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The four upper central incisors belong to the Heart. (Another theory states: The two upper and two lower central incisors belong to the Pericardium; the four teeth on the left and right, upper and lower adjacent to the incisors, belong to the Liver; the next four teeth on the left and right, upper and lower, belong to the Stomach; the next four belong to the Spleen; the next four belong to the Lung; the remaining teeth all belong to the Kidney. Generally, having more teeth is considered auspicious. In treatment, regardless of the number of teeth, dividing them according to the aforementioned locations for therapy yields good results.) The four lower central incisors belong to the Kidney; the two upper lateral incisors belong to the Stomach; the two lower lateral incisors belong to the Spleen; the uppermost left molar belongs to the Gallbladder; the lowermost left molar belongs to the Liver; the uppermost right molar belongs to the Lung; the lowermost right molar belongs to the Large Intestine. There is also a condition where the gums are swollen, elevated, and soft, named Ya Yong (Dental Abscess). Pus must be present internally; it should be pricked with a needle to drain the pus, after which it will heal spontaneously. If bleeding does not stop, apply grass paper soaked in cold water two or three times, and the bleeding will cease naturally. (From *Zhengzong*)

Wind-induced toothache occurs upon exposure to wind, followed by swelling and pain.
Fire-induced toothache involves the tooth roots pulling into the cheeks and zygomatic area, with paroxysmal pain that comes and goes.
Damp-heat induced toothache belongs to the Foot-Yangming Stomach Meridian. Symptoms include swelling of the cheeks and zygomatic area, extending to the temporal region in severe cases, pain radiating to the jaw and neck, a sensation of heat in the mouth, and dry, constipated stools.
Cavity-induced toothache results from a preference for sweet and aromatic foods, where damp-heat transforms into worms, causing frequent painful attacks.
Tooth decay (Qu Chi) is caused by the struggle between wind and heat, combined with anger and overexertion, leading to swelling and pain at the tooth roots. This relates to the Hand-Yangming and Foot-Taiyang meridians connecting to the teeth, hence the name Tooth Decay. (From *Jinnang*)

Furthermore: If toothache is unbearable, radiating to the brain, with a preference for cold and aversion to heat, and a surging, rapid, and forceful pulse, use Liang Ge San (Cooling the Diaphragm Powder) with doubled Jiuzheng Dahuang (Wine-processed Rhubarb) to purge heat.
Furthermore: Sudden, severe pain often belongs to Long Huo (Dragon Fire/Ministerial Fire), resembling violent storms and thunder, burning wood and grass with utmost speed and intensity. One must employ Cong Zhi (Following Treatment) methods: administering hot medicine frozen and drunk cold, so that the fire finds its source and returns.

Dou Hanqing said: A bean-sized abscess growing on the gum edge indicates Fire in the Stomach and Spleen meridians. It should be punctured with a small knife, applied with Bingpian San (Borneol Powder), and followed by Qingwei Tang (Clear the Stomach Decoction) and Ganjie Tang (Licorice and Platycodon Decoction), ensuring recovery.

Wang Haicang said: Dental caries with foul odor persisting for years should be treated as Yangming Blood Accumulation. Those who enjoy alcohol often suffer from this condition. Tao Ren Cheng Qi Tang (Peach Kernel Draining the Epigastrium Powder) powdered and formed into honey pills is very effective.
Furthermore: Toothache exacerbated by cooling is Cold; toothache relieved by inhaling cool air is Heat.

Feng Luzhan said: Blackened, fragmented teeth are called Beng Sha (Falling Sand). Over time, with severe filth and root loss, it is called Fu Yin (Rotting Gums). If caused by trauma or acute cancrum oris, long-term loss makes regrowth difficult. (From *Jinnang*)

Chen Yuangong said: Severe, unbearable toothache causing wailing, tears, and snot indicates excessive Fire in the Zang-Fu organs rising to the teeth. Without purging Fire, how can quick effect be achieved? However, Fire has Deficiency and Excess types. Excess Fire originates in the Fu organs, while Deficiency Fire arises from the Zang organs. Among Excess Fire, there is Stomach Fire and Pericardium Fire. Among Deficiency Fire, there is Fire from the Liver, Spleen, Lung, and Kidney meridians, which must be distinguished by meridian. I have a universal method using Zhiya Xiandan (Tooth-Curing Immortal Elixir): Xuanshen (Scrophulariae Radix) and Shengdi (Rehmanniae Radix) each one tael, decocted in water. If Pericardium Fire is identified, add Huanglian (Coptidis Rhizoma) 5 fen; Spleen Fire, add Baizhu (Atractylodis Macrocephalae Rhizoma) 1 qian; Lung Fire, add Huangqin (Scutellariae Radix) 1 qian; Liver Fire, add Danpi (Moutan Cortex) 1 qian; Kidney Fire, add Shudi (Prepared Rehmanniae Radix) one tael. After two doses, Fire dissipates; after four doses, full recovery. (*Shishi Milu* Note: How can one formula treat both Deficiency and Excess Fire? The excess of Fire is essentially the insufficiency of Water. By nourishing Yin, Yin and Yang Fire are harmonized. Moreover, Xuanshen clears floating Fire, and Shengdi extinguishes rootless flames; thus, purging contains tonification, making it suitable for both. This is a skillful approach grasping the essence. By adding specific herbs for each meridian's Fire, efficacy is assured.)

Furthermore: Greed for rich and sweet foods causes tooth damage and pain, feeling like crawling insects, indicating Worm Accumulation. Teeth are bone; how can they harbor worms? Overconsumption of rich foods creates Heat in the Stomach, which rushes upward to the oral cavity and teeth. Dampness exploits this, combining with Heat without dispersing, thereby generating worms in the teeth. Initially few, they multiply over time, eroding teeth until they fall out. Once one tooth rots, it infects others, causing lifelong suffering. This condition requires external treatment; internal medication may fail to kill worms while damaging the Zang-Fu. Use Wuling Zhisheng San (Five-Spirit Supreme Holy Powder): Baiwei (Cynanchi Atrati Radix) and Wulingzhi (Trogopterori Faeces) each 3 qian, Xixin (Asari Radix et Rhizoma) and Gusui Bu (Drynariae Rhizoma) each 5 fen, ground to fine powder. Rinse teeth thoroughly with boiling water first, then mix 5 fen of powder with boiling water to a thin paste, swish in the mouth for half a day until breathlessness forces spitting. Repeat three times; pain stops, worms die, and recurrence is prevented. (Likely because Wulingzhi and Baiwei kill worms invisibly, Xixin disperses Fire, and Gusui Bu penetrates bone to guide medicine into the bone structure, leaving no hiding place for worms; once worms are gone, pain ceases.)

Furthermore: Chronic toothache with rotting gums, inability to eat, and day-and-night wailing indicates solitary Stomach Fire rising to the teeth. Stomach Fire is the most fierce in the body; where the Fire is, there lies the disease. Fire rises easily but descends with difficulty. Rising to the teeth, which are not meant to store Fire, it burns the cheeks, causing redness and swelling of the gums, eventually leading to rot. One might consider Zhiya Xiandan plus Shigao (Gypsum Fibrosum). However, if Fire is entrenched, the previous formula works invisibly; now that ulceration exists, it is unsuitable as有形 (formidable) damage is hard to repair. Use Jiajian Zhuye Shigao Tang (Modified Bamboo Leaf and Gypsum Decoction): Zhuye (Bamboo Leaves) 300 pieces, Shigao and Qinghao (Artemisiae Annuae Herba) each 5 qian, Zhimu (Anemarrhenae Rhizoma) and Banxia (Pinelliae Tuber) each 2 qian, Maidong (Ophiopogonis Tuber) and Fuling (Poria) each 3 qian, Gegen (Puerariae Lobatae Radix) 3 qian, decocted in water. After four doses, Fire retreats and swelling subsides; subsequently, use Zhiya Xiandan to conclude treatment.

Furthermore: Toothache worsening at night, preventing sleep due to groaning, indicates Kidney Fire rushing upward. This is Deficiency Fire, not Excess Fire. Treating it as Excess Fire often fails; even treating it as Deficiency Fire sometimes fails. Why? Excess implies surplus, Deficiency implies lack. Here, the lower part is Deficient-Cold, presenting false Heat above. If the Kidney is not cold, Dragon-Lei Fire (Ministerial Fire) remains settled below. Only when the lower Kidney palace is severely cold and Kidney Water is insufficient does Kidney Fire have no place to reside, rushing up to the throat and affecting the teeth. Teeth are the remainder of bone, attracting similar energies, lingering especially at night when the Kidney governs. Water cannot nourish Fire, so Fire wanders externally, tormenting the teeth. Urgently tonify Kidney Water significantly, aided by flavors that tonify Fire, guiding Fire back to its source. Nourished by Water, Fire will not rise. Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) plus Gusui Bu, taken for one dose stops pain, two doses prevent recurrence. (Liuwei Dihuang Wan tonifies Water; Fuzi and Guirou guide Fire to Mingmen. Why add Gusui Bu? Medicine tonifying Water and guiding Fire must first enter the teeth to remove the root of pain. Using it to penetrate the dental bone allows direct entry to Mingmen. This is a brilliant method of removing the root and blocking the source.)

Furthermore: Unbearable toothache, slightly lighter when closing the mouth, heavier when opening, is often mistaken for Yangming Stomach Fire, but is actually Wind obstructing the Yangming and Taiyang meridians! This occurs after drinking alcohol, sleeping with an open mouth facing the wind, trapping Wind inside the teeth. Initial mild pain escalates. Theoretically, dispelling Wind cures it, but Wind-dispersing drugs consume Yuan Qi. Due to deficiency, Wind enters and consumes Qi further, weakening Zheng Qi. Wind exploits the weakness of Zheng Qi and refuses to exit, making pain persistent. Ancient moxibustion was miraculous: Moxa at the seam near the shoulder tip, arm slightly raised, at the bony depression, five moxa cones cure it. Severe pain follows moxibustion but settles permanently. For those fearing moxibustion, use Sanfeng Tang (Dispel Wind Decoction): Shengdi and Maidong each 5 qian, Danggui (Angelicae Sinensis Radix) 3 qian, Shigao and Huafen (Trichosanthis Radix) each 2 qian, Hutong Lei (Tectona Grandis Resin), Genge (Puerariae Radix), and Xixin each 1 qian, Baizhu (Angelicae Dahuricae Radix) and Shengma (Cimicifugae Rhizoma) each 3 fen, decocted in water. Two doses cure. This formula emphasizes tonification over dispersion; strengthened Zheng Qi easily disperses Wind.

Furthermore: Severe toothache temporarily relieved by sucking cold water but returning upon opening the mouth is often mistaken for Yangming Fire, but is actually Damp-Heat stagnating in the upper and lower teeth. Dampness below is easy to disperse; above is difficult. Treating Dampness usually involves promoting urination. Downward flow is smooth; upward is contrary. Dampness enters from below but moves up, making infection easy but dispersion hard. Damp-Heat in the teeth is hard to clear because all ingested liquids pass through the teeth, aggravating Dampness. Undispersed Dampness exacerbates Fire, causing chronic persistence. Treatment must clear Damp-Heat above without solely relying on diuretics. Adjuvant Wind drugs dry Dampness and cool Heat via Wind action. Once Damp-Heat resolves, toothache heals.

*Yilun Xuanyao* states: The outer plate is the "Ya" (tooth crown), the inner bed is the "Chi" (tooth root/gum bed).

Wang Shengzhi said: Cavity teeth are caused by Wind-Damp in the Stomach meridian. Fumigation is very swift. (From *Lili*)

The Classics state: At age eight, men's Kidney Qi becomes substantial, replacing teeth; at twenty-four, wisdom teeth grow; at forty, teeth wither; at sixty-four, teeth fall out. Women follow a seven-year cycle. The Kidney governs bone; teeth are the manifestation of bone, nourished by Marrow. Generally, teeth belong to the Kidney; upper and lower gums belong to the Yangming meridians. Upper gum pain, preferring cold drinks and avoiding hot ones, treats the Foot-Yangming Stomach; lower gum pain, preferring hot drinks and avoiding cold ones, treats the Hand-Yangming Large Intestine. Thus, diseases differ in aversion to cold or heat. Any loosening, pain, bleeding or non-bleeding, wide interdental spaces, and impending loss belong to the Kidney. The Classics say: Kidney Heat manifests as black complexion and withered teeth. Also: Shaoyin disease presents as black face and elongated, dirty teeth. Cancri dentium with swollen, non-loose but ulcerated, painful, and foul gums belongs to Yangming. Mixed pathogenic factors from various meridians and external causes must be treated by distinguishing Deficiency and Excess. Kidney Deficiency-Cold uses Anshen Wan (Kidney-Anchoring Pill) or Huan Shao Dan (Return to Youth Elixir); severe cases use Bawei Wan. Winter severe cold invading the brain with headache and loose, painful teeth indicates Taiyang and Shaoyin Cold Damage. Zhang Zhongjing used Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asari Decoction). Common in Kidney Deficiency. Loose, painful teeth with limb fatigue and poor appetite indicate Spleen-Kidney depletion; combine Anshen Wan and Buzhong Yiqi Tang. Preference for cold and aversion to heat indicates Stomach Blood injury; use Qingwei Tang. Aversion to cold and preference for heat indicates Stomach Qi injury; use Buzhong Yiqi Tang.

Furthermore: Teeth are the remainder of bone, the mark of the Kidney, lodged in the gums, nourished by Qi and Blood. Upper gums belong to Foot-Yangming Stomach; lower gums to Hand-Yangming Large Intestine. Teeth are bone, originating from Qianyuan (Heavenly Origin); gums are flesh, originating from Kunyuan (Earthly Origin), like trees growing in soil, relying on it for nourishment. Thus, dental diseases arise from Hand-Yangming, Foot-Yangming, and Foot-Shaoyin meridians. Upper and lower gums belong to Yangming Metal; teeth belong to Shaoyin Wood. When Yangming is Excess, it nourishes and stabilizes teeth; when Deficient, teeth lose nourishment and become loose. Loosening, shedding, brittleness, widening gaps, aversion to cold/heat, and dull pain indicate fundamental Kidney Deficiency leading to superficial Deficiency. Worms, swelling, bleeding, foul odor, and rot indicate excessive Damp-Heat in the intestines and stomach ("Excess Heat causes flesh to rot"). Tonify Deficiency, purge Damp-Heat, clear Stomach Fire, scatter Wind-Cold. External powder application helps. Severe gum rot and tooth loss resemble collapsing earth and falling trees; treatment focuses on gums, for firm gums ensure stable teeth.

Furthermore: Swollen/painful gums, loose/painful teeth, or black/rotten/shedding teeth belong to Yangming Damp-Heat. Although teeth belong to the Kidney, they grow in the gum beds governed by Yangming Large Intestine and Stomach, like trees in soil. Damaged by rich food and alcohol, Damp-Heat attacks upward, clouding the gums, causing swelling, pain, bleeding, or worms, unsettling the teeth like unstable soil shaking trees. Purge Yangming Damp-Heat to calm the gums and stabilize teeth. If management fails and teeth fall out, prognosis is poor.

Furthermore: Toothache triggered by exertion or worsening in the afternoon, accompanied by thirst, dark complexion, or spermatorrhea, indicates Spleen-Kidney Deficiency-Heat. Use Buzhong Yiqi Tang, Liuwei Wan, or Shiquan Dabu Tang.

Haicang stated: Toothache due to Stomach injury with pre-existing Damp-Heat floating to the gums, constrained by Wind-Cold or cold drinks, prevents Damp-Heat from dispersing externally, causing pain. Pathology has Root/Branch aspects; medication varies by Warm/Cool. Treat Cold as Branch: external washes with Biba (Piperis Longi Fructus) and Xixin disperse constraint and vent trapped Heat. Treat Heat as Root: internal meds with Shengdi, Danpi, Lianqiao (forsythiae Fruit), and Bohe (Menthae Haplocalycis Herba) clear Heat with Pungent-Cool properties. Internal and external attack together ensures cure. Sudden severe pain is often Dragon Fire; use Cong Zhi (hot medicine cold drink). Direct Cold treatment worsens it. Unbearable pain radiating to the brain, preferring cold, surging pulse: use Liang Ge San with doubled wine-processed Rhubarb.

*Yimen Guangdu* states: Teeth are the remainder of Blood; ears are the remainder of Kidney; crown is the remainder of Marrow; nails are the remainder of Tendons; speech is the remainder of Qi.

*Bitan* records: Shen Cunzhong suffered heavy waist and immobility. A general attributed it to years of using Kushen (Sophorae Flavescentis Radix) to brush teeth, entering the Kidney and damaging it. Shu Zhaoliang later did the same and developed back pain; stopping usage cured him. This is unrecorded in medical texts.