经曰∶肾衰则齿豁，精固则齿坚。又曰∶齿乃肾之标，骨之余也。夫齿者，骨之所终，髓之
所养。内床生者名齿，外单立者名牙。手足阳明所过，上龈隶于坤土，乃足阳明胃脉贯络。重浊
不动，恶热喜寒。下龈嚼物属金，乃手阳明大肠脉络，轻清能动，恶寒喜热。故痛时，饮食有寒
热相宜。又有疳蚀、蛀缺，血出而痛；有脾胃风热，龈肿而痛。有风、寒、湿、热、虫五种之别
；有牙疳臭烂秽气者，火热极也，脉见右寸关浮洪数大，二阳明之火盛矣。
主方 当归身 生地 牡丹皮 黄连（各二钱） 升麻 石膏（上齿倍） 大黄（酒煮）
黄芩条（各一钱，下齿倍） 细辛（三分）水煎，食后服。上齿痛甚，凉膈散，大黄（酒煮），
加石膏、升麻、知母，一剂即安（方见火门）。
清胃汤 治一切风热湿痰牙痛，接服七神。
栀子 苍术 条芩 当归 生地 石膏 黄连（各一钱） 白芍 青皮（各八分） 荆芥
藿香 升麻 细辛 丹皮（各五分） 甘草（四分）
水煎服。含浸痛处。
七神散 痛甚，继以姜黄、白芷、川芎、细辛末，椒盐汤漱，敷患处。
龙胆草（钱半） 黄连 防风（各一钱） 升麻（七分） 草豆蔻（建宁者，十粒，研）
北细辛（连叶，二分） 炙草（四分）
水一钟，煎半钟，哈一口含浸患处，少时咽。
宣风牢牙散 驻颜补肾，滋血固齿。
当归 川芎（各一两） 青盐（七钱） 细辛（四钱）
上为末，清晨漱口净用，擦牙，连药咽下。不咽，加石膏一两。
简便方 绿豆（十粒） 胡椒（七粒）
捣细，绵裹豆大，咬于痛处。
又 黑豆、葱白、艾叶、川椒，水煎含漱。或干姜（一钱）、雄黄（五分），研擦。或独蒜煨
热熨，冷则易。或霜后丝瓜烧，擦。或雄黄研，蜜丸塞。
走马牙疳∶妇人溺桶垢（火 ，一钱）、铜青（三分）、麝（一分）研匀，厘许敷患处。
欲取下牙∶荜菝 草乌（各五钱） 川椒 细辛（各三钱） 为末，敷患牙内外，自落。
坚牙去风∶香附（炒焦，三两）研末，入青盐（一两），日擦。
牙动出血∶白蒺藜为末，擦。
风虫牙痛∶鲜菖蒲咬痛处。或良姜煨热，咬患处痛止。或李根皮煎汤漱。或槐白皮醋煮，入
盐含。或胡荽子煎汁含。或苋茎、或茄蒂烧，搽。
《黄帝内经》说：肾气衰弱则牙齿松动脱落，精气固摄则牙齿坚固。又说：牙齿是肾脏的外在表现，是骨骼的余气所化。牙齿，是骨骼的终点，由骨髓滋养。长在牙床内的叫“齿”，长在牙床外显露的叫“牙”。手足阳明经经过此处，上牙龈归属于坤土（脾），是足阳明胃脉贯穿联络；其性质重浊而静止，厌恶热邪而喜寒凉。下牙龈咀嚼食物归属于金（肺/大肠），是手阳明大肠脉络所属；其性质轻清而能动，厌恶寒邪而喜温热。因此疼痛时，饮食需根据寒热适宜来选择。又有疳蚀、蛀牙缺损，出血且疼痛；有脾胃风热，牙龈肿胀且疼痛。分为风、寒、湿、热、虫五种类型；有牙疳臭烂散发秽气的，是火热极盛的表现，脉象见右寸关部浮洪数大，这是二阳（胃与大肠）火盛所致。
主方：当归身、生地、牡丹皮、黄连（各二钱）、升麻、石膏（上齿痛加倍用量）、大黄（酒煮）、黄芩条（各一钱，下齿痛加倍用量）、细辛（三分）。水煎服，饭后服用。若上齿疼痛剧烈，用凉膈散，加酒煮大黄、石膏、升麻、知母，一剂即可安宁（方剂见火门章节）。
清胃汤：治疗一切风热湿痰引起的牙痛，接续服用七神散。
栀子、苍术、黄芩条、当归、生地、石膏、黄连（各一钱）、白芍、青皮（各八分）、荆芥、藿香、升麻、细辛、丹皮（各五分）、甘草（四分）。
水煎服。含漱浸泡疼痛部位。
七神散：疼痛剧烈时，继用姜黄、白芷、川芎、细辛研末，用椒盐汤漱口，敷于患处。
龙胆草（一钱半）、黄连、防风（各一钱）、升麻（七分）、草豆蔻（建宁产者，十粒，研碎）、北细辛（带叶，二分）、炙甘草（四分）。
水一钟，煎至半钟，哈一口含浸患处，片刻后咽下。
宣风牢牙散：驻颜补肾，滋血固齿。
当归、川芎（各一两）、青盐（七钱）、细辛（四钱）。
以上研为细末，清晨漱口干净后使用，擦牙，连同药粉一起咽下。若不咽下，可加石膏一两。
简便方：绿豆（十粒）、胡椒（七粒）。
捣碎，用棉布包裹如豆大小，咬在疼痛处。
又方：黑豆、葱白、艾叶、川椒，水煎含漱。或用干姜（一钱）、雄黄（五分），研碎擦拭。或用独蒜煨热熨烫，冷则更换。或用霜降后的丝瓜烧灰，擦拭。或将雄黄研末，蜜丸塞入。
走马牙疳：妇人溺桶垢（火煅，一钱）、铜青（三分）、麝香（一分）研匀，少许敷于患处。
欲取下牙：荜菝、草乌（各五钱）、川椒、细辛（各三钱），研为细末，敷于患牙内外，牙齿自落。
坚牙去风：香附（炒焦，三两）研末，加入青盐（一两），每日擦拭。
风虫牙痛：鲜石菖蒲咬于痛处。或良姜煨热，咬患处痛止。或李根皮煎汤漱口。或槐白皮醋煮，加盐含漱。或胡荽子煎汁含漱。或苋菜茎、或茄蒂烧灰，搽涂。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When kidney qi declines, teeth become loose and fall out; when essence is secured, teeth remain firm. It also states: Teeth are the external manifestation of the Kidney and the remainder of bone essence. Teeth represent the culmination of bones and are nourished by marrow. Those embedded in the alveolar process are called "chi" (teeth proper), while those standing outside are called "ya" (teeth visible). The Hand and Foot Yangming meridians pass through this area. The upper gums belong to Kun Earth (Spleen/Stomach system), connected by the Foot Yangming Stomach meridian; their nature is heavy and static, disliking heat and preferring cold. The lower gums are involved in chewing and belong to Metal (Large Intestine), connected by the Hand Yangming Large Intestine meridian; their nature is light and dynamic, disliking cold and preferring heat. Therefore, during pain, diet should be chosen according to whether it suits cold or heat conditions. There are also cases of canker erosion and carious defects with bleeding and pain; cases of Wind-Heat in the Spleen and Stomach causing swollen and painful gums. These are categorized into five types: Wind, Cold, Dampness, Heat, and Worms. Cases of periodontal gangrene with foul odor and rotting indicate extreme Fire-Heat, presenting with a floating, surging, rapid, and large pulse at the Right Cun and Guan positions, signifying excess Fire in the Two Yangmings (Stomach and Large Intestine).
Main Formula: Danggui Shen (Angelica Sinensis Root Body), Shengdi (Rehmannia Root), Mudanpi (Tree Peony Bark), Huanglian (Coptis Rhizome) (each 2 qian); Shengma (Cimicifuga Rhizome), Shigao (Gypsum Fibrosum) (double dose for upper teeth); Dahuang (Rhubarb Root and Rhizome, wine-processed); Huangqin Tiao (Scutellaria Root Strip) (each 1 qian, double dose for lower teeth); Xixin (Asarum Root) (3 fen). Decoct in water, take after meals. For severe upper toothache, use Liangge San (Cool the Upper Jiao Powder), adding wine-processed Dahuang, Shigao, Shengma, and Zhimu; one dose brings relief (see Fire Gate section for formula details).
Qingwei Tang (Clear Stomach Decoction): Treats all toothaches caused by Wind-Heat, Dampness, and Phlegm; follow with Qishen San.
Zhizi (Gardenia Fruit), Cangzhu (Atractylodes Rhizome), Huangqin Tiao (Scutellaria Root Strip), Danggui (Angelica Sinensis Root), Shengdi (Rehmannia Root), Shigao (Gypsum Fibrosum), Huanglian (Coptis Rhizome) (each 1 qian); Baishao (White Peony Root), Qingpi (Bitter Orange Peel) (each 8 fen); Jingjie (Schizonepeta Spike), Huoxiang (Patchouli Herb), Shengma (Cimicifuga Rhizome), Xixin (Asarum Root), Danpi (Moutan Cortex) (each 5 fen); Gancao (Licorice Root) (4 fen).
Decoct in water and take. Hold in the mouth to soak the painful area.
Qishen San (Seven Gods Powder): For severe pain, continue with powders of Jianghuang (Turmeric Rhizome), Baizhi (Angelica Dahurica Root), Chuanxiong (Ligusticum Rhizome), and Xixin (Asarum Root). Rinse mouth with pepper-salt water and apply to the affected area.
Longdancao (Gentiana Root), Huanglian (Coptis Rhizome), Fangfeng (Saposhnikovia Root) (each 1 qian); Shengma (Cimicifuga Rhizome) (7 fen); Caodoukou (Cardamom Fruit, from Jianning, 10 grains, crushed); Beixixin (Asarum Root, with leaves) (2 fen); Zhigancao (Prepared Licorice Root) (4 fen).
Use one zhong of water, decoct until half remains. Take a mouthful, hold over the affected area, and swallow after a short time.
Xuanfeng Laoya San (Wind-Dispersing Tooth-Firming Powder): Preserves youth, tonifies Kidney, nourishes blood, and strengthens teeth.
Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Rhizome) (each 1 liang); Qingyan (Green Salt) (7 qian); Xixin (Asarum Root) (4 qian).
Grind into powder. Use in the morning after rinsing mouth thoroughly. Brush teeth and swallow the medicine together. If not swallowing, add Shigao (Gypsum Fibrosum) 1 liang.
Simple Prescription: Lvdou (Mung Bean) (10 grains); Hujiao (Black Pepper) (7 grains).
Grind finely, wrap in cotton cloth to the size of a bean, and bite on the painful spot.
Another Prescription: Heidou (Black Soybean), Congbai (Scallion White), Aiye (Mugwort Leaf), Chuanjiao (Sichuan Pepper). Decoct in water and rinse. Or use Ganjiang (Dried Ginger) (1 qian) and Xionghuang (Realgar) (5 fen), grind and rub. Or roast a single garlic clove until hot and apply as a compress, replacing when cool. Or burn loofah after frost and rub. Or grind Xionghuang (Realgar) and form pills with honey to insert.
Zouma Yagan (Running-Horse Periodontal Gangrene): Niotonggou (Urine Bucket Slime, calcined) (1 qian), Tongqing (Chrysocolla) (3 fen), Shexiang (Musk) (1 fen). Grind uniformly and apply sparingly to the affected area.
To Extract Lower Teeth: Bifa (Peperomia Bluntfruit Stem), Caowu (Aconitum Carmichaelii Lateral Root) (each 5 qian); Chuanjiao (Sichuan Pepper), Xixin (Asarum Root) (each 3 qian). Grind into powder and apply inside and outside the affected tooth; it will fall out naturally.
Strengthen Teeth and Dispel Wind: Xiangfu (Cyperus Rhizome, stir-fried until charred) (3 liang), grind into powder, add Qingyan (Green Salt) (1 liang), and rub daily.
Loose Teeth with Bleeding: Bajibali (Tribulus Fructus), grind into powder and rub.
Wind-Worm Toothache: Bite fresh Changpu (Acorus Tatarinowii Rhizome) on the painful spot. Or roast Liangjiang (Galangal Rhizome) until hot and bite the affected area until pain stops. Or decoct Liggenpi (Li Tree Bark) and rinse. Or boil Huaimaipi (Sophora Root Bark) in vinegar, add salt, and hold in mouth. Or decoct Huxizi (Coriander Seed) juice and hold in mouth. Or burn Xianjing (Amaranth Stem) or Qadi (Eggplant Peduncle) and apply ash.