Evaluation of the effect of transcutaneous electrical nerve stimulation (TENS) on whole salivary flow rate

Abstract

Background: Saliva plays a critical role in maintaining oral homeostasis; it modulates the ecosystem through lubrication of the alimentary bolus, protection against microorganisms, buffer and repair of the oral mucosa, and helps in dental re-mineralization. Various local and systemic factors such as medications, radiation therapy, systemic conditions, etc. can lead to reduction in salivary flow. A decrease in salivary function, known as Xerostomia, increases a patient’s risk for caries and other oral infections. Palliative management of Xerostomia includes wetting agents such as ice chips, drugs and saliva substitutes. Systemic agents stimulate salivary flow but often have unfavorable side effects. Newer modalities like transcutaneous electrical nerve stimulation (TENS), which has fewer side effects, have been used to stimulate salivary flow. The aim of the present study was to assess and evaluate the effect of TENS on whole salivary flow rates in healthy adult subjects. Study design: A total of 80 healthy adult subjects were enrolled in the study. Unstimulated and stimulated saliva (using TENS) was collected for 5 minutes and the mean salivary flow rates were calculated. Data obtained was analyzed using the SPSS (Statistical package for social sciences) version 15. Students ‘t’ test was employed for comparative analysis. Results: Sixty-five of the 80 subjects demonstrated an increase in the salivary flow rate on application of TENS. Twelve subjects demonstrated a mild reduction in the salivary flow rates. Seven subjects experienced transient mild twitching of facial musculature as side effects. Conclusion: Significant increase in salivary flow rates was observed on application of TENS with minimal or no side effects. Key words:Stimulated saliva, whole salivary flow, TENS.

Improvement of salivary flow and oral wetness by a lip trainer device and sonic toothbrush in older Japanese men and women with dry mouth

“…Therefore, the present study was designed to test shortterm daily facial muscle training for 6 months. An earlier study has reported that sonic toothbrushes stimulate salivary flow in a xerostomic population (17). The results of this study are also consistent; however, the precise mechanism remains unclear.…”

“…Transcutaneous electrical nerve stimulation, in which salivation is induced by electrodes placed on skin, has recently been shown to be effective on whole saliva (17). This suggests that salivary flow can be enhanced by the stimulation of adjacent oral structures.…”

Efeito agudo da Transcutaneous Electric Nerve Stimulation (TENS) sobre a hipossalivação induzida pela radioterapia na região de cabeça e pescoço: um estudo preliminar

“…Longman et al (27) found an increase in salivary flow by 71% (pre-test = 0.07 ± 0.03 mL/min; post-test = 0.12 ± 0.03 mL/min) after a single application of electrical stimulation. Similarly, Aggarwal et al (28) found, in apparently healthy individuals, an increase in salivary flow in the order of 13% (0.16 mL/min/ Pre-test = 1.25 mL/min; post-test = 1.41 mL/min), after a single application of TENS (100Hz frequency, 100 to 150uS pulse width, and electrodes allocated in the region over the parotid glands). In another study, which included a heterogeneous sample composed of patients with the most various pathologies (e.g., diabetics; users of antidepressants, antipsychotics and diuretics; and post-menopausal women), 5-minute electrical stimulation with the same parameters used in the present study (50Hz and 250uS) also resulted in benefits (pre-test: 2.343 mL/min; post-test: 3.053) (29) .…”

Effects of Neuromuscular Electrical Stimulation (NMES) on salivary flow in healthy adults

“…These results suggested that the increase in saliva flow may be promoted by stronger stimulation during NMES. In a previous study, Hersheal et al ( 26 ) reported that saliva flow quantity increased following transcutaneous electrical nerve stimulation (TENS) with low frequency applied to the parotid gland in healthy adults. As a similar type of stimulation was applied in that study, their results were similar to ours.…”

“…Twenty healthy adult volunteers (nine males, mean age ± SD = 27.9 ± 3.8 years) participated in this study as subjects. Exclusion criteria were those with salivary gland disease, those who took medications which influenced salivation, and smokers ( 19 ). Written informed consent was obtained from each participant.…”