Anesthesia is the state of insensibility induced in medicine with the aim of being able to perform therapeutic or diagnostic procedures. In the procedure of electroanesthesia (synonyms: transcutaneous electrical nerve stimulation, TENS, TNS, TENS therapy; transcutaneous electrical nerve stimulation), this state is induced by low-current electrical pulses that activate the body’s own systems to reduce pain. Pain impulses are triggered, for example, during the excavation (the removal) of caries. Electroanesthesia is used to interrupt their transmission to the brain by means of minimal electrical stimulation currents, thus preventing their perception. In principle, there is no pain that is completely resistant to TENS treatment. Four mechanisms are used to explain the analgesic effect (effect that cancels or suppresses the sensation of pain) of electroanesthesia:
- Pain-inhibiting neurotransmitters (endorphins, encephalins) are released in increased amounts. These block the receptors in the nervous system, to which otherwise pain-triggering messengers would attach.
- Blood flow-promoting vasodilatory substances such as vasoactive intestinal polypeptide (VIP hormone) are also formed increased.
- Pain-inhibiting systems in the spinal cord are activated, thereby blocking the transmission of pain impulses
- Impulse transmission of peripheral nerves (located outside the spinal cord and brain) is blocked by electrical inhibitory processes
Indications (areas of application)
- Minor low-pain procedures such as filling therapy.
- Syringe phobia (patient’s fear of local anesthesia).
- Intolerance of anesthetics (anesthetics).
- TMJ pain
- Tension in the muscles of mastication
Before the electroanesthesia
are to exclude possible contraindications (contraindications) by taking a detailed general anamnesis (medical history). The patient should be familiarized with the controller function of the device.
The procedure
The battery-powered TENS therapy device consists of a generator, whose electrical parameters can be selected either continuously or via fixed programs, depending on the type of device, and two electrodes connected to it by cables.
- Placement of the electrodes depending on the system and pain localization intraoral (in the mouth) or extraoral (outside the mouth).
- Electrical parameters such as pulse strength and pulse frequency, current intensity, etc., are set in advance by the dentist
- During the pain-inducing treatment, the patient can actively influence the intensity of anesthesia via a hand controller
After electroanesthesia
After completion of treatment, the anesthetic effect is immediately cancelled when the device is turned off.
Possible complications
Complications are rare due to the very good tolerability of TENS therapy:
- Current-related skin irritations
- Skin irritation due to incompatibility of extraoral electrode contact gel.
- Very rare vagal carotid sinus or laryngeal reactions (reactions caused by interference with the vagus nerve such as nausea, vomiting, and symptomatic bradycardia/heartbeat below 60 beats per minute) when electrodes are placed in the neck area
Contraindications
Relative contraindications (medical approval must be obtained before starting treatment for the following individuals):
- Gravidity (pregnancy).
- Epilepsy
- Pacemaker or other electronic implants
- Condition after apoplexy (stroke)
- Surgical procedures due to the promotion of blood flow through TENS.
- Treatment measures where the continuation of the anesthetic effect is desired for a certain time beyond the end of the treatment session are preferably performed under local anesthesia (local anesthesia with injection)
