How does RLT help?
There are many ways that red light therapy (RLT) may benefit your oral health: from overall mouth pain to fighting viral/bacterial infections to improving tooth sensitivity to fighting gum disease and gingivitis – the research continues to demonstrate numerous benefits to oral health via RLT.
Harvard professor Dr. Michael Hamblin, PhD, one of the top RLT researchers in the world, has observed that red/NIR light can be used with a variety of dental procedures to enhance the outcomes and accelerate the healing process.
LED light, which is emitted from all BioLight panels, serves as a safer alternative light source because it does not generate significant heat. High-powered lasers used for photobiomodulation therapy generate heat that may injure periapical (end of the roots of teeth) tissues.
Tell me more...
Red light therapy, also known as low-level laser therapy (LLLT), has also been shown to have a significant bactericidal potential without causing damage to the oral tissues. This effect has been documented both in vitro, on diverse microbial species, and in vivo, in the treatment of gingivitis, periodontitis and other oral diseases.
LLLT has been proposed to increase bone remodeling and tooth movement with the benefits like decreased pain and inflammation, collagen stimulation, and cell proliferation.
Long-term orthodontic treatment is a major concern for patients, and reducing this time requires an increase in orthodontic tooth movement. One meta-analysis demonstrated that RLT significantly increased the orthodontic tooth movement of human canine in the patients compared with the controls after 21 days, one month, 1.5 months, two months, three months, & 4.5 months.
Microbial infection plays an important role in persistent periapical lesions. Insufficient disinfection of root canals would lead to treatment failure and persistent periapical pathology. Factors such as anatomical complexities, bacterial growth as biofilm, render complete disinfection of the root canal system almost impossible.
E. faecalis is a gram positive anaerobic coccoid, which is more resistant to mechanical instrumentation and irrigation with antimicrobial agents and has the ability to adapt to the harsh environmental condition in instrumented and medicated root canals.
Gram-negative bacteria are less susceptible to photoinactivation than gram-positive species. Furthermore, RLT significantly reduces the counts of E. faecalis in infected root canals compared to traditional endodontic instrumentation/irrigation treatment protocols; however controversial results have been reported.
Advantages of RLT include immediate effects, selectivity, access to complex areas such as furcation, pits over the root, decreasing the possibility of bacteremia in immunocompromised systemic patients, decreasing dentin sensitivity after root planning, decreasing patient discomfort, pain, and edema after surgery, low cost and time saving and avoidance of interfering with normal flora of adjacent tissues. Furthermore, it has low toxicity and causes minimal damage to host tissue.
Studies reporting the effectiveness of alternative treatments like diode lasers for dentin hypersensitivity have been appearing with increasing frequency. Reduction of hypersensitivity at seven days achieved by LLLT suggests the need for long-term, large sample-sized clinical studies in order to better understand the performance of RLT when compared to desensitizer applications. However, the advantages and limitations of RLT treatments for clinical use have not yet been fully clarified.
What does the research show?
“The clinical analysis showed that PBMT reduced edema and improved the repair of oral mucosa at 7 days after surgery… Dual-wavelength PBMT improved the post-operative clinical course in patients undergoing lower third molar extraction, without altering bone repair.” (1)
“PBM therapy showed a positive effect on implant stability during the early stages of healing and can be considered for patients with dental implants.” (2)
“Photobiomodulation, in particular, red laser protocols, resulted in improvement in pain and in quality of life of burning mouth syndrome patients.” (3)
(Regarding oral ulcers): “PBM treatment affects macrophage polarization and enhances wound healing.” (4)
(Regarding dry sockets): “PBMT following MC and Alveogyl dressing is more efficient in reducing post-operative pain compared with MC with or without Alveogyl dressing in patients with alveolar osteitis (i.e., dry socket).” (5)
Pesevska S and colleagues compared low level laser and fluoride therapy and observed complete resolution of pain achieved in 86.67% of the laser-treated group, compared to 26.67% of the control group with topical fluoride treatment. (6)
Researchers have shown that the use of the diode lasers at wavelengths in the visible and near-infrared regions may lead to an increase in the resistance of teeth against demineralization (enamel erosion). (7)
"The results of this research show that photodynamic therapy (PDT) could be an effective supplement in root canal disinfection. PDT using LED lamp was more effective than diode laser 810nm in reducing CFUs of E. faecalis in human teeth." (8)
"Based on the findings of the present study, it can be concluded that LLLT is an effective modality for the treatment of aphthous ulcers (canker sores). Not only does LLLT reduce the healing time, it also provides immediate pain relief." (9)
"The LLLT can speed up the rate of tooth movement of human canine and consequently decrease the treatment time. LLLT represents a proper adjuvant therapy for fixed orthodontic treatment." (10)
This study suggests that RLT with LED lights provides a significant further reduction in CFU (colony-forming units) counts after irrigation with NaOCl and can serve as an effective method in reducing the bacterial load within the root canal system. (11)
"Reduction of hypersensitivity at 7 days achieved by LLLT suggests the need for long-term and large sample-sized clinical studies in order to better understand the performance of this treatment when compared to desensitizer applications." (12)
"LLLT had an inhibitory effect on typical oral microbial biofilms, and this capacity can be altered according to the interactions between different species." (13)
"Conclusion: LLLT is effective in the treatment of denture stomatitis." (14)
**While the current scientific research seems to indicate many positive benefits of RLT in relation to oral health pathologies, there is still an appreciable necessity for more extensive research to be conducted in this area, including double-blind RCT (randomized controlled trials), to provide a more comprehensive, robust overview that will further elucidate the optimal parameters & appropriate uses of RLT, which will ultimately lead to the most safe & efficacious uses for individuals dealing with oral health impairments.
(1) Pereira, Davisson Alves et al. “Effect of the association of infra-red and red wavelength photobiomodulation therapy on the healing of post-extraction sockets of third lower molars: a split-mouth randomized clinical trial.” Lasers in medical science vol. 37,5 (2022): 2479-2487. doi:10.1007/s10103-022-03511-5
(2) Vande, Aaditee et al. “Effectiveness of the photobiomodulation therapy using low-level laser around dental implants: A systematic review and meta-analysis.” Dental and medical problems vol. 59,2 (2022): 281-289. doi:10.17219/dmp/143242
(3) Camolesi, Gisela Cristina Vianna et al. “Efficacy of photobiomodulation in reducing pain and improving the quality of life in patients with idiopathic burning mouth syndrome. A systematic review and meta-analysis.” Lasers in medical science vol. 37,4 (2022): 2123-2133. doi:10.1007/s10103-022-03518-y
(4) Ryu, Hyun Seok et al. “Improved healing and macrophage polarization in oral ulcers treated with photobiomodulation (PBM).” Lasers in surgery and medicine vol. 54,4 (2022): 600-610. doi:10.1002/lsm.23510
(5) ALHarthi, Shatha S et al. “Photobiomodulation for Managing "Dry Socket": A Randomised Controlled Trial.” International dental journal, S0020-6539(22)00114-9. 5 Jul. 2022, doi:10.1016/j.identj.2022.06.002
(6) Pesevska, S., Nakova, M., Ivanovski, K., Angelov, N., Kesic, L., Obradovic, R., … Nares, S. (2009). Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment. Lasers in Medical Science, 25(5), 647–650. doi:10.1007/s10103-009-0685-0
(7) de-Melo, M. A. S., Passos, V. F., Alves, J. J., Barros, E. B., Santiago, S. L., & Rodrigues, L. K. A. (2010). The effect of diode laser irradiation on dentin as a preventive measure against dental erosion: an in vitro study. Lasers in Medical Science, 26(5), 615–621.doi:10.1007/s10103-010-0865-y
(8) Asnaashari, M., Mojahedi, S. M., Asadi, Z., Azari-Marhabi, S., & Maleki, A. (2016). A comparison of the antibacterial activity of the two methods of photodynamic therapy (using diode laser 810 nm and LED lamp 630 nm) against Enterococcus faecalis in extracted human anterior teeth. Photodiagnosis and Photodynamic Therapy, 13, 233–237.doi:10.1016/j.pdpdt.2015.07.171
(9) Aggarwal H, Singh MP, Nahar P, Mathur H, Gv S. Efficacy of low-level laser therapy in treatment of recurrent aphthous ulcers - a sham controlled, split mouth follow up study. J Clin Diagn Res. 2014;8(2):218–221. doi:10.7860/JCDR/2014/7639.4064
(10) Imani, M., Golshah, A., SafariFaramani, R., & Sadeghi, M. (2018). Effect of Low-level Laser Therapy on Orthodontic Movement of Human Canine: a Systematic Review and Meta-analysis of Randomized Clinical Trials. Acta Informatica Medica, 26(2), 139. doi:10.5455/aim.2018.26.139-143
(11) Rios, A., He, J., Glickman, G. N., Spears, R., Schneiderman, E. D., & Honeyman, A. L. (2011). Evaluation of Photodynamic Therapy Using a Light-emitting Diode Lamp against Enterococcus faecalis in Extracted Human Teeth. Journal of Endodontics, 37(6), 856–859.doi:10.1016/j.joen.2011.03.014
(12) Orhan, K., Aksoy, U., Can-Karabulut, D. C., & Kalender, A. (2010). Low-level laser therapy of dentin hypersensitivity: a short-term clinical trial. Lasers in Medical Science, 26(5), 591–598. doi:10.1007/s10103-010-0794-9
(13) Basso, F. G., Oliveira, C. F., Fontana, A., Kurachi, C., Bagnato, V. S., Spolidório, D. M. P., … Costa, C. A. de S. (2011). In Vitro effect of low-level laser therapy on typical oral microbial biofilms. Brazilian Dental Journal, 22(6), 502–510. doi:10.1590/s0103-64402011000600011
(14) Maver-Biscanin, M., Mravak-Stipetic, M., & Jerolimov, V. (2005). Effect of Low-Level Laser Therapy on Candida albicans Growth in Patients with Denture Stomatitis. Photomedicine and Laser Surgery, 23(3), 328–332.doi:10.1089/pho.2005.23.328