J5 Myomonitor TENS – Indications and Contraindications in Dentistry

To Read More: FDA Approved  TENS Myotrode Placement Guidelines Specific for Both the  V and VII Cranial Nerve Stimulation

Electrical Muscle Stimulation (EMS) in Dentistry

Indications for use of EMS in Dentistry:

1. To treat temporomandibular joint (TMJ dysfunction and associated pain.
2. To relieve symptoms  associated with muscles spasm.
3. To relax muscles and establish a physiologic occlusion.
4. To take occlusal registration.
5. To take denture impressions.
6. To increase local blood circulation.
7. To  maintain or increase mandibular range of motion.

Contraindications:

1. Powered muscle stimulators should not be used on patients with cardiac demand pacemakers. Prior to treatment of pacemaker patients with the J5, the patients primary care physician should be consulted.
2. 2. EMS devices such as the  J5 should not be used over, or in proximity to cancerous lesions.

Warning:

1. Long term effects of chronic electrical stimulation are unknown.  Safety has not been established for the use of EMS devices during pregnancy.
2. Adequate precautions should be taken when using EMS on patients with suspected or diagnosed epilepsy or heart problems.
3. EMS devices should not be applied transcerebally.  When stimulating muscles of mastication, carefully follow directions in this manual for placement of electrodes over the coronoid notch.
4. Stimulating electrodes should not be placed over the carotid sinus nerves, especially in patients with a known sensitivity to the carotid sinus reflex.  Caution should be used in the transthoracic application of EMS devices in that the introduction of electrical current into the heart may cause arrhythmias.
5. Severe spasm of the laryngeal and pharyngeal muscles may occur when the electrodes are positioned over the neck or mouth.  The contractions may be strong enough to close the airway or cause difficulty in breathing.
6. EMS devices should not be used over swollen, infected, or inflamed areas or skin eruptions, e.g. phlebitis, thrombo phlebitis, varicose veins.
7. EMS DEVICES SHOULD BE KEPT OUT FO THE REACH OF  CHILDREN.

Adverse effects:

1. Skin irritation and burns beneath the electrodes have been reported with the use of electrical stimulators.

Precautions:

1. Some individuals may experience skin irritation or hypersensitivity due to the elecrtode adhesive or conductive medium or due to electrical stimulation.  The irritation can usually be reduced by use of an alternate conductive medium or alternate electrode placement.  If a strong stinging feeling is experienced at an electrode site, check electrode and replace if necessary.  Avoid placing electrodes over areas where the skin is read or inflamed.
2. In some individuals with headaches of vascular origin, EMS may induce or aggravate the pain.  The doctor’s judgment should be used as to whether or not to continue.
3. If an individual suffers from senility, psychological or motor limitations precautions should be exercised to insure that the EMGS units are used properly to insure the patient’s safety.
4. Precautions should be observed in the presence of the following:
   1. When there is a tendency to hemorrhage following acute trauma or fracture.
   2. Following recent surgical procedures when muscle contraction may disrupt the healing process.
   3. Application of EMS over the menstruating uterus.
   4. Where sensory nerve damage is present by a loss of normal skin sensation.

To read more on the ADA and FDA approval

Neuromuscular Dentistry