Afferent stimulation induced pain relief in acute oro-facial pain and its failure to induce sufficient pain reduction in dental and oral surgery

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Abstract
Transcutaneous electrical nerve stimulation (TENS) and vibratory stimulation can reduce pathological pain but give insufficient pain reduction to allow dental and oral surgery. Patients [37] were assigned to 1 of 4 groups receiving either TENS of high (100 Hz) or low (2 Hz) frequency, vibration at 100 Hz or placebo stimulation. Pain intensity was continuously assessed. A crude assessment of pinprick threshold, paresthesia and anesthesia was made prior to the clinical treatment. After 30 min of afferent stimulation the surgical treatment was started, aiming at pulp surgery, abscess incision or tooth extraction. All patients experienced intolerable pain at these attempts although about half of the patients experienced relief of their pathological pain, increase in pinprick threshold, paresthesia as well as anesthesia during the stimulation period. All patients were thus given conventional local anesthesia and were all painlessly treated.