bubble_chart Concept

The uneven and jagged edges of the tongue, resembling a sawtooth shape, are referred to as "舌邊齒痕" (teeth-marked tongue). It is also known as "teeth-marked tongue" or "舌邊鋸痕".

Normal individuals with a larger tongue often exhibit teeth marks on the edges; however, teeth marks caused by uneven or defective teeth are not discussed in this section.

bubble_chart Pattern Analysis

1. Qi Deficiency︰The tongue texture is pale, the tongue coating is thin and white, the tongue body is swollen and tender with tooth marks on the edges, the complexion is pale or slightly yellow. Symptoms include shortness of breath and reluctance to speak, fatigue and lack of strength, spontaneous sweating, reduced appetite, abdominal distension and fullness after eating, loose stools, and a weak, thin pulse. This is often due to prolonged deficiency of pestilent qi, excessive contemplation, or overexertion damaging the heart and spleen, manifesting a series of clinical signs of qi deficiency: shortness of breath, spontaneous sweating, dull complexion, worsening with slight exertion or activity. If spleen qi is deficient and weak, symptoms include reduced appetite, abdominal distension and fullness, loose stools, lack of strength in the limbs, shortness of breath and reluctance to speak, and a weak, thin pulse. Treatment should focus on greatly tonifying the middle qi, using Middle-Tonifying Qi-Replenishing Decoction.
2. Yang Deficiency︰The tongue texture is pale, with a moist and glossy surface or a slippery surface, and the tongue body is round, large, plump, and tender. The complexion is pale or bluish-black. There is mental fatigue and lack of strength, weariness, and a preference for lying down. The mouth has a bland taste and lacks thirst. There is anorexia and reduced food intake, cold pain in the abdomen that is relieved by warmth, fear of cold, cold limbs, clear urine, loose stools, or possible edema. The pulse is deep and faint. This condition is often caused by congenital deficiency, prolonged illness, overwork, or aging and physical decline, leading to a depletion of yang qi. It presents a series of clinical manifestations of yang deficiency with external cold (insufficiency of the fire of the life gate): a bluish-black or pale complexion, general aversion to cold, soreness in the waist and cold knees, cold pain in the abdomen, abdominal distension and fullness that prefers warmth, mental fatigue and lack of strength, weariness and a preference for lying down, loose stools or diarrhea, and a deep, slow, or faint pulse. Although qi deficiency and yang deficiency are distinct, they are also interconnected. Zhang Jing-yue said, "Qi is inherently yang in nature," and "Insufficiency of qi is equivalent to cold." Qi deficiency can further develop into yang deficiency. Treatment should focus on warming and tonifying yang with pungent herbs. The recommended formula is Cold-Extremities Decoction combined with Ginseng Decoction.

The symptom of tooth marks on the sides of the tongue often indicates a swollen and enlarged tongue, with a delicate tongue texture. Regardless of the color of the tongue coating, the condition is generally classified as a deficiency pattern. According to "Research on Pathology in Chinese Medicine: A Discussion on the Mechanisms of Tongue Manifestation Formation," "Tooth marks are clinical manifestations of yang deficiency and qi deficiency, commonly seen in swollen, tender tongues and pale tongues."

bubble_chart Documentation

1. 《Inspection of the Tongue According to the Classics》, "If the edges of the tongue are defective, like a sawtooth, it indicates deficiency of visceral qi and exhaustion, an incurable disease."
2. 《Guide to Tongue Differentiation: The Method of Observing the Tongue》: "In cases of dampness-heat with phlegm, the texture of the tongue swells to fill the mouth, with tooth marks on the edges."
3. 《Essentials of Clinical Practice in Chinese Medicine: Sawtooth Marks on the Tongue Edge》: "Irregular edges of the tongue, resembling a sawtooth pattern, indicate stagnation of liver qi and blood."