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Oral Health
Published on
October 12, 2026

José Alves A. et al. - Photobiomodulation versus TENS in Temporomandibular Disorders: A Systematic Review

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This systematic review of 14 studies (620 patients) compares photobiomodulation and transcutaneous electrical nerve stimulation (TENS) for temporomandibular disorders. While more studies report better numerical outcomes with photobiomodulation, the quality of the evidence is limited, and no conclusion regarding superiority can be drawn.

What this study measured

Temporomandibular disorders are among the most common causes of chronic facial pain. Photobiomodulation and TENS are two widely used conservative treatments, but it is unclear which is more effective. This review directly compares the two and assesses the methodological quality of the studies.

Augusto José Alves and his colleagues conducted a systematic review in accordance with PRISMA guidelines, with the protocol registered on PROSPERO. Five databases were searched (Medline, Web of Science, Scopus, Cochrane, Embase), with no restrictions on date or language. Of 402 references, 14 studies were included, involving 620 patients with joint pain, muscle pain, or disc displacement. The quality of the reports was assessed using an adapted CONSORT checklist.

Key Findings

The authors were unable to pool the data in a meta-analysis. The abstract describes the following trends.

  • Pain: A greater number of studies report a numerically greater improvement with photobiomodulation than with TENS
  • Maximum mouth opening: the same trend in favor of photobiomodulation
  • Report quality: 12 out of 14 studies are classified as Level III, indicating limited report quality
  • The authors' conclusion: Both approaches could improve pain and mandibular function

How photobiomodulation works for this indication

The abstract does not describe any specific mechanism. Generally speaking, it is proposed that red or near-infrared light, absorbed by mitochondrial cytochrome c oxidase, may modulate inflammation and pain perception in the muscles and joints of the jaw. TENS, on the other hand, works by electrically stimulating the nerves. These explanations remain hypotheses, which this review does not test.

Limits You Should Know

The authors emphasize the need for caution. Diagnoses, treatment protocols, and measurement criteria vary widely across studies. There is no quantitative synthesis, and therefore no numerical estimate of the difference between the two approaches. A majority of the studies are of limited methodological quality. The observed differences are described as numerical: they prove neither superiority nor equivalence. The summary also provides no data on adverse effects or long-term follow-up.

What This Means in Practice

For affected individuals and healthcare professionals, this review indicates that photobiomodulation and TENS are two plausible conservative treatment options, although it is not possible to determine which is better. The choice depends on the diagnosis, availability, and the practitioner’s judgment. Neither of these approaches replaces an evaluation and follow-up by a healthcare professional. Better-reported trials are needed, with common diagnostic criteria, detailed descriptions of photobiomodulation protocols, and a direct comparison of the two approaches over a sufficiently long follow-up period.

Frequently Asked Questions

Is photobiomodulation more effective than TENS for jaw pain?

More studies report better numerical results with photobiomodulation for pain and mouth opening. The authors, however, decline to conclude that it is superior, due to the lack of a quantitative synthesis and the heterogeneity of the studies.

How many studies and patients were analyzed?

The review includes 14 studies and 620 patients, selected from 402 references. Twelve of the 14 studies are classified as Level III in terms of report quality.

Do these two methods improve jaw function?

According to the authors, both could improve pain and mandibular function, with the caveat that these results should be interpreted with caution.

Reference

Alves AJ, Braz CDV, Mourão ELS, Oliveira JEM, Souza NR, Paiva PCP, Flecha OD, Leonan-Silva B. Comparative efficacy of photobiomodulation therapy and transcutaneous electrical nerve stimulation for temporomandibular disorders: a CONSORT-based methodological appraisal. Swiss Dental Journal, 2026. PMID 42817778. View the study on PubMed

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.