Can Pregnant Women Receive TENS Treatments in Dentistry?

In pediatric patients, TENS has been used effectively to control pain during various dental procedures. Oral health care, including taking dental x-rays and administering local anesthesia, is safe at any time during pregnancy. The American Dental Association and the American College of Obstetricians and Gynecologists (ACOG) agree that emergency treatments, such as extractions, root canals, or restorations, can be safely performed during pregnancy and that delaying treatment can cause more complex problems. Although the ACOG has a statement about delaying the choice of general non-obstetric surgery and some invasive procedures, it is recognized that it is safe to perform scraping and root smoothing if periodontitis develops during pregnancy.

The ACOG statement on oral care during pregnancy and throughout life also states that “prenatal periodontal therapy” is associated with improved maternal oral health. Questions often arise about the use of medications by patients who are breastfeeding. Most drug leaflets contain information related to use during breastfeeding and the National Library of Medicine also provides a searchable database (LactMed) on this topic. Nitrous oxide is classified as a category C drug in the pregnancy risk group, which means that there is a risk of fetal harm if administered during pregnancy.

It is recommended that pregnant people, both patients and staff, avoid exposure to nitrous oxide. The National Institute for Occupational Safety and Health (NIOSH) recommends the use of a system for eliminating and limiting exposure of N2O concentrations in dental operations at approximately 25 ppm during the administration of analgesics. X-rays are considered safe for the pregnant patient, at any stage of pregnancy, when abdominal and thyroid protection are used. During pregnancy, people may be at greater risk of oral conditions, such as gingivitis and tooth decay, and both their obstetrician and dentist should inform them about the importance of good oral hygiene throughout their pregnancy.

Regular and emergency dental care, including the use of local anesthetics and x-rays, is safe at any stage of pregnancy. The application of TENS increases salivary flow in healthy individuals, as well as in xerostomic patients. After much research, TENS or electronic dental anesthesia has established itself as an anesthetic agent. In addition to its analgesic effect, TENS can also be used to produce non-analgesic physiological effects and has been found to be beneficial in the treatment of xerostomia.

In a double-blind study of 20 patients who needed class 1 amalgam restorations on their first permanent mandibular molars, they treated 10 patients with TENS and 10 patients without using TENS. They found that “patients' fear is the most important factor in preventing the effective use of TENS”, but factors such as the depth of the cavity, the preparation or the group of teeth are not significant. In pediatric patients, TENS has been used effectively to control pain during various procedures such as the placement of pit and fissure sealants, the preparation of cavities, minor extractions and endodontic procedures. In adults, TENS has been successfully used as an excellent analgesic during several 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.

Conventional TENS is the approach that was first used in people new to the modality often with a continuous pulse pattern of mid-range frequencies and durations. They concluded that TENS can be a useful adjunct in pediatric patients during several minor dental procedures.

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