小儿牙痛，不外风火虫三项。又有虚火实火之分∶虚火其痛甚缓。日轻夜重；实火痛不可忍。风痛者痛而且
肿，甚至头面皆
痛，呵风亦痛。虫痛者，发时必在一处，叫号不已。古方有分别上下左右，按经施治之法，不甚见功，盖因未详
辨风火虫及虚实不同之故耳。再举古方之多见效者，风火牙痛，以生地捣烂，加入潮脑少许，不可过多，捶匀贴
患处，吐出涎水即愈。虫牙痛者，以韭子煎浓汤漱之，或用五倍子煎浓汁，含漱数次即愈。
〔真按〕小儿牙痛，含漱之药每多不便，但用细辛头末七分，片脑二厘，麝香二厘，牙硝一分，硼砂六厘，
白矾四厘，研极细末，无论风火虫，擦患处即愈。但须斟酌虚实，内服汤剂，以杜后患。
小儿上下牙床肿者，此足阳明胃、手阳明大肠实热也。但用连翘、薄荷、淡竹、知母、石膏、生甘草煎汤，
频频含咽即消。
小儿牙龈肿者，因肾脏积热附龈而肿痛，但用生黄柏研末，敷牙龈上有效。
小儿梦中切牙，风热也。由手足阳明二经积热生风，故令相击而有声也。其必在梦中者，风属阳，动则风行
于阳，静则风归于里也。此症惟痘疹见之为危候，余则无大害。但用蝉蜕、陈皮、竹茹、甘草等分，煎服有效。
小儿牙缝出血，乃阴虚热极所致，名曰牙衄，又名牙宣。但用黄豆渣（即豆腐店中取过黄豆浆之渣）敷之立
止，如神，若血出不止，速煎六味地黄汤去萸肉，服之立愈。
小儿牙痛，不外乎风、火、虫三种病因。又有虚火和实火的区别：虚火引起的疼痛较为缓慢，白天轻晚上重；实火引起的疼痛难以忍受。风邪引起的疼痛伴有肿胀，甚至头面部都痛，吹到风也会痛。虫蛀引起的疼痛，发作时必定局限在某一处，患儿哭闹不止。古方中有分别上下左右、按经络施治的方法，但效果不甚显著，大概是因为没有详细辨别风、火、虫以及虚实不同所致。再列举几个古方中见效较多的方法：风火牙痛，用生地黄捣烂，加入少许冰片（不可过多），捶打均匀后贴敷患处，吐出涎水即可痊愈。虫牙痛，用韭菜子煎浓汤漱口，或者用五倍子煎浓汁，含漱数次即可痊愈。
〔陈守真按语〕小儿牙痛，含漱的药物往往多有不便，只用细辛头末七分，冰片二厘，麝香二厘，牙硝一分，硼砂六厘，白矾四厘，研成极细的粉末，无论是风、火、虫哪种原因，擦涂患处即可痊愈。但必须斟酌是虚证还是实证，内服汤剂，以杜绝后患。
小儿上下牙床肿胀，这是足阳明胃经和手阳明大肠经实热所致。只用连翘、薄荷、淡竹、知母、石膏、生甘草煎汤，频频含咽即可消退。
小儿牙龈肿胀，是因为肾脏积热附着于牙龈导致肿痛，只用生黄柏研末，敷在牙龈上有效。
小儿睡梦中磨牙，属于风热。由于手足阳明二经积热生风，所以导致牙齿相击而有声音。之所以一定发生在睡梦中，是因为风属阳，动则风气行于阳分，静则风气归于里。此症只有在痘疹病中出现时为危重征候，其余情况则无大害。只用蝉蜕、陈皮、竹茹、甘草等量，煎服有效。
小儿牙缝出血，乃阴虚热极所致，名叫“牙衄”，又名叫“牙宣”。只用黄豆渣（即豆腐店中取过黄豆浆后的豆渣）敷之，立刻止血，如神效一般。如果血止不住，迅速煎服六味地黄汤去掉山茱萸，服用后立即痊愈。
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.