Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults

Authors

  • Satish Chhugani
  • Gunjan Khatwani Chhugani
  • Abhishek Sahu Vishwa Pratap
  • Lokesh Adwani
  • Supreet Jain
  • Santosh Rayagouda Patil

Keywords:

Saliva, Transcutaneous Electric Nerve Stimulation, Xerostomia

Abstract

Objective: To evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on whole salivary flow in patients with xerostomia and healthy adults. Material and Methods:  Thirty subjects with a history of xerostomia and subjects with unstimulated salivary flow equal to or less than 0.5 ml in 5 min were included in the study group, and 30 healthy subjects were included in the control group. Low forced spitting unstimulated saliva was collected for five minutes in a test tube fitted with a funnel. Then electrode pads of the TENS unit were applied bilaterally on skin overlying the parotid glands and at optimal intensity, stimulated saliva was collected for 5 minutes with the same method in a separate graduated test tube. The salivary flow rate (per minute) was calculated by dividing the amount of collected saliva (volume in mL) by the duration of collection period (5 minutes) and the salivary flow rates prior and after electrostimulation were compared for both groups. The Student’s t-test (unpaired and paired) was performed for group-wise comparisons. Results: In study group, the mean unstimulated salivary flow rate was 0.07 ± 0.01 mL/min. There was an 85.71% increase in salivary flow (0.13 ± 0.03 mL/min) during the TENS application and the difference was highly significant (p<0.001). In control group, the mean unstimulated salivary flow rate was 0.37 ± 0.07 mL/min. There was a 21.62% increase in salivary flow (0.45 ± 0.07 mL/min) during the TENS application and the difference was highly significant (p<0.001). An increase in mean salivary flow rate both in males and females after TENS application in both groups (p<0.001) was noted. The difference between unstimulated, stimulated and mean difference in salivary flow rate between males and females was not statistically significant in both groups (p>0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

References

Kessler AT, Bhatt AA. Review of the major and minor salivary glands, part 1: anatomy, infectious, and inflammatory processes. J Clin Imaging Sci 2018; 8:47. https://doi.org/10.4103/jcis.JCIS_45_18

Kessler AT, Bhatt AA. Review of the major and minor salivary glands, part 2: neoplasms and tumor-like lesions. J Clin Imaging Sci 2018; 8:48. https://doi.org/10.4103/jcis.JCIS_46_18

Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag 2014; 11:45-51. https://doi.org/10.2147/TCRM.S76282

Hargitai IA, Sherman RG, Strother JM. The effects of electrostimulation on parotid saliva flow: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99(3):316-20. https://doi.org/10.1016/j.tripleo.2004.06.080

Steller M, Chou L, Daniels TE. Electrical stimulation of salivary flow in patients with Sjögren's syndrome. J Dent Res 1988; 67(10):1334-7. https://doi.org/10.1177/00220345880670101701

Strietzel FP, Martín-Granizo R, Fedele S, Lo Russo L, Mignogna M, Reichart PA, et al. Electrostimulating device in the management of xerostomia. Oral Dis 2007; 13(2):206-13. https://doi.org/10.1111/j.1601-0825.2006.01268.x

Garrett JR. The proper role of nerves in salivary secretion: a review. J Dent Res 1987; 66(2):387-97. https://doi.org/10.1177/00220345870660020201

Porter SR, Scully C, Hegarty AM. An update of the etiology and management of xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97(1):28-46. https://doi.org/10.1016/j.tripleo.2003.07.010

Travers MJ, O'Connell NE, Tugwell P, Eccleston C, Gibson W. Transcutaneous electrical nerve stimulation (TENS) for chronic pain: the opportunity to begin again. Cochrane Database Syst Rev 2020; 4:ED000139. https://doi.org/10.1002/14651858.ED000139

Wong RK, Jones GW, Sagar SM, Babjak AF, Whelan T. A Phase I-II study in the use of acupuncture-like transcutaneous nerve stimulation in the treatment of radiation-induced xerostomia in head-and-neck cancer patients treated with radical radiotherapy. Int J Radiat Oncol Biol Phys 2003; 57(2):472-80.

https://doi.org/10.1016/s0360-3016(03)00572-8

Aagaard A, Godiksen S, Teglers PT, Schiødt M, Glenert U. Comparison between new saliva stimulants in patients with dry mouth: a placebo-controlled double-blind crossover study. J Oral Pathol Med 1992; 21(8):376-80. https://doi.org/10.1111/j.1600-0714.1992.tb01369.x

Mittal A, Masuria B L, Bajaj P. Transcutaneous electrical nerve stimulation in treatment of post herpetic neuralgia. Indian J Dermatol Venereol Leprol 1998; 64:45-7.

Pattipati S, Patil R, Kannan N, Kumar BP, Shirisharani G, Mohammed RB. Effect of transcutaneous electrical nerve stimulation induced parotid stimulation on salivary flow. Contemp Clin Dent 2013; 4(4):427-31. https://doi.org/10.4103/0976-237X.123017

Vilas SK, Shashikant M, Ali I. Evaluation of the effects of transcutaneous electrical nerve stimulation on whole saliva flow: A clinical study. J Ind Acad Oral Med Radiol 2009; 21(1):7-11. https://doi.org/10.4103/0972-1363.57771

Domingo D. The effects of electrostimulation on saliva production in post-radiation head and neck cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97(4):464. https://doi.org/10.1016/j.tripleo.2004.02.052

Ghezzi EM, Lange LA, Ship JA. Determination of variation of stimulated salivary flow rates. J Dent Res 2000; 79(11):1874-8. https://doi.org/10.1177/00220345000790111001

Dyasnoor S, Kamath S, Khader NFA. Effectiveness of electrostimulation on whole salivary flow among patients with type 2 diabetes mellitus. Perm J 2017; 21:15-164. https://doi.org/10.7812/TPP/15-164

Aparna PV, Sankari SL, Deivanayagi M, Priyadharshini A, Vishnupriya CK, Niveditha B. Effect of transcutaneous electrical nerve stimulation on parotid saliva flow in patients with hyposalivation. J Pharm Bioallied Sci 2017; 9(Suppl 1):S142-S146. https://doi.org/10.4103/jpbs.JPBS_124_17

Singh D, Agrawal S, Shashikanth MC, Misra N. The effects of transcutaneous electric nerve stimulation (TENS) on salivary flow: a study. J Indian Acad Oral Med Radiol 2015; 27(1):16-9. https://doi.org/10.4103/0972-1363.167068

Vijayan A, Asha ML, Babu S, Chakraborty S. Prospective phase II study of the efficacy of transcutaneous electrical nerve stimulation in post-radiation patients. Clin Oncol 2014; 26(12):743-7. https://doi.org/10.1016/j.clon.2014.09.00425262845

Lakshman AR, Babu GS, Rao S. Evaluation of effect of transcutaneous electrical nerve stimulation on salivary flow rate in radiation induced xerostomia patients: a pilot study. J Cancer Res Ther 2015; 11(1):229-33. https://doi.org/10.4103/0973-1482.138008

Ojha S, Bhovi TV, Jaju PP, Gupta M, Singh N, Shrivastava K. Effectiveness of transcutaneous electrical nerve stimulation on saliva production in post-radiated oral cancer patients. J Indian Acad Oral Med Radiol 2016; 28(3):246-51. https://doi.org/10.4103/0972-1363.195664

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Published

2021-10-31

How to Cite

Chhugani, S. ., Chhugani, G. K. ., Pratap, A. S. V. ., Adwani, L. ., Jain, S., & Patil, S. R. . (2021). Effectiveness of Transcutaneous Electrical Nerve Stimulation Therapy on whole Salivary Flow in Patients with Xerostomia and Healthy Adults. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 21, e0008. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/573

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