If you suffer from temporomandibular joint disorder or have a fear of needles, TENS therapy could be the answer to your pain relief needs. People with certain medical conditions, such as cancer, epilepsy, heart disease, or those with implanted devices like pacemakers, should consult their doctor or dentist before using a TENS unit. Your dentist can help you decide if TENS therapy is the right choice for your condition or procedure. They can also answer any questions you may have and guide you to a pain-free smile.
Once your dentist has placed the adhesive pads on your face and activated the machine, you'll feel a tingling sensation. If it's too strong or uncomfortable, let your dentist know so they can adjust the level of stimulation. Once it's at a comfortable level, you can relax while the machine blocks pain signals. You may also find that your facial muscles become more relaxed.
The J5 dental TENS (low frequency, not high frequency) helps break the spastic muscle engrams (memory) that pull, clench and twist the jaw. Experienced dentists understand that TENS does not automatically put the patient in the correct position, especially when there are issues with the joint, disc, condyle and strong muscle traction. This is why GNM dentists are trained to use TENS and special methods to overcome these anatomical obstacles. TENS does not always produce a proper bite (classic NM thinking), so GNM dentists use what is called the TENS bite optimization technique.
Relaxing tense and spastic muscles is becoming increasingly popular in comprehensive diagnostic and treatment planning due to value-seeking patients in North America (United States, Canada, Europe, Asia, Mexico and Australia). Patients with TMD pain are looking for experienced and trained dentists who can provide definitive high-end care and treatments. To meet these needs, GNM dentists use low-frequency TENS (J5 Dental TENS, Myotronics Inc.) and muscle tension (muscle strain) in 6 dimensions as a diagnostic tool in initial diagnosis and treatment planning. Botox is known for its ability to reduce wrinkles and improve facial appearance, but it can also be used to treat TMJ disorders.
Botox paralyzes certain areas of the face to prevent them from moving and creating lines around the mouth, eyes and eyebrows. This paralysis also prevents the jaw from moving unconsciously which can cause additional strain on the jaw joints. Nathan and Wall (30) used TENS in 1974 to relieve severe postherpetic neuralgia pain in 30 patients who had not responded to other treatments. In a double-blind study of 20 patients who needed class 1 amalgam restorations on their first permanent mandibular molars, 10 patients were treated with TENS and 10 without it. The application of TENS increases salivary flow in both healthy individuals and xerostomic patients.
The pain gate control theory proposed by Melzack and Wall (in 1965) is the most popular theory to explain how TENS works. An article published in the Journal of Clinical and Experimental Dentistry reports that people in ancient Egypt, Greece and Rome used electric shocks from electric lightning fish to relieve pain. William Stenberg (2 years old) reported on using TENS to control pain during cavity preparation in a 24-year-old patient susceptible to malignant hyperthermia with favorable results. The use of TENS requires patient cooperation so it should not be attempted on patients with communication problems or mental disabilities. Quanstrom and Milgrom (2) in 1989 combined TENS with nitrous oxide and oxygen in 309 patients compared to 62 patients who only received TENS to verify its effectiveness in controlling pain during restorative procedures without local anesthesia. Patients with pacemakers should not use TENS as they may not be aware of what type of pacemaker they have.
A decrease in pain intensity greater than 50% was found in 38% of patients who received any form of TENS while only 10% of those who received placebo experienced a similar reduction in pain. The use of TENS has positive effects on pediatric patient behavior which reduces anxiety levels by eliminating their fear of needles. The TENS device or transcutaneous electrical nerve stimulation machine is a treatment that uses low-voltage electrical currents to relieve pain usually in the back. Patients who received TENS reported a significant decrease in pain with EVA at 24, 36 and 48 hours while the control group experienced pain even after 60 hours. In pediatric patients, TENS has been used effectively to control pain during various procedures such as placing pit and fissure sealants, preparing cavities, minor extractions and endodontic procedures. Katch reported using TENS to control TMJ pain in a 10-year-old girl and managed to reduce it by 50-75%.
