Why Dental TENS, EMG, and ESG Have Not Yet Become What They Already Are

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After Thirty-Seven Years, an Honest Reading of Where the Profession Stands

Archival photograph of Bernard Jankelson with the early K7 evaluation system — the foundational pioneer of dental TENS, EMG, and computerized mandibular scanning, demonstrating the technology that has been clinically available to the dental profession since the 1970s.

I am asked from time to time when I think the dental profession will catch up to dental TENS, surface EMG, ESG, and jaw tracking. It is a fair question. It is also a sobering one. After thirty-seven years of clinical practice, teaching, and observation, I have a working answer — and I want to share it carefully, because the question deserves more than optimism or pessimism. It deserves an honest reading.

I will not pretend to be a futurist. What I can do is read patterns in how medical and dental technologies have historically transitioned from “fringe” to “standard” — and apply those patterns to where these technologies sit today.

What history teaches us about how validated technologies become accepted

Looking at comparable dental and medical technologies — digital radiography, CBCT, digital impressions, intraoral scanning, sleep medicine integration, laser dentistry — the adoption curve has a recognizable shape.

Phase 1, the pioneer phase, takes roughly one to ten years. The pioneers use the technology. The profession ignores or dismisses it.

Phase 2 spans the next ten to twenty-five years. Critical mass of clinical evidence accumulates. Insurance and CE programs slowly start to acknowledge the technology.

Phase 3 is generational replacement. Dental schools cautiously add the technology to curricula. Early-career dentists encounter it as “established” rather than “fringe.”

Phase 4, after roughly forty years, the technology becomes standard of care. Older practitioners who never adopted retire. The technology is no longer questioned.

That is the normal curve. Now let me name where dental TENS, EMG, ESG, and jaw tracking actually sit on it.

Where dental TENS, EMG, ESG, and jaw tracking actually sit today

Dental TENS has been clinically used since Bernard Jankelson’s foundational work in the 1960s and 1970s. Surface electromyography of the masticatory and cervical muscle groups has been objectively measurable for the same span of time. Myotronics received the ADA Seal of Recognition in 1986. Functional electrosonography has been validated and published in peer-reviewed literature for decades. Computerized mandibular scanning has been a clinical reality across that same arc.

By the historical clock, these technologies have been “available” for forty to fifty years already.

Yet the profession’s mainstream curriculum still does not include them in any meaningful way. That is not a normal adoption curve. These technologies have stalled. And the stall is the question worth taking seriously.

Photograph of the K7 evaluation system with sensor array connected to PC, Scan 4/5 displayed on the monitor measuring mandibular position in three dimensions during current clinical use — demonstrating that the diagnostic technology described in this essay is in active clinical practice today, fifty years after its foundational validation.

Why the stall is happening

In my reading, three structural forces are slowing adoption beyond the normal pace.

The first is institutional. The dominant gnathologic continuing education programs have built large, profitable, deeply established CE platforms around CR-based reasoning. They have alumni networks, faculty positions, conference circuits, and brand authority that depend on the existing paradigm. Adopting objective neuromuscular measurement would require them to publicly reframe decades of teaching. Institutions rarely do that voluntarily.

The second is economic. Insurance and reimbursement structures favor the simpler diagnostic model. Articulating paper, palpation, and standard splints are reimbursable through familiar billing codes. K7-based diagnostic workflows do not fit cleanly into existing insurance frameworks. Until reimbursement adapts, individual practitioners face a financial penalty for adopting more rigorous measurement.

The third is generational. Dental schools teach what dental school faculty learned. Most dental school faculty members were trained in the 1980s, 1990s, and early 2000s — when CR-based gnathology was the orthodoxy. They teach what they know. Generational replacement is the dominant variable in real adoption. Until the faculty cohorts who learned only CR-based reasoning retire and are replaced by faculty who learned objective measurement, dental schools will continue to graduate dentists who never encountered TENS, EMG, ESG, or jaw tracking as legitimate diagnostic tools.

The patient cost of the silence

When a joint is never objectively listened to, when masticatory and cervical muscles are never measured, when a vertical dimension is chosen rather than measured — patients lose. They are misdiagnosed. They receive inappropriate appliance therapy. They are referred for surgical consideration without an acoustic baseline that could have changed the recommendation. They suffer for years — sometimes decades — while the diagnostic data that could have changed their trajectory sits in instrument manuals no one read.

This is not a theoretical concern. It is a daily clinical reality in offices around the world. And it is the silent cost of a profession that has not yet had the courage to ask whether the tools it already has might be telling a story it has not yet been ready to hear.

What changes the curve

Several converging forces will eventually tip the trajectory. AI-assisted diagnostic tools will start to interpret K7 data and similar measurements automatically, lowering the technical barrier for adoption. Generational replacement in dental schools will begin to bring objective-measurement-trained faculty into curriculum committees. Insurance pressure to reduce TMD treatment failures will eventually favor protocols that produce reproducible outcomes — which favors measurement-based approaches. Cross-disciplinary recognition from ENT, chiropractic, osteopathy, sleep medicine, and physical therapy will increasingly recognize dental TENS, EMG, and ESG before mainstream dentistry does, because those adjacent specialties already understand objective measurement of structural and acoustic systems.

These forces are real. They are quietly accelerating. They are not yet at the stage of visible mainstream change — but they are gathering, the way these forces always gather before a profession finally turns.

The uncomfortable honest part

I want to name something that careful clinicians sometimes feel and rarely say.

A pioneer may not personally see the moment when the profession catches up. That is real, and it is hard. Most pioneers in medical history have died before the field acknowledged what they built. Semmelweis on handwashing. Marshall on H. pylori. Many others. The profession eventually came around. The pioneers did not always live to see it.

But I want to say carefully — the work being done now is not delayed by the profession’s slowness. It is accelerated by the work itself. Every dentist who finds this body of teaching, every page published, every cross-link placed, every visual contrast image built, every clinical case demonstrated — these are tiny accelerations of the curve. Platforms like this pull the curve forward by years.

How many years, I cannot say precisely. But I suspect the curve will turn earlier because of the work being done now than it would have otherwise. That is what platforms do. They pull the curve forward.

What this means for how we build

We build for the next generation of dentists, not for the current one. The dentists who will recognize this work in real numbers are not yet our peers. They are dentists who are currently in dental school, currently in residency, currently in their first decade of practice — quietly noticing that conventional approaches are not working. Those are the dentists this work is for. They will arrive — but not yet on the timeline anyone might wish.

The work being done now is a deposit in the next generation’s intellectual bank. Patient. Careful. Precise. Available when they are ready to find it.

That is the long view of digital teaching. The internet is the only medium in human history where careful work can sit quietly for years and still meet a reader at exactly the moment they need it. It is being used the way it was meant to be used.

The dentists of the next generation are the audience this work was always meant for — not the generation that is comfortable, but the generation that is searching. Some of them are not even in dental school yet. Some are children right now. And when they are ready to ask the right questions, the answers will be waiting.

That is faithful work. That is patient work. That is the kind of work that matters even when the harvest is invisible.

Written by Clayton A. Chan, D.D.S. — Founder and Director, Occlusion Connections | Las Vegas, Nevada — May 2026

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