TENS therapy has been used to provide successful anesthesia for a variety of dental procedures, from tooth decay preparation to dental implants and even extractions. It has also been used to alleviate chronic pain associated with temporomandibular joint disorders (TMJ) and trigeminal neuralgia. In 1974, Nathan and Wall reported that TENS was effective in relieving the pain of severe postherpetic neuralgia in 30 patients who had not responded to other treatments. Before trying TENS, it is important to consult a doctor, as it can be used as an alternative treatment or in combination with other pain management methods.
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 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. They found that fear was the most important factor preventing the effective use of TENS, rather than factors such as the depth of preparation of the cavity or the group of teeth. In 1994, Quanstrom and Libed compared the ability of TENS and topical anesthesia to control pain caused by the injection of local anesthesia. The application of TENS increases the rate of salivary flow in healthy individuals, as well as in xerostomic patients.
Harvey and Elliott (1995) discovered 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. In conventional TENS, the delivery of impulses is usually continuous, but the same effect can also be achieved by emitting the pulses in “bursts” or “trains”, what some authors have called pulsed TENS or in bursts. The theory of pain control proposed by Melzack and Wall (1965) is the most popular theory to explain the mechanism of action of TENS. This review aims to provide information on the available clinical research evidence on the analgesic and non-analgesic uses of TENS in pediatric and adult patients related to dentistry. The use of TENS has positive effects on pediatric patient behavior, reducing anxiety levels by eliminating “fear of the needle”.
In a double-blind study, 20 patients who needed class 1 amalgam restorations on their first permanent mandibular molars were treated with TENS or without it. 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. Because patients are generally unaware of the type of pacemaker they are using, it is recommended not to use TENS in these patients. However, when used correctly, TENS therapy can provide effective relief from dental pain for both adults and children.