.
Yi Jing Theory
Fakun Wen
In today’s busy modern life, irregular eating habits and disrupted routines often lead to neglect of oral hygiene. Many people skip brushing or rinsing after meals, neglecting their dental care. Over time, this neglect can result in symptoms such as bleeding gums and toothaches, signaling the onset of periodontal disease. The symptoms of periodontal disease can manifest in various ways. In the early stages, there are ten common symptoms, including bleeding gums while brushing, pus formation, swollen and discolored gums, bad breath, painful and receding gums, tooth sensitivity, widening gaps between teeth, tooth displacement or elongation, weak chewing sensation, and tooth loss. Periodontal disease is the main cause of tooth loss, and its prevalence increases with age, with older adults being at higher risk. While professional cleaning can effectively treat gingivitis before it progresses to periodontitis, advanced cases require intervention by dental professionals for possible recovery.
Western medicine has developed numerous preventive and treatment methods for periodontal disease. For prevention, various products such as toothpaste, mouthwash, dental floss, and interdental brushes have emerged. As for the treatment of periodontal disease, options include procedures like root planing, flap surgery and bone grafts, periodontal regeneration surgery, and dental implants, among others. However, prolonged use of mouthwash, toothpaste, and similar products may potentially lead to adverse effects on the body due to the chemical ingredients they contain. For example, “Toothpastes have three main components, including (I) detergents, such as sodium lauryl sulfate and cocamidopropyl betaine, (II) insoluble abrasives for plaque removal, such as silica, aluminum hydroxide, and calcium carbonate, and (III) cariostatic agents, such as fluoride compounds (NaF and sodium monofluorophosphate). Sodium lauryl sulfate and cocamidopropyl betaine are among the most toxic components in the composition of toothpastes. Other substances added to toothpastes for different functions include desensitizers, anti-plaque agents, anti-inflammatory agents, anti-odor agents, preservatives, artificial colors, and essences; each of these agents can have toxic effects. In addition to toothpastes, zinc lactate, paraben, and sodium benzoate are also added as antimicrobial agents and food preservatives. Some studies have evaluated the carcinogenicity of these materials, especially paraben.” (Tabatabaei et al, 2019)
Nowadays, people are increasingly concerned about their quality of life and health. They are becoming more mindful of the potential side effects of non-natural foods and chemically synthesized medications. Consequently, there is a growing preference for organic, natural foods and medicines. As a result, with the gradual advancement of both Eastern and Western medicine, traditional Chinese herbal medicine is gaining recognition and thriving. The antibacterial and anti-inflammatory properties of traditional Chinese medicine, along with its tendency to have fewer side effects on the human body, have been substantiated and highlighted in numerous modern medical research studies. As a result, Chinese herbal medicine is gradually gaining prominence in natural medicine, with TCM practices receiving increasing emphasis.
Currently, numerous research reports highlight the antibacterial properties and minimal side effects of natural herbs and traditional Chinese herbs on the human body. One study pointed out that Wu Mei (Fructus armeniaca mume) effectively combatted four types of bacteria, including Streptococcus mitis, Streptococcus sanguis, Streptococcus mutans, and Porphyromonas gingivalis. Thirteen traditional Chinese medicine herbs exhibited antimicrobial activity against Porphyromonas gingivalis, including Hou Po (Cortex magnoliae officinalis), Huang Bai (Cortex phellodendri), Ding Xiang (Flos caryophylli), Jin Yin Hua (Flos lonicerae japonicae), Wu Mei (Fructus armeniaca mume), Lian Qiao (Fructus forsythiae suspensae), Zi Hua Di Ding (Herba cum radice violae yedoensitis), Bo He (Herba menthae haplocalycis), Shi Liu Pi (Pericarpium granati), Da Huang (Radix et rhizoma rhei), Qin Jiao (Radix gentianae), Gui Zhi (Ramulus cinnamomi cassia), and Sheng Ma (Rhizoma cimicifugae). Many toothpaste products available on the market have already incorporated Chinese herbs such as Jin Yin Hua, Ye Ju Hua, Tian Qi, Liang Mian Zhen, Yunnan Baiyao, among others. (Wong et al, 2010)
In TCM, health is viewed as a harmonious balance of Yin and Yang energies, as well as the smooth flow of Qi throughout the body. This holistic perspective extends to oral health, where the mouth is seen as a reflection of the body’s internal state. According to TCM principles, imbalances in the body’s energy can manifest as oral health issues such as bleeding gums, toothaches, and bad breath. Herbal medicine plays a central role in TCM treatment strategies, offering natural remedies that address underlying imbalances and promote overall health.
There is growing recognition of the effectiveness of herbal toothpaste in promoting oral health, and I am inclined to agree with TCM principles regarding its benefits. The antibacterial and anti-inflammatory properties of Chinese herbs offer a promising alternative to conventional toothpaste, with fewer potential side effects on the body. By addressing the root causes of oral health issues and supporting the body’s natural healing processes, herbal toothpaste aligns with the holistic approach of TCM.
While I acknowledge the potential limitations of herbal toothpaste, such as variations in efficacy and individual responses, I believe that integrating TCM principles into oral hygiene practices can offer valuable benefits for overall well-being. Moreover, the cultural and historical significance of Chinese herbal medicine adds depth and richness to our understanding of oral health care.
Several Chinese herbs commonly used in toothpaste formulations have been shown to have beneficial effects on oral health. For example, Gu Chi Shen Fang is an ancient formula originating from Chen Xiuyuan, a renowned doctor in the Qing Dynasty. According to 72 Kinds of Chen Xiuyuan’s Medical Books, this ancient formula is specifically designed for dental health care. Historically, people would use the powdered form of the formula to maintain oral hygiene and dental health. The ingredients in Gu Chi Shen Fang are ground into a Chinese herbal tooth powder, which is then applied to the teeth and gums for effective oral care.
The ingredients of Gu Chi Shen Fang include:
Qing Yan 15g (can be replaced with table salt)，Sheng Shi Gao 15g，Bu Gu Zhi 12g，Hua Jiao 5g，Bai Zhi 5g，Fang Feng 8g，Bo He Ye 8g，Han Lian Cao 8g，Xi Xin 5g.
To use Gu Chi Shen Fang, a small amount of the powdered formula is poured onto the palm of the hand, using a quantity similar to that of regular toothpaste. The teeth are then brushed with the powder, or the teeth and gums can be rubbed with a finger dipped in the powder, mimicking the action of brushing. It is recommended to refrain from rinsing the mouth immediately after use, allowing the powder to work in the mouth for a period of time before rinsing. The duration of time the powder is left in the mouth may vary depending on the severity of periodontal disease, ranging from 1 to 10 minutes. For individuals with severe periodontal disease, it is advised to apply the powder directly to the affected area with wet hands and massage the gums for approximately 1 minute before rinsing. Alternatively, the formula can be diluted into a mouthwash and gargled more frequently. This is particularly beneficial as periodontal bacteria thrive in anaerobic conditions and may be deterred by a fluid environment. Regular rinsing helps create an environment less conducive to bacterial growth, thus supporting periodontal health.
The incorporation of ancient formulas such as Gu Chi Shen Fang into oral hygiene practices underscores the rich heritage and effectiveness of traditional Chinese herbal medicine in promoting dental health and overall well-being.
In conclusion, the integration of traditional Chinese medicine principles into oral hygiene practices offers a promising approach to promoting oral health and overall well-being. Herbal toothpaste, with its natural ingredients and holistic benefits, represents a valuable alternative to conventional dental care products. While further research is needed to fully understand the efficacy and safety of herbal toothpaste, the growing recognition of Chinese herbal medicine in modern healthcare underscores its potential to complement Western approaches and enrich our understanding of oral healthcare practices.
By embracing the wisdom of traditional Chinese medicine and harnessing the therapeutic power of Chinese herbs, we can cultivate a holistic approach to oral health that supports the body’s innate healing abilities and contributes to a healthier, happier life.
Author information:
NianZhu Li (Emily) graduated from Nanjing University of Traditional Chinese Medicine with a bachelor degree in 2021. Currently, Emily is pursuing her Master of Acupuncture and Oriental Medicine at MCPHS.
Bing Yang, licensed acupuncturist in Massachusetts. She got bachelor and Master degrees of Acupuncture and Chinese Medicine from Beijing University of Chinese Medicine in 1990s and Doctor degree from Massachusetts College of Pharmacy and Health Sciences (MCPHS). Currently she is the associate professor and Director of Chinese Herbal Programs of New England School of Acupuncture, MCPHS. She also maintains a private practice in Boston.
References:
1．Tabatabaei, M. H., Mahounak, F. S., Asgari, N., & Moradi, Z. (2019). Cytotoxicity of the Ingredients of Commonly Used Toothpastes and Mouthwashes on Human Gingival Fibroblasts. Frontiers in dentistry, 16(6), 450–457. https://doi.org/10.18502/fid.v16i6.3444
2．Wong, R. W., Hägg, U., Samaranayake, L., Yuen, M. K., Seneviratne, C. J., & Kao, R. (2010). Antimicrobial activity of Chinese medicine herbs against common bacteria in oral biofilm. A pilot study. International journal of oral and maxillofacial surgery, 39(6), 599–605. https://doi.org/10.1016/j.ijom.2010.02.024
3．Gao, Q., Zhu, M., Wang, J., Wang, S., Zhou, J., & Zhang, J. (2023). Literature review and prospect on oral cognition and disease diagnosis and treatment between Han and Tang dynasties. Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology, 41(5), 604–612. https://doi.org/10.7518/hxkq.2023.2023183
4．賴崇煌（2014）。骨碎補之中藥牙粉治療牙周疾病的臨床療效。﹝碩士論文。中國醫藥大學﹞。 https://hdl.handle.net/11296/5997c2
中醫和口腔衛生
李念築 楊冰
在今天繁忙的現代生活中，不規則的飲食習慣和打亂的生活作息經常導致口腔衛生的忽視。許多人在飯後不刷牙或漱口，忽視了他們的牙齒護理。隨著時間的推移，這種忽視可能導致出血牙齦和牙痛等症狀，預示著牙周疾病的發作。牙周疾病的症狀可以以多種方式表現。在早期階段，有十種常見症狀，包括刷牙時牙齦出血、膿液形成、牙齦腫脹和變色、口臭、牙齦疼痛、牙齒敏感、牙齒之間的間隙擴大、牙齒位移或延長、咀嚼感覺減弱和牙齒喪失。牙周疾病是牙齒脫落的主要原因，其盛行率隨著年齡增長而增加，老年人處於較高的風險之中。雖然專業清潔可以有效治療牙齦炎，防止其發展為牙周炎，但晚期病例仍需要牙醫專業幹預，以恢復健康。
西方醫學已經發展出許多預防和治療牙周疾病的方法。在預防方面，出現了各種產品，如牙膏、漱口水、牙線和間隙刷。至於牙周疾病的治療，選項包括根麵整理、翻瓣手術和骨移植、牙周再生手術和植牙等程序。然而，長時間使用漱口水、牙膏和類似產品可能會因其含有的化學成分而潛在地對身體產生不良影響。例如，牙膏有三種主要成分，包括（I）洗滌劑，如十二烷基硫酸鈉和椰油酰胺丙基甜菜鹼，（II）用於去除牙菌斑的不溶性磨料，如二氧化矽、氫氧化鋁和碳酸鈣，以及（III）抗齲劑，如氟化物化合物（NaF和單氟磷酸鈉）之一外，鋅乳酸鹽、對羥基苯甲酸酯和苯甲酸鈉也被添加為抗菌劑和食品防腐劑。 （Tabatabaei al，2019）
如今，人們越來越關注他們的生活品質和健康。他們越來越注意非天然食品和化學合成藥物的潛在副作用。因此，人們越來越傾向於選擇有機的、天然的食品和藥物。隨著東西方醫學的逐漸進步，傳統中藥正獲得認可並蓬勃發展。傳統中醫具有抗菌和抗發炎的特性，以及對人體副作用較少的特點，在許多現代醫學研究中得到了證實和加強。因此，中醫正逐漸在自然醫學中佔有重要地位，中醫實踐也受到越來越多的重視。
目前，许多研究报告突出了天然草药和传统中药对人体的抗菌特性和比较小的副作用。
一项研究指出，乌梅（Fructus armeniaca mume）有效地对抗了四种细菌，包括米氏链球菌、血清链球菌、龋齿链球菌和黑色素单胞菌。13种传统中药草药对黑色素单胞菌表现出抗菌活性，包括厚朴（Cortex magnoliae officinalis）、黄柏（Cortex phellodendri）、丁香（Flos caryophylli）、金银花（Flos lonicerae japonicae）、乌梅（Fructus armeniaca mume）、连翘（Fructus forsythiae suspensae）、紫花地丁（Herba cum radice violae yedoensitis）、薄荷（Herba menthae haplocalycis）、石榴皮（Pericarpium granati）、大黄（Radix et rhizoma rhei）、秦艽（Radix gentianae）、桂枝（Ramulus cinnamomi cassia）和升麻（Rhizoma cimicifugae）。市场上许多牙膏产品已经加入了金银花、夜菊花、田七、两面针、云南白药等中草药。（Wong et al，2010）
在中醫中，健康被視為依靠陰陽能量的和諧平衡，以及體內氣的順暢流動。這種整體觀念延伸到口腔健康領域，口腔被視為身體內部狀態的反映。根據中醫原理，身體能量的不平衡可能表現為口腔健康問題，如牙齦出血、牙痛和口臭。中草藥在中醫治療策略中發揮核心作用，提供自然療法來解決潛在的不平衡，並促進整體健康。
中草藥牙膏在促進口腔健康方面的有效性越來越受到認可，中草藥具有抗菌和抗炎的特性，為傳統牙膏提供了一種有前景的替代方案，對身體的潛在副作用更少。透過解決口腔健康問題的根本原因，並支持身體的自然癒合過程，中草藥牙膏符合中醫的整體治療方法。
雖然中草藥牙膏有其局限性，例如療效的差異和個體反應，但將中醫原理融入口腔衛生實踐中可以為整體健康帶來寶貴的益處。此外，中國中草藥醫學的文化和歷史意義為理解口腔保健增添了深度和豐富性。
一些常用於牙膏配方中的中草藥已被證明對口腔健康有益。例如，固齒神方是一種古老的配方，起源於清朝著名醫師陳修園。根據《陳修園醫書七十二種》記載，這個古老的配方是專門用於口腔健康護理的。歷史上，人們會使用這個配方的粉末形式來保持口腔衛生和牙齒健康。固齒神方中的成分被研磨成中草藥牙粉，然後塗抹在牙齒和牙齦上，以進行有效的口腔護理。
固齒神方的成分包括：
青鹽15克（可用食鹽替代）、生石膏15克、補骨脂12克、花椒5克、白芷5克、防風8克、薄荷葉8克、旱蓮草8克、細辛5克。
使用固齒神方時，將少量粉末配方倒在手掌上，使用與常規牙膏相似的量。然後用粉末刷牙，或者可以用浸有粉末的手指擦拭牙齒和牙齦，模彷刷牙的動作。建議使用後不要立即漱口，讓粉末在口腔中起作用一段時間後再漱口。留在口腔的時間長度可能會根據牙周疾病的嚴重程度而有所不同，範圍從1到10分鐘不等。對於患有嚴重牙周疾病的個體，建議用濕手將粉末直接塗抹在受影響的區域，並在漱口前按摩牙齦約1分鐘。或者，該配方可以稀釋成漱口水，更頻繁地漱口。這對於牙周疾病細菌在厭氧條件下生長繁殖，而在液體環境中可能會受到阻礙的情況尤其有益。定期漱口有助於創造一個不利於細菌生長的環境，從而支持牙周健康。
將古代配方如固齒神方納入口腔衛生實踐中，突顯了傳統中草藥醫學在促進口腔健康和整體健康方面的豐富傳統和有效性。
總之，將傳統中醫原理融入口腔衛生實踐提供了一種有前景的促進口腔健康和整體健康的方法。中草藥牙膏以其天然成分和整體益處，代表了傳統牙科護理產品的有價值的替代品。雖然還需要進一步研究來充分了解中草藥牙膏的功效和安全性，但對於中國中草藥在現代醫療中的日益認可突顯了其與西方方法相輔相成的潛力，並豐富了我們對口腔保健實踐的理解。
透過擁抱傳統中醫的智慧，利用中草藥的治療力量，我們可以培養一種促進口腔健康的整體方法，支持身體內在的自癒能力，為更健康、更幸福的生活做出貢獻。
參考文獻
1．Tabatabaei, M. H., Mahounak, F. S., Asgari, N., & Moradi, Z. (2019). Cytotoxicity of the Ingredients of Commonly Used Toothpastes and Mouthwashes on Human Gingival Fibroblasts. Frontiers in dentistry, 16(6), 450–457. https://doi.org/10.18502/fid.v16i6.3444
2．Wong, R. W., Hgg, U., Samaranayake, L., Yuen, M. K., Seneviratne, C. J., & Kao, R. (2010). Antimicrobial activity of Chinese medicine herbs against common bacteria in oral biofilm. A pilot study. International journal of oral and maxillofacial surgery, 39(6), 599–605. https://doi.org/10.1016/j.ijom.2010.02.024
3．Gao, Q., Zhu, M., Wang, J., Wang, S., Zhou, J., & Zhang, J. (2023). Literature review and prospect on oral cognition and disease diagnosis and treatment between Han and Tang dynasties. Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology, 41(5), 604–612. https://doi.org/10.7518/hxkq.2023.2023183
4．賴崇煌（2014）。骨碎補之中藥牙粉治療牙周疾病的臨床療效。﹝碩士論文。中國醫藥大學﹞。 https://hdl.handle.net/11296/5997c2
作者簡介：
李念築， 2021 年畢業於南京中醫藥大學。目前正在攻讀麻州健康大學的針灸與東方醫學碩士學位。
楊冰，九十年代畢業於北京中醫藥大學， 獲中醫學學士，碩士學位，後於美國麻省藥科與健康科學大學獲博士學位。現爲麻省藥科與健康科學大學新英格蘭中醫學院教授，中醫係主任，並在波士頓行醫。
