Comparative Effects of Transcutaneous Electrical Nerve Stimulation, Cryotherapy and Placebo on Pain, Swelling and Trismus Following Third Molar Tooth Extraction
DOI:
https://doi.org/10.34058/njmr.v15i1.2.57Keywords:
TENS, Cryotherapy, Placebo, Pain, Swelling, TrismusAbstract
Background & Objective: This study compared the therapeutic effects of Transcutaneous Electrical Nerve Stimulation (TENS), Cryotherapy and Placebo on pain, swelling and trismus following surgical extraction of the third molar tooth.Methods: Eighteen (18) patients who underwent surgical extraction of the impacted tooth were randomly assigned into three groups- TENS, Cryotherapy and Placebo. Following the surgery, a standard form of TENS was applied over the painful area of cheek for TENS group, Ice was applied directly over the painful area for Cryotherapy group. The TENS machine was detuned while electrodes were applied on the painful sides of the cheek for Placebo group. The pre-operative, pre and post physiotherapy treatment pain ratings, swelling and mouth opening were monitored in each group and the results were compared. Data were analyzed with ANOVA, Turkey's Post-Hoc and t-tests. Level of significance used was 0.05.
Results: There was significant reduction in pain in all the groups. TENS and Cryotherapy were more effective in pain modulation than Placebo treatment. Significant reduction in trismus was also demonstrated in the TENS and Cryotherapy over the placebo group (P<0.05). Apart from the placebo treatment, the result did not show significant changes (p>0.05) in swelling resolution.
Conclusion: TENS and Cryotherapy were more effective than Placebo treatment in pain modulation and relief of trismus following dental surgery. Therefore the choice between TENS and Cryotherapy should be based on larger number of patients are suggested to evaluate the effect on swelling resolution.
References
Basur R, Sherpherd E Moses G (1976) A cooling method in treatment of ankle sprain. Practitioner, 216: 708.
Belanger AY (1985) Physiological evidence for an endogenous opiate-related pain modulating system and it relevance to TENS: A review of literature. Physiotherapy Canada. 37: 1080-4.
Doubell P, Mannon J, Woolf CJ (1999) The dorsal horn: State dependent sensory processing, plasticity and the generation of pain in Wall PD, Melzack R [eds] Textbook of Pain 4th edn Churchill Livinstone, New York 165-182.
Killey HC, Kay LY. (1980) The impacted wisdom tooth. Churchill Livingstone Inc. pp.112-118.
Kitchen S (2002) Heat and Cold: Conduction methods in Kitchen S [ed] Electrotherapy: -Based Practice. Churchill Livingstone 129-136.
Knight KL. (1995) Cryotherapy in sports injury management. Champaign IL: Human Kinetics pp: 3-98.
Kumar V, Mitchel RN, Abbas AK, Fausto N (1996) Pathologic basis of diseases, Saunder, Philadelphia 44-46.
Lee JM, Warren MP, Mson SM. (1978). Effects of Ice the on nerve conduction velocity. Physiotherapy, 64: 2-6.
Melzack R Wall PD (1965) Pain Mechanism: A new theory.
Science. 150: 971-979
Melzack R, Wall PD (1996) The Challenge of Pain [2nd edn]. Penguin, London.
Okeson JP (1993) Management of temporomandibular joint disorders and occlusion. Mosby Year Book Inc. [3rd Edition]
Olaogun MOB, Fagade OO, Akinloye AA, Omojowolo O (2001) Effects of Transcutaneous Electrical Nerve Stimulation on pain, swelling and trismus following third molar tooth extraction. Nigerian journal of Health Sciences, 1 (1): 18-22.
Readyard LB, Edward WT (1992) Management of Acute Pain: A practical guide. International Association for the Study of Pain Publication, Seattle,
Sato A, Schmidt RF (1973) Somatosympathetic Reflexes: Afferent fibres, central pathways, discharge characteristics. Physiological Reviews, 53(4): 916-947.
Sjolund BH, Erickson MBE. (1979) Endorphins and Analgesia produced by peripheral conditioning stimulation. Advances in pain research and therapy, Vol 3.
Starkes RD. (1997) The Merck Manual of Medical Information. Pocket Books, New York.
Strassburg HM, Kranic JV, Thoden V (1977) Influence of
TENS on acute pain. Journal of Neurology, 217: 1-10.
Students Microsoft Encarta. Third molar tooth. Available from: http//www.encarta.msn.com/text 761562931 14/ teeth.html.
Thorsteinsson G, Stonnington HA (1978) The placebo effect of transcutaneous electrical stimulation. Pain, 5: 31-41.
Walsh ME, Martin BC, Deyo RA (1990). A controlled trial of transcutaneous electrical nerve stimulation and exercise for chronic low back pain. N England Med: 322: 1647-1634.
Weil K, Hopper L, Afzal Z, Esposito AM, Worthington HV, Wijk AJ, Coulthard P. (2007) Paracetamol for pain relief after surgical removal of lower wisdom teeth. Cochrane Databases of Systematic Reviews, 3.
Wells G, Milne S, Welch V, Brosseau L, Saginum M, Shea B, Tugwell P. (2001). TENS for chronic Low back Pain (Cochrane Review). In: The Cochrane Library 4, Oxford: Updated software.
