Relaxing the Muscles with TENS

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Clayton Chan Patient Ed3

J5 Myomonitor TENS (Transcutaneous Neural Stimulation)

Relaxing spastic and tight muscles is a continued growing trend toward comprehensive diagnosis and treatment planning, driven by value seeking patients across North America (United States, Canada, Europe, Asia, Mexico and Australia).  TMD pain patients are searching for high end definitive care and treatment.  To meet the needs of these savvy patients who are searching for knowledgeable and skilled dentists, the GNM dentists use low frequency TENS (J5 Myomonitor, Myotronics, Inc., Kent, WA) to establish a optimized “physiologic” upper and lower jaw relationship (based on relaxed muscles vs. tight strained muscles) in 6 dimensions as a diagnostic tool in initial diagnosis and treatment planning.

The ADA and FDA has granted Myotronics TENS 510K approval status from the Center for devices and Radiological Health (a branch of the FDA).

J5 Myomonitor TENS

Relaxing the masticatory muscles and to decompress the temporomandibular joints is a logical and recognized first step therapeutric medical model that all GNM dentist recognize in order to re-establish homeostasis to the human body.  Compression, strain, torque and skews add to the patho-genesis of pathology.  Establishing a “physiologic” rested position for the mandible is one of the most crucial yet, highly overlooked principles for effective diagnosis and treatment within the dental profession.

Click to Read More on Physiologic Rest

Finding a bite relationship, without manual intervention, after 45-60 minutes of muscle relaxation has allowed the GNM clinician to capture an un-torqued bite registration of the mandible in a sitting up right postural position before mounting their casts to an articulator.  They are finding that with specific GNM protocols and Optimized TENS training there are fewer adjustments, less chair time and faster resolution time required than traditional neuromuscular (NM) approaches when implementing restorative, orthodontic and TMD occlusal treatment for patients desiring comprehensive care.  The low frequency TENS/Myomonitor has been for the past 15 years been the standard bite recording instrument among OC dentists.

Occlusion leaders are now recognizing its usefulness, safety and scientific validity over these past 50 years.  The medical and dental profession has recognized its effectiveness for:

  1. Therapeutic Muscle Relaxation of masticatory and cervical neck muscles.
  2. Finding a Physiologic Bite
  3. Determining Diagnostic Cast Relationships for treatment planning of all TMD, Orthodontic, Restorative and Prosthetic cases.
  4. Treating TMD – Phase I appliance therapy.
  5. Bite Management – Adjusting/resurfacing any occlusion established on a neuromuscular myo-trajectory to eliminate mandibular torque for:
    • TMD – Orthotics
    • Dentures/Prosthetics
    • Restorative/ Implants
    • Natural Dentition
  6. Taking a Master Impression and Border Molding edentulous ridges.
  7. Finishing the Bite of all restorative, orthodontic and prosthetic cases.

The J5 Myomonitor (6 lead system) is the latest version of low frequency TENS units that sends a “bilateral” stimulation of both the masticatory muscle region in addition to the lower back and cervical neck region synchronously.

There is sufficient supportive evidence showing efficacy for the use of Low Frequency Transcutaneous Neural Stimulation (TENS), Electromyography (sEMG), Jaw Tracking (Kineseogrphy/CMS) and Electrosonography (ESG) in the diagnosis and treatment of TMD.

Read more on: Efficacy of Myomonitor TENS

FDA and K7

The Myomonitor TENS is FDA approved for neurally mediated muscle stimulation of both the fifth and seventh cranial nerves.  The Myomonitor/TENS technology has a 50 year proven track record for effective bite recordings before, during and post treatment bite management.  The GNM trained clinicians have been seeing the positive impact it is having with their pain patients who present with mandibular postural compromises, challenging occlusal and joint problems, breaking restorations, ringing in the ears, ear congestion feelings, pressure behind the eyes, vertigo, to name a few.

The scientific literature is unanimous in validating the safety of TENS devices. This is an excerpt from an FDA publication titled “An Introduction to Electrical Nerve Stimulation: TENS” dated August 1986, published by Center for Devices and Radiological Health branch of the FDA:

  • “The approximately one hundred publications from the most recent years are virtually unanimous in TENS safety. The notable exception is a necessary awareness of potential fetal stimulation during labor pain. In all other aspects, TENS risk is limited to minor and easily remedied skin irritations from electrodes and electrode gels in a rather small number of reported cases.”

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