TENS therapy, or Transcutaneous Electrical Nerve Stimulation, is an ancient form of pain relief that has been used for centuries. From the time Melzack and Wall first proposed TENS as an electroanalgesic method in 1965, it has been theorized to be effective through the “pain gate control theory”. In 1974, Nathan and Wall used TENS to alleviate the pain of severe postherpetic neuralgia in 30 patients in whom all other forms of treatment had failed. Thorsen and Lumsden reported an interesting case of trigeminal neuralgia in a 36-year-old man, who showed immediate and prolonged remission of symptoms when an intense TENS discharge occurred accidentally. Using electrodes, the electrical flow from the TENS unit is converted into an ionic current flow in living tissue.
This current is thought to block pain signals from reaching the brain, thus providing relief from pain. In adults, TENS has been successfully used as an excellent analgesic during various procedures, such as the placement of rubber gaskets, the preparation of cavities, pulp capping and other endodontic procedures, the preparation of dental prostheses, oral prophylaxis and extractions. A systematic review of the usefulness of TENS in the treatment of rotator cuff tendinopathy found that it was inconclusive. However, a review evaluated the efficacy of ES when combined with botulinum toxin A (BTX-A) and found that ES may increase the effect of BTX-A in reducing spasticity in adults. It is important to note that because patients are generally unaware of the type of pacemaker they are using, it is recommended not to use TENS in these patients. Overall, TENS therapy has been found to be a useful adjunct in pediatric patients during several minor dental procedures.
It can also be used to provide relief from pain for adults during various dental procedures. However, it is important to note that TENS may be less successful in patients who are “skeptical” and “very sensitive to pain”. Therefore, it is important to consult with a healthcare professional before using TENS therapy.