bubble_chart Concept

Gingival recession refers to the gradual atrophy of the gum tissue.

This condition is sporadically mentioned in ancient medical texts under discussions of conditions such as exposed gums, loose teeth, gingival hemorrhage, and tooth protrusion. Clinically, gingival recession rarely occurs in isolation; it is often accompanied by conditions such as root exposure, tooth mobility, gum ulceration, and gingival bleeding.

bubble_chart Pattern Analysis

1. Stomach Heat︰The gum tissue atrophies and decays, exposing the tooth roots, accompanied by fetid mouth odor, thirst, a preference for cool drinks, severe constipation, a slippery and rapid pulse, a red tongue texture, and a thick yellow coating. It often begins with red, swollen, and painful gums, bleeding, or pus discharge. Prolonged scorching and burning in the mouth lead to gum atrophy, presenting symptoms of excess-fire pattern, such as fetid mouth odor, thirst with a preference for cool drinks, constipation, a slippery and rapid forceful pulse, and a thick yellow tongue coating. The treatment should focus on clearing stomach fire, and the recommended formula is Stomach-Clearing Powder.
2. Kidney Yin Deficiency︰The gums are receding and ulcerated, with slightly red and swollen edges, exposed tooth roots, accompanied by loose teeth, dizziness, tinnitus, soreness in the waist, feverish feeling in the palms and soles, a thin and rapid pulse, and a red tongue with scant coating. Loose teeth often appear first, followed by gum recession and ulceration. The key points for pattern identification are: yin deficiency with effulgent fire manifestations, such as dizziness, tinnitus, slightly red and swollen gum edges, feverish feeling in the palms and soles, a thin and rapid pulse, a red tongue texture, and scant coating. The treatment should focus on nourishing yin and reducing fire, and the prescription of choice is Anemarrhena, Phellodendron, and Rehmannia Pill.
3. Deficiency of Both Qi and Blood︰The gums are receding and pale in color, the teeth are loose, accompanied by gum bleeding, dizziness and blurred vision, insomnia dreamfulness, deep and thin pulse, tongue texture pale with thin white coating. It is commonly seen in individuals with deficiency conditions. Due to insufficiency of qi and blood, the gums lose nourishment, combined with deficiency-type pathogens invading the teeth. The key points of differentiation are: gum recession accompanied by pale gum color, which is distinctly different from the red and swollen gums in the previous two syndromes. Additionally, there are a series of deficiency symptoms such as dizziness and blurred vision, insomnia dreamfulness, thin pulse, and pale tongue. The treatment should focus on tonifying qi and nourishing blood, and the recommended formula is Eight Precious Ingredients Decoction.

Stomach fire flaring up and kidney yin deficiency: Both are caused by pathogenic fire scorching the gums to varying degrees. The upper and lower gums belong to the Yangming stomach and large intestine. Overconsumption of rich, fatty, and sweet foods can lead to heat accumulation in the stomach and intestines, or indulgence in alcohol and spicy foods can cause heat to scorch the stomach, allowing pathogenic heat to ascend along the meridians and damage the gums. In cases of cervical malignancy with cachexia, the gum tissue atrophies, exposing the roots. Additionally, teeth are considered the surplus of bones, and the kidneys govern the bones. Excessive sexual activity or emaciation can deplete kidney essence, preventing the essence and blood from nourishing the teeth. Combined with deficiency fire flaming upward, this results in gum recession and exposed tooth roots. Stomach fire flaring up is an excess pattern, while kidney yin deficiency is a deficiency pattern.

Furthermore, gum recession is also related to oral hygiene. Poor oral hygiene, along with the consumption of spicy and rich foods, can erode the gum tissue, and food debris left between the teeth can corrode the gums, leading to ulceration and gradual recession over time. Therefore, maintaining good oral hygiene and reducing the intake of irritating foods are important measures to prevent this condition. For those already suffering from gum recession, avoiding excessive sexual activity and preventing the depletion of kidney qi are also crucial.

bubble_chart Documentation

1. Shengji Zonglu．Oral and Dental Section: "Although the teeth are the end of the bones and nourished by the marrow, they can become firm and strong if properly cared for. However, if the qi and blood are insufficient and there is no proper method of care, wind evil can invade and lodge between the teeth, causing the muscles to become cold and the blood weak, leading to the shrinking and falling away of the gums, gradually exposing the teeth, and they will never reattach to the roots."
2. Yizong Jinjian．Waike Xinfa Key Points: "Swelling of the gums, with the gum flesh gradually decaying and shrinking over time, leading to gingival atrophy and exposure of the teeth. This is generally caused by prolonged accumulation of guest heat in the stomach meridian, combined with external wind evil and cold, resulting in a struggle between cold and heat. Those who prefer cold drinks and have an aversion to heat are affected by guest heat encountering cold, which stagnates between the gum flesh; those who prefer hot drinks and dislike cold are affected by guest heat encountering wind evil, which lingers within the gum flesh. For those with guest heat encountering cold, symptoms include gum bleeding, aversion to heat, and fetid mouth odor, and they should take Stomach-Clearing Decoction; for those with guest heat encountering wind, symptoms include aversion to cold in the gums and severe pain when exposed to wind, and they should take Pubescent Angelica Powder."