Chinese Medicine and Periodontal Gum Disease 11/1/2006
by Marco Lam, L.Ac.
According to the American Academy of Periodontology, “Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.”
The website of AaoP, www.perio.org, offers the basics:
“In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.”
Many patients are at the stage when they have heard from their hygienist that their teeth are forming small pockets and that they should pay closer attention to flossing, are given proper brushing habits and recommendations to have more regular teeth cleanings. These patients can take the benefits of Chinese Medicine to prevent further pocketing of their gums and the gradual healing of the gums can take place.
Patients who have gone further done the road to periodontitis, may have gone through teeth scalings or minor oral surgery and may be further motivated to pursue the deeper benefits that can come from pursuing a more indepth commitment to acupuncture and chinese herbs.
The holisitic viewpoint of traditional Chinese medicine looks at gum problems as originating from underlying imbalances of the organs, particularly those related to the digestive system. It seems to make a basic type of sense that the ecology of bacteria in your digestive system would effect the ecology of the bacteria in your mouth. Chinese medicine’s classical viewpoint is that periodontitis originates from Heat accumulation in Yang Ming stomach viscera. The Chinese medicine ecological metaphor of “Heat” is fairly similar to the Western concept of inflammation. Traditionally, this would be treated with dietary changes, herbal protocols and acupuncture to stabilize the organ physiology. Each patient is treated differently as their underlying constitution shifts how the accumulation of heat effects the overall system. There is one acupuncture point that is commonly used in most cases of Heat accumulation in the Stomach, Stomach 44, Inner Neiting. It is located between the junction of the 2nd and third toes on the web of both feet and is often quite tender on patients who have gum disorders. As a home therapy, pressing this point daily can help the body come back to balance. The amount of clinical research coming out of the East on integrative medicine is growing daily as more sophisticated Chinese medicine practitioners in the west pressure the amount of translation work being done on Chinese medicine. The Malaysian government which uses an enormous amount of integrated Eastern and Western medicine in its health care has an enormous database on clinical medicine which can be accessed at http://content.nhiondemand.com/moh/media/TCMHC1.asp?objID=100975&ctype=tcmhc
I have listed in the Appendix, clinical trials and references for health care practitioners who want to further research the formulas. This is also accessible on the website above and does not constitute my personal research.
In addition, Integrative medicine has been make large gains in the nutritional understanding of treating gum diseases especially has the Eastern understanding of relating digestive health to gum health is incorporated. Seth Braun, our Certified Health Counselor and Nutritionist at the Mandala Integrative Medicine Clinic, suggests the following nutritional protocol while treating periodontal disease, “Reduce inflammation by reducing plaque. Plaque, the sticky mix of bacteria, mucus and food matter, is more abundant in a highly acidic body. Bring the ph balance back into alignment by reducing refined carbohydrates, sugar, corn syrup, etc. Increase the variety of mineral rich, green leafy vegetables such as kale, collard and mustard greens, bok choy, and mineral rich foods such as wheat grass juice, barley grass juice, dulse, kombu and other culinary sea vegetables.” Braun also recommends, “In the acute phase of inflammation, painful swelling and bone loss, encourage the elimination of processed foods, refined carbohydrates and all concentrated sweeteners. Use a ‘green’ drink such “Pure Synergy,” “Pro-Greens,” or other top quality product to immediately re-mineralize the body and bring balance to the overly acidic environment. Include anti-oxidant supplementation with Vit. A ( as mixed carotenoids), Vit. C ( with bioflavonoids), Vit. E (as mixed tocopherols and tocotrienols),. Include Co-Q10 and MSM for rapid cell repair and healing.”
In combination with proper dental care, I have seen remarkable regeneration of the gums of patients with Chinese medicine. The regeneration of gums while taking herbs has often astounded their dental health care providers. Chinese medicine does take time and it is an overall commitment to a bigger view of what constitutes health that provides such amazing results. The combination of both Western and Eastern approaches to dental care provides a path to a higher level of health for not only the gums but for the whole body.
Marco Chung-Shu Lam draws from his heritage an affinity for both traditional Chinese medicine and an amazing ability to make this millennium old medicine make sense to the modern western mind. Marco has a gentle touch and works with many patients who mgiht be afraid of acupuncture, including children and elders. Marco practices the living system of herbalism and integrates the traditional Chinese herbology with the use of many local medicinal herbs that he harvests himself. He is the founder of the Mandala Clinic of Integrative Medicine, a beautiful green built clinic with over a dozen different practitioners of the highest caliber. Marco has written extensively on the subject of natural healing and is currently teaching at Naropa University. Marco invites you to the path of Chinese Medicine and to the fullness of health that you can experience.
Primary Treatments with Chinese Medicinal Herbs
Qing Wei San
Zhu Ping Zhuo, et al. treated 60 cases of acute periodontitis with Qing Wei San. The formula consisted of the following herbs: Huang Lian (Coptis), Sheng Ma (Cimicifuga), Sheng Di Huang (Rehmannia Root), Mu Dan Pi (Moutan), Huang Qi (Astragalus Root), and Sheng Shi Gao (Gypsum). In a control group, 55 cases were treated with metronidazole. The total effectiveness rate for the treatment group was 95%, while that of the control group was 90.9%.(1)
Yu Nu Jian
Hou Ying Ming, et al. treated 48 cases of periodontal disease with a modified Yu Nu Jian formula. The formula contained Sheng Di Huang (Rehmannia Root), Ku Shen (Sophora Root), Sheng Shi Gao (Gypsum), Zhi Mu (Anemarrhena), Mai Dong (Ophiopogon Root), and Chuan Niu Xi (Chuan Achyranthes). The ingredients were modified according to the patients’ symptoms. One dose of the formula in a decoction was administered daily. The results showed that 23 cases were resolved, 20 had significant improvement, and 5 cases had some improvement.(2)
Zhong Tong An
Xiong Tin, et al. treated 100 cases of periodontitis with Zhong Tong An capsules (a swelling and pain relieving capsule). The formula consisted of San Qi (Notoginseng), Tian Ma (Gastrodia), and Jiang Can (Silkworm). The total effectiveness rate was 95%, which was much higher than the control group that was treated with acetyl-spiramycin.(3)
Bu Shen Gu Chi Tang
Kai Yan, et al. used Bu Shen Gu Chi Tang to treat 54 cases of chronic periodontitis. The formula consisted of Shou Di Huang (Cooked Rehmannia Root), Huang Qi (Astragalus Root), Shan Yao (Dioscorea), Gu Sui Bu (Drynaria), Nu Zhen Zi (Ligustrum), Shan Yu Rou (Cornus), Dang Shen (Codonopsis), Jiao Bai Zhu (processed Atractylodes), and Gan Cao (Licorice). One dose of the formula in a decoction was administered daily. One month constituted one course of treatment. Each treatment course was separated by a 7-day interval. After 2 courses, 10 cases were resolved, 37 cases had improved, and 7 did not respond to the treatment. The total effectiveness rate was 87%.(4)
Fu Ke Qian Jin Pian
Zhang Jun Hui treated periodontitis with a Fu Ke Qian Jin Pian formula. Patients were randomly divided into two groups. 38 cases were treated by this formula (8 tablets were administered orally 3 times a day). The 23 cases in the control group were treated with Bai Yan Jing 0.96g, twice a day and Metronidazole 0.2g, 3 times a day. The results showed that in the treatment and control group: 21 and 6 cases had significant improvement, 16 and 15 cases had some improvement, and 1 and 2 cases had no improvement. The total effectiveness rates were 97.4% and 91.3% respectively. The treatment group had superior results than the control group (P<0.05).(5)
Liang’s Periodontitis Formula
Tai Quan Liang, et al. treated 182 cases of acute periodontitis with a self-made powder for relieving toothaches. The formula consisted of Sheng Shi Gao (Gypsum), Pao Tong Shu Gen (Radix Paulowniae), and Zhi Zi (Gardenia). It was administered with sugar water, 10g, 3 times a day. The results demonstrated that 162 cases were resolved, 17 cases had improvement, and 3 cases did not respond to the treatment.(6)
Rong’s Periodontitis Formula
Liu Mei Rong, et al. treated 60 cases of periodontitis of stomach heat with deficiency in kidney type with Chinese herbs. The formula consisted of Sheng Di Huang (Rehmannia Root), Gou Qi Zi (Lycium), Zhi Mu (Anamarrhena), Mai Dong (Ophiopogon Root), Niu Xi (Achyathes), Shan Yu Rou (Cornus), Sheng Shi Gao (Gypsum), and Mu Dan Pi (Moutan). One dose of the formula was administered 3 times daily. 15 days constituted one course of treatment. The results showed that 32 cases were resolved, 15 cases had significant improvement, 3 cases had some improvement, and 10 cases did not respond to the treatment. The total effectiveness rate was 83%.(7)
Liu Zhong, et al. applied acupuncture on the following points: Li Dui (ST 45) on the stomach channel, Er Jian (LI 2) on the large intestine channel, and Tai Xi (KI 3) on the kidney channel. The needles used were No.28 of 1 cun (=1/3 cm) length and three-edged. After routine sterilization of the acupoints and the needles, 1ml of blood-letting from the Li Dui and Er Jian points was performed after pricking with the three-edged needle. The reinforcing needling method was used on the Tai Xi point afterwards. The needles were retained for 30 minutes. They were manipulated once every minute. Acupuncture was performed once every other day. Seven sessions constituted one course of treatment. The results showed that 63 cases (64.29%) were resolved, 29 cases (29.59%) improved, and 6 cases had no effect.(12)
1 Zhu Ping Zhuo. Therapeutic observations on Qin Wei San treatment for acute periodontitis. Shanghai Journal of Traditional Chinese Medicine and Herbs. 2000;34(7):37-38.
2 Hou Ying Ming, et al. Treating 48 cases of periodontal disease with modified Yu Nu Jian. Journal of Anhui College of TCM. 1999;18(6):37.
3 Xiong Ting. Therapeutic observations on treating 100 cases of periodontitis with Zhong Tong An Capsules (swelling and pain relieving capsules). Journal of Guiyang College of TCM. 2000;22(2):30-31.
4 Kai Yan. Treating 54 cases of chronic periodontitis with Bu Shen Gu Chi Tang. Sichuan Journal of TCM. 1999;17(12):48.
5 Zhang Jun Hui. Treating 38 cases of periodontitis with Fu Ke Qian Jin Pian. Hunan Journal of TCM. 1999;15(6):54.
6 Tai Quan Liang. Treating 182 cases of acute periodontitis with self-made powder for relieving toothache. AnHui Journal of Clinical Application of TCM. 1999;11(2):140.
7 Liu Mei Rong, et al. Using Chinese herbs to treat 60 cases of periodontitis of stomach heat with deficiency in kidney type. Journal of Traditional Chinese Medicine Information. 1999;16(6):35.
8 Liu Cheng Hua, et al. Treating 56 cases of periodontitis with Kou Kang Ye Solution. Journal of Shizhen Medicine. 1999;10(10):785-786.
9 Dou Jian. Clinical observations on treating acute periodontitis and pericoronitis with Niu Huang Xiao Yan Wan (anti-inflammation calculus bovis pill). Heilongiang Journal of Chinese Medicine. 1999;(6):14.
10 Zhu Wei Min. Treating 78 cases of acute periodontitis with integration of Western and traditional Chinese medicine. Hubei Journal of TCM. 1999;21(11):509.
11 Zhou Hong. Clinical observation on treating 150 cases of periodontitis with integration of Western and traditional Chinese medicine. Zhejiang Journal of Integrated Traditional Chinese and Western Medicine. 1999;9(3):205-206.
12 Liu Zhong, et al. Treating chronic periodontitis with combination of acupuncture and pricking method with blood-letting. Journal of Clinical Acupuncture and Moxibustion. 1996;12(9):45-46.