Federal law in the United States restricts the sale of TENS devices to licensed or prescribed health professionals. For more information, call (800) 426-0316. Research has found that fear is the most significant factor preventing effective use of TENS, and factors such as the depth of cavity preparation or the group of teeth are not significant. Patients who received TENS reported a significant decrease in pain with EVA at 24, 36, and 48 hours, while the control group experienced pain after adjustment even after 60 hours. In pediatric patients, TENS has been used successfully to control pain during various procedures, such as placement of pit and fissure sealants, cavity preparation, minor extractions, and endodontic procedures. According to Hochman (2), TENS is less successful in patients who are “skeptical” and “very sensitive to pain”.
A decrease in pain intensity greater than 50% was found in 38% of patients who received any form of TENS, while only 10% of patients who received TENS with placebo experienced a pain reduction of more than 50%. In 1974, Nathan and Wall (30) used TENS to alleviate the pain of severe postherpetic neuralgia in 30 patients in whom all other forms of treatment had failed. The use of TENS has positive effects on the behavior of pediatric patients, reducing anxiety levels by eliminating the “fear of the needle”. In conventional TENS, impulses are usually delivered continuously, but the same effect can also be achieved by emitting pulses in “bursts” or “trains” - what some authors have called pulsed TENS or burst TENS. This review aims to provide information on available clinical research evidence on analgesic and non-analgesic uses of TENS in pediatric and adult patients related to dentistry. In adults, TENS has been successfully used as an excellent analgesic during various procedures such as placement of rubber gaskets, cavity preparation, pulp capping and other endodontic procedures, preparation of dental prostheses, oral prophylaxis, and extractions.
Therefore, an alternative explanation for the mechanism of action of TENS is that it stimulates the release of endogenous opioids in the spinal cord - which could result from activation of local circuits within the spinal cord or from activation of descending pain-inhibiting pathways. William Stenberg (2) reported in 1994 on the use of TENS to control pain during cavity preparation in a 24-year-old patient susceptible to malignant hyperthermia and obtained favorable results. Additionally, this article will briefly analyze the history of therapeutic electricity, mechanism of action of TENS, components of TENS equipment, types, techniques for administration, advantages and contradictions associated with its use. It should be noted that TENS does not always produce a proper bite - which is what OC GNM dentists use - known as the TENS bite optimization technique. Because patients are generally unaware of the type of pacemaker they are using, it is recommended not to use TENS in these patients. The theory proposed by Melzack and Wall (in 1965) is the most popular theory to explain the mechanism of action of TENS.
