Cardiovascular disease can have a major impact on dental health and treatment, and patients with heart conditions require special consideration when it comes to dental care. Dental professionals can be the first line of defense in detecting and referring patients who may be suffering from cardiovascular disease, an uncontrolled state of illness, or adverse reactions to oral medications. TENS treatments are generally safe for patients with heart conditions, as long as the device is used correctly and as indicated in the instructions. The TENS ultra-low frequency myomonitor (ULF TENS) has been found to be clinically safe and effective in treating masticatory dysfunctions, hypertonic (tense) muscles, and temporomandibular joint alteration problems related to TMD.
However, dentists should be aware of the manufacturer's recommendations for use, as well as any contraindications. If you have a pacemaker, it is important to tell your dentist or doctor before undergoing any medical or dental treatment. Your health care team can contact your cardiologist and work together to find the best treatment for you and your device. Electromagnetic waves of high frequency and intensity are used in this medical procedure, but it is usually not recommended for people with an ICD or pacemaker.
A review of available clinical research evidence on the analgesic and non-analgesic uses of TENS in pediatric and adult patients related to dentistry found that 83.7% of patients improved significantly with the application of TENS. Constant mode yielded slightly better therapeutic results than burst mode. TENS can also be used to relieve pain during several dental procedures, although it cannot replace local anesthesia. Anticoagulant treatment should not be interrupted in patients with mechanical valve prosthesis.
Patients who are “skeptical” and “very sensitive to pain” may not respond as well to TENS treatments. Coronary heart disease is very common in the general population, so dentists should be aware of how to safely treat these patients. Katch reported using TENS to control TMJ pain in a 10-year-old girl and managed to relieve pain by 50 to 75%. William Stenberg 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.
A study found that active devices increased saliva production more than placebo devices, while another study found that 38% of patients who received any form of TENS experienced a pain reduction of more than 50%, compared to only 10% of patients who received TENS with placebo.