"Open wide!"
This phrase fills the best of us with such dread. Is it the procedure that scares us, or something else?
Check-ups, fillings, extractions, and drilling sessions… the process can be grueling, but it's the lingering, achy pain and the days of being stuck on a liquid diet that many people fear the most. No wonder we need a bravery sticker after each visit!
Oral health is more than just the visual appeal
In today's world of Zoom calls, social media videos, and selfies, everyone wants a nice smile. But taking care of our oral health isn't just about looking good; it's also important for our overall health.
Regular trips to the dentist are important to catch and treat issues like cavities and gum disease early. Some studies have found connections between poor oral health and heart disease [1] (the No.1 killer of Americans) and there’s increasing evidence to show that the health of the gut microbiome starts in our mouth [2]. That makes sense right?! The mouth is the gatekeeper of the gut.
Does Red Light Therapy have a role to play in dental health?
An emerging technology holds the potential to assist the body in temporarily managing pain, inflammation, and more throughout dental procedures.
Red light therapy offers a non-invasive approach that may temporarily reduce pain and inflammation, and support the body’s natural ability to heal [3].
Red light therapy harnesses the power of red (visible) and near-infrared (invisible) light, delivering them at a high enough intensity that these wavelengths reach into our cells to support energy production. How?
By targeting the mitochondria, the powerhouses of our cells, where all this energy is made in the form of ATP. More efficient mitochondria = healthier cells = better cell rejuvenation and repair.
Red light therapy also targets several other pathways, including the production of reactive oxygen species (ROS). In small amounts, these molecules act as ‘healthy stress’ to the cell, stimulating it to produce more antioxidants, thus lowering inflammation. This is similar to the benefits of exercise where the right amount of stress brings about positive changes in the body.
Red light therapy has been shown to lower inflammation [3, 4, 5, 6]. Since inflammation underlies so many conditions in the mouth (e.g. periodontitis), a temporary reduction of inflammation is desirable.
Additionally, red light therapy may trigger the release of nitric oxide. Nitric oxide acts as a vasodilator in our body. This means the blood vessels relax and widen, allowing more blood to flow through them to support tissue repair. [4]
We interviewed holistic dentist Dr. Leedia to get her take on Red Light Therapy in dental health
Dr. Leedia, why do you recommend the use of red light therapy in your practice?
“As an integrative & holistic dentist, I believe in the power of the human body. There is so much power in tools like appropriate supplementation, meditation, nutrition, and various adjunctive remedies to help optimize cellular function and aid in the healing process after a dental procedure.
Red light therapy is one of these adjunct tools that I find to be integral in supporting the optimization of the healing process.
LUMEBOX’s red light therapy helps with wound healing and cellular repair by optimizing cellular function. I’ve also seen it to help with postoperative, TMJ, and muscular discomfort after dental procedures (especially longer appointments). And last but not least, it helps reduce inflammation in soft tissue, and optimize bone regeneration after implants and extractions.”
Can you give an example of how you’ve suggested the use of red light therapy to your patients?
“For our famous root canal prevention procedure that we often perform to try to save teeth from needing unnecessary/preventable root canals. There’s nothing like supporting the blood supply, nerve supply, and lymph supply to teeth with deep cavities to decrease the potential need for a root canal. Using the LUMEBOX 1 or 2 times per day for 10 minutes each session aids in doing that!”
Have you seen results in your patients?
Yes!
“After performing an integrative dental extraction, in which we utilize tools such as PRF, ozone, and laser therapy to remove infection (most often caused by an infected root canal), we always recommend the LUMEBOX to help with pain support, bone regeneration, inflammation reduction, and mitochondrial function optimization. We see a difference between patients who consistently utilize this healing tool vs. those who don’t.”
Why are dentists using Red Light Therapy on their patients?
In summary, these are the 4 main reasons red light therapy may be helpful for dental health.
-
A healthy inflammatory response in common dental conditions
e.g. gum diseases and post-operative discomfort - Pain and discomfort
- Oral tissue healing
- Blood flow in the tissues
Let’s have a look at some studies, shall we?
Red Light Therapy and oral health science
Study #1: Pain Reduction in TMD
One randomized, controlled, double-blind, clinical trial studied the effects of red and near-infrared LED light on pain levels in individuals with temporomandibular disorder (TMD), one of the most common orofacial pains. [7] Temporomandibular joint disorders cause pain, discomfort, and restricted jaw movement, and around 95% of cases of orofacial pain result from dental conditions [8] like toothaches, inflammation, and abscesses. After dental pain, pain from the joint itself is the second most common cause of TMD.
In this study, 18 participants were randomly split into a control or light treatment group. The control followed the same protocol but the red light device was switched off (i.e. they didn’t get red light therapy).
The light treatment group received:
- RED at 660 nm and NIR at 850 nm
- Delivered through 36 LEDs, each bulb with an irradiance of 4.45 mW/cm2
- Device attached to the side of the face covering TMJ muscles and joints
- Treatment for 20 minutes, 3 times per week on non-consecutive days for 2 weeks
- Total 6 treatment sessions
- Total dose 907.2 J after the end of treatment
Pain intensity was measured using the VAS - also known as the Visual Analog Scale, a standardized method used in studies to measure pain. VAS was used here, and evaluated before treatment, immediately after the first LED session, and after all 6 sessions.
The results: “Pain intensity was significantly lower in the LED group compared to the control group at the end of treatment, as well as in the comparison between the pretreatment and end of treatment evaluations.”
Study #2: Combined Laser and LED Therapy for TMD Pain
A separate randomized, placebo-controlled, double-blind, clinical trial [9] looked at the effect of light therapy (combined laser and LED) on TMD-related pain. 30 women received:
- Either red light therapy treatment or a control
- Device delivering 1 super pulsed infrared laser (905 nm, 0.27 J), 4 RED LEDs (640 nm, 15mW), 4 NIR LEDs (875 nm, 17.5 mW)
- 6 sessions of 5 minutes
- Total dose: 39.27
Again, pain was measured on a VAS scale. The analysis showed that “active photobiomodulation was significantly more effective than placebo photobiomodulation after 48 h and after six sessions”. Photobiomodulation is a term used to describe red light therapy here.
Study #3: Reduction of dental plaque using red LED
A clinical trial [10] was conducted with 20 healthy volunteers to assess the impact of photodynamic therapy on dental plaque formation. The study specifically examined the growth of S. oralis bacteria, which is known as an initial colonizer in plaque formation on teeth. The study was conducted in a randomized, single-blind design where each subject received a test and control treatment on a separate side of the mouth.
First, photosensitizer was applied to the teeth on the side of the mouth that was going to receive red light therapy. A photosensitizer acts as a special ingredient to enhance the effectiveness and precision of red light therapy. In this case, it makes the red light more efficient at targeting and destroying infections while promoting healing.
Next LED red light was delivered:
- 660 nm wavelength
- 940 mW/cm² irradiance (this is very high - red light from LUMEBOX is 125 mW/cm2)
- Delivered for 80 seconds to two premolar teeth
- Total dose was 24.8J for each tooth
- Light applied 2x per day (morning and evening) 6 times total
- The volunteers were not allowed to brush these teeth or use mouthwash for the 4 days of testing.
On the 4th day, the “total number of bacteria in the dental plaque was significantly lower … in the photodynamic therapy group compared to the control group”. See the images below - areas of red show the remaining plaque after the 4 days. The left side is after red light treatment, and the right side is the control.
Laser studies are the bulk of the research
As demonstrated above, LED technology is emerging in clinical trials and dentistry. However, there have only been a few studies using solely red LED light for dental health. Most research has been done studying red and near-infrared laser devices for treatments like root canal therapy [11], bone metabolism [12], and periodontitis treatment [13, 14]. As a result, a lot of dentists still use lasers in their practices.
Some blogs will extrapolate the results from laser studies and apply them directly to LED lights. We are not here to say they will work equally as well, but we can present some solid evidence that shows potential for the future of both laser and LED red light therapy.
Study #1: Pain reductions with near-infrared laser
A systematic review [11] honed in on 7 randomized control studies that used different types of red light laser treatment to help with pain when biting, inflammation-related tooth pain, or pain from abnormal growth in the teeth. The wavelengths ranged between 800-970 nm, with most studies emitting 100mW/cm2 irradiance, delivered to the tooth for 60 -180 seconds, within 1cm of the tooth or tissue.
“Most of them revealed that LLLT (or red light therapy) significantly reduced the pain intensity” after treatment, and of the three studies that reported on painkiller use, two showed that fewer patients needed painkillers after laser therapy compared to the control group.
Studies #3 & 4: Lasers in Orthodontics
Two randomized controlled trials investigated whether red laser light could aid orthodontic remodeling or bone healing to support tooth movement or implant stability after orthodontic treatment. (Unfortunately, there are no LED studies specifically addressing this yet).
#3: The first was a split-mouth study [12] on 12 patients. After a molar was extracted from each side of the mouth and orthodontic brackets were fixed (to align and move the teeth in a desired direction), one side of the mouth was randomly chosen to receive the red light therapy treatment:
- Near-infrared laser (810 nm)
- Power 100 mW delivering 6.29J/cm2
- Applied to 4 sites around the implant for 40 seconds at a time.
- The patients received this treatment once a week for 3 weeks.
Results: the teeth in the red light therapy group moved in the desired direction significantly quicker compared to the control group over 4 weeks. Additionally, there were significant changes in the levels of proteins that regulate bone metabolism and inflammation, which can be very useful for orthodontists when remodeling the mouth.
#4: In the second laser study [15], across 24 patients, 40 implants total were inserted. Half of the patients were assigned to a control group while the other half received red light therapy.
- Red wavelengths (635 nm)
- Irradiance 199 mW/cm2
- Total dose 48J
- Laser applied to 2 points for 40 seconds each, 1 day before surgery, immediately after, and 2, 4, 7, and 14 days after.
The result?
“Subjects irradiated with [red light therapy] accounted for significantly greater secondary stability (after 4 weeks) and bone density (after 12 weeks) in contrast to nonirradiated subjects”.
Grayscale values were also measured–a lower grayscale value can indicate lower bone density, in other words, less healing and stability. After 12 weeks, the grayscale value was significantly higher around the implants in the red light therapy group!
How do laser and LED compare?
Laser and LED treatments differ slightly in their application and the type of light they use, so they are not entirely comparable. You can read more about their differences on our blog.
However, both laser and LED red light therapy could be viable options for managing pain and inflammation after surgery and for supporting healthy tissue.
LED performed better than laser in this study:
This study used photodynamic therapy (a type of red light therapy that applies a photosensitizer before light treatment) and compared near-infrared laser treatment with red LED light [16]. This study was done on 56 freshly extracted adult teeth in a lab. Root canals infected with a bacteria (E. faecalis) received light treatment, delivered with either:
- Near-infrared laser light, at 810 nm, 4 times for 8 seconds, every 10 seconds.
- Red LED light, at 660 nm, for 30 seconds, with irradiance of 200 mW/cm2.
The results aren’t what you’d expect… LED performed better than laser treatment! Both the “laser and LED group had significantly lower colonies compared to the control group” and “microbial load reduction in LED group was significantly higher than laser group”.
So, red light might also provide the antimicrobial benefits of blue light too… time will tell as research on this continues!
What other potential does red light technology hold?
Red light therapy is a great adjunct to the practices above, but it isn’t just a tool for teeth.
Red light therapy (RLT) is best known for its skin health benefits and may reduce the appearance of fine lines and breakouts. Many people also use RLT to ease muscle and joint pain, as well as support rest, energy, mood, and promote healthy inflammatory responses throughout the body.
New to red light therapy? Download our free eBook to help you choose the best device.
Already have a LUMEBOX? Download our 6 time-saving tricks guide!
Medical Disclaimer: The information contained in this blog post is intended for educational purposes only and should not be used as medical advice. Everyone responds to light differently. Testimonials are not a guarantee of the results you or anyone who uses LUMEBOX will get because your success depends entirely on your circumstances, and the studies on red light therapy shared were not specifically performed using LUMEBOX. Please check with your doctor before using red light therapy and do not change your medical treatments or lifestyle without consulting your physician first.
References:
[1] Kotronia, E., Brown, H., Papacosta, A. O., Lennon, L. T., Weyant, R. J., Whincup, P. H., Wannamethee, S. G., & Ramsay, S. E. (2021). Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA. Scientific reports, 11(1), 16452. https://doi.org/10.1038/s41598-021-95865-z
[2] Park, S. Y., Hwang, B. O., Lim, M., Ok, S. H., Lee, S. K., Chun, K. S., Park, K. K., Hu, Y., Chung, W. Y., & Song, N. Y. (2021). Oral-Gut Microbiome Axis in Gastrointestinal Disease and Cancer. Cancers, 13(9), 2124. https://doi.org/10.3390/cancers13092124
[3] Hamblin M. R. (2017). Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS biophysics, 4(3), 337–361. https://doi.org/10.3934/biophy.2017.3.337
[4] de Freitas, L. F., & Hamblin, M. R. (2016). Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE journal of selected topics in quantum electronics : a publication of the IEEE Lasers and Electro-optics Society, 22(3), 7000417. https://doi.org/10.1109/JSTQE.2016.2561201
[5] Serafim, K.G.G., Ramos, S., de Lima, F.M. et al. Effects of 940 nm light-emitting diode (led) on sciatic nerve regeneration in rats. Lasers Med Sci 27, 113–119 (2012). https://doi.org/10.1007/s10103-011-0923-0
[6] Langella, L. G., Casalechi, H. L., Tomazoni, S. S., Johnson, D. S., Albertini, R., Pallotta, R. C., Marcos, R. L., de Carvalho, P. T. C., & Leal-Junior, E. C. P. (2018). Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty-a randomized, triple-blind, placebo-controlled clinical trial. Lasers in medical science, 33(9), 1933–1940. https://doi.org/10.1007/s10103-018-2558-x
[7] de Sousa, D. F. M., Malavazzi, T. C. D. S., Deana, A. M., Horliana, A. C. R. T., Fernandes, K. P. S., Bussadori, S. K., & Mesquita-Ferrari, R. A. (2022). Simultaneous red and infrared light-emitting diodes reduced pain in individuals with temporomandibular disorder: a randomized, controlled, double-blind, clinical trial. Lasers in medical science, 37(9), 3423–3431. https://doi.org/10.1007/s10103-022-03600-5
[8] Tecco, S., Ballanti, F., & Baldini, A. (2018). New Frontiers in Orofacial Pain and Its Management. Pain research & management, 2018, 6286717. https://doi.org/10.1155/2018/6286717
[9] Herpich, C. M., Leal-Junior, E. C. P., Politti, F., de Paula Gomes, C. A. F., Dos Santos Glória, I. P., de Souza Amaral, M. F. R., Herpich, G., de Azevedo, L. M. A., de Oliveira Gonzalez, T., & Biasotto-Gonzalez, D. A. (2020). Intraoral photobiomodulation diminishes pain and improves functioning in women with temporomandibular disorder: a randomized, sham-controlled, double-blind clinical trial : Intraoral photobiomodulation diminishes pain in women with temporomandibular disorder. Lasers in medical science, 35(2), 439–445. https://doi.org/10.1007/s10103-019-02841-1
[10] Ichinose-Tsuno, A., Aoki, A., Takeuchi, Y., Kirikae, T., Shimbo, T., Lee, M. C., Yoshino, F., Maruoka, Y., Itoh, T., Ishikawa, I., & Izumi, Y. (2014). Antimicrobial photodynamic therapy suppresses dental plaque formation in healthy adults: a randomized controlled clinical trial. BMC oral health, 14, 152. https://doi.org/10.1186/1472-6831-14-152
[11] Chen, Y., Chen, X. L., Zou, X. L., Chen, S. Z., Zou, J., & Wang, Y. (2019). Efficacy of low-level laser therapy in pain management after root canal treatment or retreatment: a systematic review. Lasers in medical science, 34(7), 1305–1316. https://doi.org/10.1007/s10103-019-02793-6
[12] Zheng, J., & Yang, K. (2021). Clinical research: low-level laser therapy in accelerating orthodontic tooth movement. BMC oral health, 21(1), 324. https://doi.org/10.1186/s12903-021-01684-z
[13] Malgikar, S., Reddy, S. H., Sagar, S. V., Satyanarayana, D., Reddy, G. V., & Josephin, J. J. (2016). Clinical effects of photodynamic and low-level laser therapies as an adjunct to scaling and root planing of chronic periodontitis: A split-mouth randomized controlled clinical trial. Indian journal of dental research : official publication of Indian Society for Dental Research, 27(2), 121–126. https://doi.org/10.4103/0970-9290.183130
[14] Pamuk, F., Lütfioğlu, M., Aydoğdu, A., Koyuncuoglu, C. Z., Cifcibasi, E., & Badur, O. S. (2017). The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non-smoking chronic periodontitis patients: A split-mouth, randomized control study. Journal of periodontal research, 52(5), 872–882. https://doi.org/10.1111/jre.12457
[15] Matys, J., Świder, K., Grzech-Leśniak, K., Dominiak, M., & Romeo, U. (2019). Photobiomodulation by a 635nm Diode Laser on Peri-Implant Bone: Primary and Secondary Stability and Bone Density Analysis-A Randomized Clinical Trial. BioMed research international, 2019, 2785302. https://doi.org/10.1155/2019/2785302
[16] 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. https://doi.org/10.1016/j.pdpdt.2015.07.171
