ST7].

Explanation: LI4 of the contralateral side is used to disperse pathogenic heat from the Hand - Yangming Meridian. ST44, the ying-spring point of the Stomach Meridian, is used to reduce the fire in the stomach. ST7 and ST6 are local points to stop pain and regulate the qi circulation in the Foot - Yangming Meridian.

b) Toothache caused by wind fire:

Method: The reducing method is applied to dispel wind and clear off heat. Points of the Sanjiao Meridian of Hand - Shaoyang are selected.

Prescription: [TH2 - GB20 - LI4 - ST6 - ST7 - TH5].

Explanation: TH5 is the ying-spring point of the Sanjiao Meridian of Hand - Shaoyang. GB20 is used to dispel wind and clear off fire.  LI4, ST6 and ST7 are selected to regulate the qi circulation in the Yangming Meridians of Hand and Foot and to eliminate heat for relieving pain.

c) Toothache caused by deficiency of the kidney yin:

Method: The even movement is applied to nourish yin and lower the fire. Points of the Foot - Yangming and Foot - Shaoyin Meridians are selected.

Prescription: [ST6 - ST7 - KI3].

Explanation: The teeth relate to the kidney and are situated at the place where the Stomach Meridian and Large Intestine Meridian go through. Thus KI3 is used to nourish yin of the kidney and lower the asthenic fire. ST6 and ST7 relieve pain by regulating the qi in the meridians.

 

Remarks

Toothache described here is involved in acute and chronic pulpitis, dental caries, peridental abscess and pericoronitis.