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Pediatric toothache is not beyond the categories of wind, fire, and insects. There are also distinctions between deficiency-fire (Xu Huo) and excess-fire (Shi Huo): pain caused by deficiency-fire is slow in onset, lighter during the day and heavier at night; pain caused by excess-fire is unbearable. Pain due to wind is accompanied by swelling, even extending to the head and face, and blowing on the wind exacerbates it. Pain due to dental caries (insects) is localized to one area during attacks, with incessant crying and wailing. Ancient formulas included methods for treating based on upper/lower and left/right locations according to meridians, but they were not very effective, likely because they failed to carefully distinguish between wind, fire, insects, and the patterns of deficiency and excess. Here are some ancient formulas that have proven effective: For wind-fire toothache, crush fresh Rehmanniae Radix (Sheng Di Huang), add a small amount of Borneolum Syntheticum (Bing Pian, do not use too much), beat evenly, and apply to the affected area; recovery occurs after spitting out saliva. For toothache due to dental caries, rinse with a strong decoction of Trichosanthis Semen (Jiu Zi), or rinse several times with a strong juice decoction of Galla Chinensis (Wu Bei Zi).

[Commentary by Chen Shouzhen] For pediatric toothache, rinsing agents are often inconvenient. Instead, use 7 fen of Xixin root powder (Xixin Tou Mo), 2 li of Borneolum Syntheticum (Pian Nao), 2 li of Moschus (Shexiang), 1 fen of Natrii Sulfas (Yaxiao), 6 li of Borax (Pengsha), and 4 li of Alumen (Baifan), grind into an extremely fine powder. Apply to the affected area regardless of whether the cause is wind, fire, or insects, and it will heal. However, one must discern deficiency versus excess and administer internal decoctions to prevent future complications.

Swelling of the upper and lower alveolar ridges in children is due to excess-heat in the Foot-Yangming Stomach Meridian and Hand-Yangming Large Intestine Meridian. Use a decoction of Forsythiae Fructus (Lian Qiao), Menthae Haplocalycis Herba (Bohe), Dendrocalamus Latiflorus Caulis (Dan Zhu), Anemarrhenae Rhizoma (Zhi Mu), Gypsum Fibrosum (Shi Gao), and Glycyrrhizae Radix et Rhizoma Recens (Sheng Gancao); frequent gargling and swallowing will resolve the swelling.

Swelling of the gingiva in children is caused by accumulated heat in the Kidney attaching to the gums, leading to swelling and pain. Applying powdered Phellodendri Cortex (Sheng Huangbai) to the gums is effective.

Teeth grinding during sleep in children indicates wind-heat. This arises from accumulated heat in the Hand and Foot Yangming meridians generating wind, causing the teeth to strike each other and produce sound. It occurs specifically during sleep because wind belongs to Yang; when active, wind moves in the Yang aspects, and when quiet, wind returns inward. This symptom is critical only when appearing during variola (smallpox/variolous diseases); otherwise, it poses no major harm. A decoction of equal parts of Bombyx Batryticatus (Chantui), Citri Reticulatae Pericarpium (Chenpi), Bamboo Shavings (Zhuru), and Glycyrrhizae Radix et Rhizoma (Gancao) is effective when taken orally.

Bleeding from the interdental spaces in children is caused by extreme heat due to Yin deficiency, known as "Ya Nu" (gingival bleeding) or "Ya Xuan" (alveolar pyorrhea). Applying soybean dregs (the residue remaining after extracting soy milk in tofu shops) to the area stops bleeding immediately, like magic. If bleeding does not stop, quickly prepare Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia Decoction) removing Corni Fructus (Yurou), and ingestion leads to immediate recovery.