Effect of transcutaneous electrical nerve stimulation on parotid saliva flow in patients with hyposalivation

Abstract

Context:In recent days, we have come across an increase incidence of dry mouth as a side effects of drugs and in order to bring an awareness about a simple non- invasive method to increase the salivary flow, we have used TENS which in many way is beneficial to patients with metabolic disorders.Aims and Objectives:The aim is to assess the effectiveness of transcutaneous electrical nerve stimulation on salivary gland function in patients with hyposalivation.Subjects and Methods:The present study included total of 25 subjects with complaint of hyposalivation. Written informed consent was obtained from all the participants. Subjects with pacemakers, autoimmune diseases, pregnancy, and history of salivary gland pathology were excluded from the study. Subjects were asked to refrain from eating, drinking, chewing gum, smoking, and oral hygiene procedures for at least 1 h before the appointment. Unstimulated saliva was collected using modified Carlson Crittenden cup placed over the Stenson's duct bilaterally for 5 min and measured. TENS pads were placed over the parotid region and were activated. The intensity control switch was adjusted for patient's comfort. The intensity was turned up 1 increment at a time at 5 s intervals until the optimal intensity level was reached and stimulated saliva was then collected for 5 min using the modified Carlson Crittenden cup and measured. Any increase in parotid salivary flow (SF) with electrostimulation was considered a positive finding.Statistical Analysis Used:A paired t-test, evaluating mean changes in stimulated versus unstimulated SF rates, was applied to look for statistically significant differences using PASW 18.0 for Windows. An independent sample t-test was performed to note difference between genders.Results:There was significant increase in parotid SF in 19 of 25 patients after transcutaneous electrical nerve stimulation. Males showed more salivary secretion when compared to females.Conclusions:From the results of the study and within limitations of the study, it can be concluded that TENS was effective in increasing the SF rate in hyposalivatory patients with residual saliva. TENS was less effective in patients who are under xerogenic drugs. Thus, TENS may be an ever-growing armamentarium in the management of salivary gland hypofunction when other therapies have failed or are contraindicated.

A Review of Selected Studies That Determine the Physical and Chemical Properties of Saliva in the Field of Dental Treatment

“…Various studies using physical stimuli were conducted in order to help people suffering from xerostomia. Aparna et al observed that the production of saliva by the parotid glands increased in 76% of patients suffering from xerostomia after the use of percutaneous electrical stimulation (TENS currents) [ 34 , 35 ].…”

Response of salivary flow rate to transcutaneous electrical nerve stimulation in haemodialysis patients

“…After 1 extraoral TENS session, 6 diabetics (4 females and 2 males) presented a saliva flow increase from 2.53 to 3.33 ml/min [24]. Also, after a 5-minute extraoral TENS session, 19 out of 25 subjects with hyposalivation complaints exhibited an increased parotid saliva flow [25]. Electrical stimulation of saliva via TENS showed a statistically significant improvement in the whole salivary flow rate among postmenopausal females with or without dry mouth [26].…”

A Prospective Cohort Study Analyzing Radiation-Induced Xerostomia and Quality of Life of Head and Neck Cancer Patients Treated With Intensity-Modulated Radiotherapy and 3D Conformal Radiotherapy Techniques at a Tertiary Cancer Center in Eastern India

“…The functional cells of salivary glands behave like acute responding tissues to radiation. Radiation-induced xerostomia starts early during treatment [ 12 ]. Almost a 50%-60% decline in salivary flow occurs in the first week, and after seven weeks, salivary flow diminishes to approximately 20%.…”