Lasers in Oral Medicine: A Review

Abstract

Lasers have become an integral component of modern oral medicine, transforming both diagnostic and therapeutic approaches through precision, versatility, and minimally invasive techniques. Since their introduction in dentistry, lasers such as CO?, Nd:YAG, erbium-based, and diode systems have been applied in diverse clinical scenarios including oral mucosal lesions, caries management, periodontal therapy, endodontics, and photobiomodulation. Diagnostic applications like optical coherence tomography and laser-induced fluorescence spectroscopy enhance early detection of malignant and potentially malignant disorders, thereby improving prognosis. Therapeutically, lasers provide superior hemostasis, reduced discomfort, faster healing, and improved esthetic outcomes compared to conventional approaches. Low-level laser therapy (LLLT) has shown remarkable benefits in conditions such as oral lichen planus and mucositis, while advanced modalities support both hard and soft tissue interventions. Despite barriers such as high costs and specialized training requirements, technological advancements particularly in nanotechnology, imaging integration, and AI-guided diagnostics promise broader adoption, consolidating lasers as essential tools in the future of oral healthcare.

Introduction

Lasers have become essential in modern oral medicine, offering precise, minimally invasive, and versatile diagnostic and therapeutic options. The acronym LASER stands for Light Amplification by Stimulated Emission of Radiation, describing highly focused light that interacts selectively with tissues. Since their dental introduction in the 1960s, lasers have enabled less painful procedures, faster recovery, and improved clinical outcomes compared to traditional methods. They are used in managing oral mucosal lesions (e.g., aphthous ulcers, leukoplakia, lichen planus), biopsies, pain management, caries detection, periodontal care, and peri-implant procedures. Key benefits include reduced bleeding, better operative visibility, minimal postoperative discomfort, faster healing, and decreased need for sutures or anesthesia.

Principles and Mechanisms:
Laser light is directional, monochromatic, and coherent. Its interaction with tissues depends on wavelength and tissue chromophores (water, hemoglobin, melanin). Effects range from ablation and coagulation to low-level laser therapy (LLLT), which promotes healing and reduces inflammation without tissue damage. Specific lasers are suited to different tissues: CO? for soft tissue, diode for pigmented tissue, Nd:YAG for deep tissue penetration, and Erbium lasers for both hard and soft tissues.

Types of Lasers:

• CO?: Soft tissue surgery, excision, hemostasis.

• Nd:YAG: Periodontal therapy, coagulation, lesion ablation.

• Erbium (Er:YAG, Er,Cr:YSGG): Hard and soft tissue applications including cavity prep, osseous surgery.

• Diode: Soft tissue surgery, photobiomodulation, pain relief.

• Excimer, Helium-Neon, Pulsed Dye: Specialized applications in mucosal disorders and photodynamic therapy.

Therapeutic Applications:
Lasers are effective in managing oral mucosal disorders like lichen planus, leukoplakia, mucositis, and Fordyce granules. LLLT reduces pain, inflammation, and immune response, promoting lesion healing. CO? and diode lasers assist in excision and aesthetic management, while photodynamic therapy helps maintain lesion regression.

Diagnostic Applications:
Lasers enhance early detection of oral malignancies through techniques like optical coherence tomography (OCT) and laser-induced fluorescence. They also improve caries detection (e.g., DIAGNOdent), facilitate minimally invasive biopsies with better hemostasis, and aid in periodontal assessments.

Challenges and Future Directions:
Barriers to widespread use include high cost, need for specialized training, and limited evidence in some areas. However, ongoing technological improvements and research are expanding clinical applications, making lasers increasingly integral to patient-friendly, precise oral healthcare.

Conclusion

Lasers have revolutionized oral medicine by offering precise, minimally invasive, and patient-friendly diagnostic and therapeutic options. Their applications span from caries management and periodontal therapy to early cancer detection and photobiomodulation. Despite challenges such as high costs and specialized training needs, ongoing innovations in laser technology continue to expand their clinical potential. With integration of AI, nanotechnology, and advanced imaging, lasers are poised to become indispensable tools in the future of dentistry.

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Copyright

Copyright © 2025 Dr. Pazhanivel K, Dr. Priya Ramani, Dr. Sarubala Nachiar M, Dr. Sathya V, Dr. Seshmaa S S. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.