Articles

Periodontal Disease

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Periodontal Disease

Introduction

Periodontitis is the most common chronic inflammation of the periodontal tissue. It usually develops secondary to unsuitable treatment of marginal gingivitis. In the early stages, there are no apparent subjective symptoms. In the advanced stages, symptoms include severe damage to the periodontal tissue, loosened teeth, or symptoms that attract attention only when they become acute. The disease is manifested in gingival bleeding, swelling, and changes in color and morphology. Dental calculus forms over and beneath the gingival. Pressure forms on the periodontal pocket and produces a discharge. The degree of tooth decay varies. The disease occurs most commonly among older people. In traditional Chinese medicine, it belongs to the category of gingival atrophy, gingival abscess, bleeding from the gum, and mobile teeth.

Etiology/Pathogenesis

Periodontitis originates from heat accumulation in Yang Ming stomach viscera in addition to poor dental care, tooth erosion with caries, or invasion of wind heat pathogen through damaged tooth, which induces upward flow of stomach fire. Wind heat is steamed with the stomach heat in the gums, transforming the tissue into pus. Otherwise, it is caused by deficiency in the visceral organs or in gum malnutrition.

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)

Other Treatments with Chinese Medicinal Herbs

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

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. (5)

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%. (6)

Other Treatments

External use of Chinese Herbs
Liu Cheng Hua, et al. treated periodontitis with a Kou Kang Ye solution. 56 cases in the treated group and 40 cases in the control group were randomly selected. Both groups were cleansed with normal saline and dried. This solution formula consisted of Huang Qin (Scutellaria), Ku Shen (Sophora Root), Wu Bei Zi (Galla Chinensis), Ming Fan (Alumen), etc. The formula was dripped into periodontal pockets by dental forceps. In the control group, 20% iodi-glycerin was used instead. Treatment was given twice a week. The results for both groups were: significant effectiveness was seen in 38 and 10 cases; some effectiveness in 17 and 27 cases; and no effectiveness in 1 and 3 cases respectively. The total effectiveness rates for the two groups were 98.2% and 92.5%. The treatment group achieved a higher effectiveness rate than the control group. (P

References

  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. 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.
  6. 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.