Application of Electrical Current in Dental Anesthesia.

Abstract : This work concerns the electrical control of orofacial pain (Electroanalgesia (EA)) by two distinct physiological mechanisms. The writers have used tooth pulp as a model of general orofacial pain in all their studies. One mechanism--gating block ea -- involves diffuse, low intensity stimulation of orofacial skin or mucous membranes, and is apparently effective through the interaction of multiple sensory modalities in the central nervous system. Human experiments have demonstrated that this form of EA has definite analgesic effects, characterized certain features of electrical waveforms and sites of stimulation, and permitted attainment of institutional sanction to begin tests on pathological pain in patients. Experiments in behaving cats have been initiated. Effective EA was demonstrated using subcutaneous stimulation near the mental foramen. The second mechanism -- receptor block EA -- involves localized stimulation at the focus of pain origin. Such effects have historically been attributed to anodal blockade, but the authors success with a novel pulsating direct current waveform suggests subtler mechanisms having superior clinical practicality. The experiments involved acute recording procedures from single pulp-driven units of the Gasserian ganglion in anesthetized cats. Using the pulsating waveform, they demonstrated analgesia equivalent to continuous direct current without its serious side effects.