Can Patients with Pacemakers Receive TENS Treatments in Dentistry?

Transcutaneous electrical nerve stimulation (TENS) is a popular treatment for certain painful conditions, but it can interfere with the operation of pacemakers or implantable cardioverter defibrillators (ICDs). If you have a pacemaker or ICD, it is important to inform your doctor before considering TENS treatment. In 1989, Quanstrom and Milgrom conducted a study to evaluate the effectiveness of TENS combined with nitrous oxide and oxygen in 309 patients, compared to TENS alone in 62 patients. They found that 38% of patients who received any form of TENS experienced a pain reduction of more than 50%, while only 10% of patients who received TENS with placebo experienced the same level of pain relief.

TENS has also been used effectively to control pain during various pediatric procedures, such as the placement of pit and fissure sealants, cavity preparation, minor extractions, and endodontic treatments. Katch reported using TENS to control temporomandibular joint (TMJ) pain in a 10-year-old girl and managed to reduce pain by 50-75%. In 1986, Roth and Thrash used TENS to evaluate its effect on periodontal pain associated with orthodontic spacers placed mesial and distal to the first upper molars in 45 adult patients. Harvey and Elliott discovered in 1995 that TENS is effective in reducing pain during tooth decay preparation in pediatric patients. They found that 83.7% of patients improved significantly with the application of TENS and that a constant mode yielded slightly better therapeutic results than the TENS burst mode.

The application of TENS also increases salivary flow in healthy individuals as well as xerostomic patients. In 1999, Baghdadi conducted a study on 28 children to determine the effectiveness of TENS compared to local anesthesia for restorative procedures. In adults, TENS has been successfully used as an excellent analgesic during various procedures such as rubber gasket placement, cavity preparation, pulp capping, endodontic treatments, dental prosthesis preparation, oral prophylaxis, and extractions. TENS is not suitable for all patients. It requires cooperation from the patient, so it should not be attempted on those with communication problems or mental disabilities. However, it has been found to have positive effects on pediatric patient behavior which can reduce anxiety levels by eliminating the “fear of the needle”.

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