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J5 Dental TENS (Transcutaneous Neural Stimulation)

The main reason why OC doctors specifically use the J5 Dental low frequency TENS (Myotronics, Inc.) is due to the bilateral simultaneous involuntary pulse that is unique and a key requirement in recording an “optimized bite” registration.  Breaking up spastic masticatory muscle engrams is a fundamental necessity and benefit in achieving a physiologic 6 dimensional inter occlusal recorded relationship for diagnosis and effective treatment.

• Not Every TENS Unit is FDA Approved for DENTAL USE: What Type of TENS is being used on you?
• About the J5 Dental/Myomonitor TENS FDA 510K Status and Classification
• Dental TENS Safety and Effectiveness

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J5 Dental TENS (a low Frequency not high frequency) helps break up spastic muscle engrams (memory) that pull, torque and twist a jaw. At a more sophisticated level from experience a dentist will also realize that TENS does not make a patient go to the correct position by itself, especially when there is joint disc condyle problems and strong muscle pulling. So the GNM dentist is trained to know what to do under these circumstances to use TENS at the same time as using special methods to over come some of these other anatomical hindrances. TENS doesn’t always produce a proper bite (that is classical NM thinking), this is what OC GNM dentists use what is called an Optimizing the Bite technique with TENS.

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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 Dental TENS, 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).

Relaxing the masticatory muscles and to decompress the temporomandibular joints is a logical and recognized first step theraputic 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.

    

Myotrode placement for both the upper trapezius as well as masticatory regions are used according to manufacturers FDA approved protocols and recommendations.

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 Dental TENS (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 J5 Dental TENS

The J5 Dental TENS is approved for neurally mediated muscle stimulation of both the fifth and seventh cranial nerves.  The Dental 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.

• Measuring Technology Passes the Validity and Reliability Criteria

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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Read more on:

• Physiologic Standards that Validate Treatment Stability
• K7 Clinical Purpose and Use of the J5 Myomonitor TENS 
• Relaxing the Muscles with J5 Myomonitor TENS  – Scientific References for TENS Efficacy
• Effect of Postural Cervical Muscles on the Occlusion – TENsing the Cervical Muscles
• Not Every TENS Unit is FDA Approved for DENTAL USE: What Type of TENS is being used on you?
• About the J5 Dental/Myomonitor TENS FDA 510K Status and Classification
• Dental TENS Safety and Effectiveness
• Contraindications for Ultra Low Frequency Myomonitor TENS
• Bells Palsy: Thoughts and Considerations
• Science of K7 Electro-Diagnostic Instrumentation 
• Low Frequency J5 Myomonitor TENS
• Computerized Mandibular Scanning (CMS)
• Science of Electrosonography (ESG)
• Lateral Pterygoid Muscle: It’s Relevance to Clinical Dentistry