🌿 Folk Prescriptions

Toothache is a common clinical symptom of oral diseases, mostly caused by local dental and periodontal tissue disorders. Traditional Chinese medicine holds that "teeth are the remnants of bones" and "the kidneys govern bones," while the meridian of the Stomach (Yangming) connects to the gums. Thus, teeth are closely related to the kidneys, and gums are closely related to the stomach. From a holistic perspective, toothache is often associated with external pathogenic factors, inflammation, liver-kidney dysfunction, and neglect of self-care. Generally speaking, acute toothache with swollen gums is primarily treated by addressing the Stomach; chronic toothache with loose teeth, dull pain, and mild swelling should be treated by addressing the Kidneys.
Wind-fire Toothache: Severe toothache in paroxysmal episodes, triggered or worsened by wind, relieved by cold but aggravated by heat, accompanied by red swollen gums, chills, fever, thirst, rapid pulse, commonly seen in early-stage acute pulpitis or apical periodontitis. Treatment aims to dispel wind, clear heat, detoxify, and reduce swelling. Formula: Modified Yin Qiao San: Honeysuckle 18g, Forsythia 18g, Great Burdock Seed 10g, Bamboo Leaf 10g, Schizonepeta 10g, Angelica Root 10g, Anemarrhena Rhizome 10g, Rehmannia Root 15g, Silkworm Pupa 10g, Scutellaria Root 10g, Licorice 6g.
Stomach-fire Toothache: Severe pain, redness and swelling of gums and face, possible pus discharge from gums, gum bleeding, sometimes difficulty opening mouth, accompanied by headache, thirst, bad breath, reduced urination, constipation, fever, yellow greasy tongue coating, commonly seen in pericoronitis or suppurative apical periodontitis. Treatment aims to clear stomach fire, cool blood, and relieve pain. Formula: Modified Qing Wei San: Coptis 10g, Rehmannia Root 15g, Cortex Moutan 10g, Platycodon Root 6g, Scutellaria Root 12g, Raw Gypsum 30g, Forsythia 15g, Angelica Root 10g, Asarum 3g, Rhubarb 6–12g. For those with pre-existing yin deficiency, use Yu Nu Jian with Lycium Bark and Scrophularia Root.
In both types above, herbs such as Dandelion, Purple Vetchling, Wild Chrysanthemum, Prunella, White Cowhage, and Honeycomb are commonly added based on symptoms.
Deficient Fire Toothache: Mild intermittent toothache, worsening in afternoon or night, gums usually not red or swollen, often accompanied by loose teeth, increased pain when chewing, gum bleeding. Systemic symptoms may include lower back soreness, dizziness, dry mouth and throat, red tongue with white coating, fine rapid pulse. Commonly seen in elderly patients with chronic periodontal disease. Treatment aims to nourish yin, tonify the kidneys, and reduce fire. Formula: Modified Zhi Bai Di Huang Tang: Anemarrhena Rhizome 10g, Phellodendron Bark 10g, Raw and Prepared Rehmannia Roots 15g each, Cornus Fruit 10g, Chinese Yam 30g, Cortex Moutan 10g, Alisma 10g, Bone-breaker 15g, Dog Spine 30g, Asarum 3g, Eucommia 10g.
Liver-fire Toothache: Toothache radiating to headache, exacerbated by emotional fluctuations, accompanied systemically by bitter taste, red eyes, tinnitus, rib pain, irritability, red tongue with yellow coating, rapid strong pulse. Treatment aims to clear liver and gallbladder fire, regulate liver qi, and relieve pain. Formula: Long Dan Xie Gan Tang without Caulis Akebiae, adding Coptis and Cortex Moutan.
Wind-cold Toothache: Paroxysmal toothache, triggered or worsened by wind and cold, relieved by heat, gums may swell or remain normal, systemic symptoms include aversion to wind and cold, no sweating, headache, nasal congestion, pale tongue with white coating. Mainly seen in patients with yang deficiency constitution suffering from periodontal disease. Treatment aims to dispel wind, scatter cold, and relieve pain. Formula: Chuan Xiong Cha Tiao San with Piper longum.
External Medication for Toothache (Tooth Pain Powder): Piper longum 3g, Angelica Root 3g, Ginger 3g, Asarum 3g, Realgar 3g, White Pepper 3g, Menthol 1.5g, Borneol 1.5g. Grind into fine powder, apply with small cotton ball into carious cavity.
Acupuncture can also be combined for treating toothache.