Efficiency of Transcutaneous Electrical Nerve Stimulation and Piroxicam to Alleviate Pain During Orthodontic Tooth Separation - A Prospective Study

Objective: This study was conducted to assess the effectiveness of TENS in comparison with TENS-Placebo and prophylactic Piroxicam (20 mg) for pain control before orthodontic tooth separation by Elastomeric separators, Brasswire and Kesling separators. Study design: 108 patients seeking orthodontic treatment were categorically administered extraoral TENS, TENS-Placebo and Piroxicam (20 mg) using Elastomeric, Kesling and Brasswire separators prior to their orthodontic treatment. The subjects were instructed to rate their pain 2, 6, 12, 24 and 48 hours after the procedure on a Visual Analog Scale. Results: No statistically significant difference was found in the mean VAS scores when TENS group was compared with Piroxicam. However, significant differences were found between the mean VAS scores when placebo TENS group was compared to the aforementioned groups. Maximum pain was perceived at 24 hours with elastomeric and Kesling springs, but brasswire separators were most painful 6 hours after placement altogether. At all time stamps, pain felt was significantly less with brasswire separators than elastomeric separators and Kesling springs. Conclusion: TENS was found to be equally effective in reducing pain as Piroxicam. TENS could be thus stated as an effective pain management modality which is safe, comfortable and easy to use and also eliminates adverse drug effects of NSAIDs like GI irritation and reduced orthodontic tooth movement.