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

Satish Chhugani,Lokesh Adwan,Santosh Rayagouda Patil,Abhishek Sahu Vishwa Pratap,Supreet Jain,Gunjan Khatwani Chhugani

doi:10.1590/pboci.2021.166

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 0.05). Conclusion: TENS can be an effective therapy in increasing whole salivary flow rates in patients with xerostomia.

Highlights

In humans, the saliva is secreted by three pairs of major salivary glands, the parotid, the submandibular and the sublingual glands and in addition, 600-1,000 minor salivary glands line the oral and pharyngeal mucosa, which contributes a small portion of total salivary production [1,2].Salivary gland hypofunction or hyposalivation is the condition of having reduced saliva production due to various causes, leading to the subjective complaint of oral dryness, which is termed xerostomia
There was an 85.71% increase in salivary flow, i.e., 0.13 ± 0.03 mL/min, during the transcutaneous electrical nerve stimulation (TENS) application and the difference was highly significant (p
Method unstimulated saliva collection was similar to Aagaard et al [11], except a graduated tube was used in place of a preweighed cylinder and stimulated saliva collection was similar to Hargitai et al [4]

Summary

Introduction

Salivary gland hypofunction or hyposalivation is the condition of having reduced saliva production due to various causes, leading to the subjective complaint of oral dryness, which is termed xerostomia. It leads to numerous oral sequelae, including mucosal dryness, difficulty in mastication, deglutition and articulation, burning and pain of oral mucosa, propensity to damage of oral mucosa and recurrent infections, demineralization of teeth and increase in caries, dysgeusia, halitosis and difficulty to wear the dentures [3]. Neural electrostimulation of salivary gland function by applying electric current, through the oral mucosa, on afferent nerve pathway receptors has been reported to increase saliva production and reduce the symptoms of xerostomia [6]

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Discussion

Conclusion