Diagnostics: Removing Unwanted Muscle Engrams with Ultra Low Frequency TENS

DIAGNOSTICS: First Step in Accessing Unresolved Occlusal/Muscle and TMJ Problems – Importance to Use the J5 Dental TENS

Ultra Low Frequency Transcutaneous Neural Stimulation (Dental ULF TENS)

J5 Dental TENS is a very important first step for any clinician who desires to find a physiologic jaw relationship between the upper and lower jaws. It is a THREE Electrode Lead System (3 leads for the masticatory muscles and 3 leads for the cervical and shoulder regions).
J5 Dental TENS is key in identifying the unseen craniomandibular torquing interferences in the occlusion.
J5 Dental TENS combined with the K7’s CMS (computerized mandibular scanning): jaw tracking technology gives the treating clinician the additional advantage to strategically decipher the unresolved issues as to mandibular positioning, quality of function, quality of muscle and occlusal balance and quality of CNS calmness/stability.
Experience shows that diagnosis and treatment is not as effective nor precise without the use of J5 Dental TENS.
Experience shows the use of both J5 Dental TENS combined with the K7 brings to light the issues and problems that are often missed by TMD experts.

Transcutaneous electrical nerve stimulation (TENS) is a specific therapy for the treatment and resolution of pain related to neurological and myofacial conditions. It does this by delivering a mild electronic impulse through the nerves that control the masticatory and facial muscles. The rhythmic pulsing relaxes the muscles and therefore allows us to determine the correct relation of the mandible to the cranium. It also relieves pain and trismus of the muscles of the face caused by spasms and tension. In addition, it propels the mandible through space to a position which is most compatible with a relaxed musculature. This procedure involves the placement of electrodes bilaterally in the preauricular area anterior to the right and left ears, just lateral to the coronoid notch. The current emanating form the electrodes stimulate the motor divisions of the fifth and seventh cranial nerves. The TENS pulse rate is once every 1.5 seconds (low frequency). It mimics the natural pulsing action of the body somewhat like a massage. The effectiveness of the TENS therapy is documented by EMG recordings.

The efficacy of low frequency TENS in the diagnosis and treatment of TMJ/ MSD has been clearly confirmed in the published literature. It is clear and unequivocal that low frequency TENS (.05 Hz – 10 Hz) is both safe and efficacious for muscle relaxation and pain control. It is clear that low frequency TENS has a high degree of specificity when utilized for craniofacial pain. (Over 44 internationally published studies support and confirm this fact).
There is more than adequate confirming evidence to support the effectiveness of such diagnostic instrumentation as verified and confirmed by the American Dental Association (ADA) and the Food and Drug Administration (FDA).
The American Dental Association’s Council on Scientific Affairs has awarded surface electromyography (SEMG), Computer Mandibular Scanning (CMS), and Sonography its “Seal of Acceptance”, as diagnostic aids in the management of temporomandibular disorders. (Report on Acceptance of TMD Devices, ADA Council on Scientific Affairs, JADA, Vol. 127, November 1996).

The U.S. Food and Drug Administration has granted 510k status to each of these mentioned devices for use in the diagnosis and management of TMD in my practice.

This reflects that the U.S. Government and the dental profession acknowledges the safety and efficacy of the devices as recording and measuring devices used in the diagnosis and management of TMD and orofacial pain.

Although the use of TENS is a mode of treatment it can be used most effectively when used in conjunction with CMS and EMG recordings simultaneously in objectively documenting and diagnostically gathering information before, during and after treatment.

“Breaking up unwanted proprioceptive muscle engrams in the masticatory system is the foundation to Physiologic Occlusion.” – Clayton A. Chan, D.D.S.

Scientific Article: Ulfra Low Frequency TENS and Gnathology

Nicolae Chipaila, et al, The effects of ULF–TENS stimulation on gnathology: the state of the art. CRANIO: The Journal of Craniomandibular & Sleep Practice 2014 VOL. 32 NO. 2

How TENS Works

The J5 TENS is specifically designed to produced a “synchronous bilateral Low Frequency TENS” stimulation. Amplitude as well as balance can be controlled to regulate the often asymmetric muscle tension of most patients who experience masticatory dysfunction, pain and joint derranagment problems (TMD).

Relaxes spastic muscles – bilaterally.
Breaks up pathologic occlusal engrams.
Improves posterior vertical dimensions.
Assist the clinician to Optimize the Physiologic Bite without manipulation or mechanical referencing.

SUPPORTIVE SCIENTIFIC REFERENCES:

Studies that Document Myo-monitor (J4 or J5) TENS Efficacy

Monaco A, Sgolastra F, Ciarrocchi I, Cattaneo R.: Effects of transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorders: a placebo-controlled study. J Electromyogr Kinesiol. 2012 Jun;22(3):463-8. doi: 10.1016/j.jelekin.2011.12.008. Epub 2012 Jan 14.
Eble OS, Jonas IE, Kappert HF.: Transcutaneous electrical nerve stimulation (TENS): its short-term and long-term effects on the masticatory muscles. J Orofac Orthop. 2000;61 (2):100-11.
Bazzotti L.: Electromyography tension and frequency spectrum analysis at rest of some masticatory muscles, before and after TENS. Electromyogr Clin Neurophysiol. 1997 Sep;37(6):365-78.
Wessberg GA, Carroll WL, Dinham R, Wolford LM.: Transcutaneous electrical stimulation as an adjunct in the management of myofascial pain-dysfunction syndrome. J Prosthet Dent. 1981 Mar;45(3):307-14.
Konchak P.A., Thomas N.R., Lanigan D.T., Devon R.M.: Freeway Space Measurement Using Mandibular Kinesiograph & EMG Before and After TENS. Angle Orthodontist. October 1988.
Wessberg Geroge A., Dinham, Richard, DMD: The Myo-monitor and the myo-facial pain dysfunction syndrome. Journal of the Hawaii Dental Association. vol. 10, No. 2, Aug. 1977.
Pantaleo, T.,M.D., Prayer-Galletti, F. M.D., Ph.D., Pini-Prato, g., M.D., and Prayer-Galletti, S.,M.D.: An electromyographic study in patients with myofacial pain-Dysfunction syndrome. Bull. Group. int. Rech.sc Stomat. et Odont. Vol. 26, pp. 167-179, 1983.

Summary:

“An electromypgraphic (EMG) study of ipsilateral masseter and temporalis muscles was undertaken in healthy volunteers and in patients with MPD syndrome, with the aim of getting further insight into the pathophysiology of this disease. Unlike controls, patients had abnormal MKG features and displayed involuntary sustained EMG activity at rest, chiefly in the temporalis muscles.

Transcutaneous electrical nerve stimulation (TENS) performed with the Myo-monitor induced relaxation and relief of pain: these effects were however revesred by voluntary mouth closures.

The correction of occlusal position by acrylic splints was able to induce persistant reduction or a suppression of the abnormal EMG activity at rest and a good relief of pain: more over, after the correction, higher levels of EMG activity were found during maximal biting in the intercuspal position.

Mechanisms underlying these effects were discussed and in particular it was suggested that abnormal afferenct activity from periodontium and jaw muscles may contribute to the establishment of sustained contraction leading to muscular pain, which in turn may cause reflex muscle activity in vicious circles”.

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