When most people think about lasers in dentistry, they tend to picture cutting or cauterizing. Those are key tasks, for sure, so lasers are routinely used for procedures like oral surgery and periodontal therapy. They can be used in placing dental restorations or even to brighten smiles – and that’s just the start.
This range is just one reason why lasers have become such a valuable tool in biological dentistry. But it’s not only what lasers can do to dental tissues that matters. It’s also how tissues respond when a laser is thoughtfully used.
Yet these kinds of “hot” laser uses tell only part of the tale – the part that involves heating, cutting, or coagulating. The other part comes courtesy of what was once known as cold laser therapy and is now referred to as photobiomodulation. This nonthermal approach uses specific wavelengths of light at much lower intensities to support how cells function. Instead of changing tissue mechanically, it works at a biological level – supporting circulation, helping regulate inflammation, and encouraging cells to carry out repair more efficiently.
In essence, photobiomodulation (PBM) supports healing by helping tissues respond more effectively at a time when demand is high – like after oral surgery, when tissues are inflamed, vulnerable, and actively repairing themselves. This, in fact, is a key way we use it here in our own office, where we incorporate PBM into procedures such as “cavitation” surgery.
One review of the science looked at PBM in oral surgery, with particular attention to post-op outcomes such as pain, swelling, and limitations in mouth opening after procedures such as tooth extraction and jaw surgery.
Across the 46 clinical trials that the researchers included, many reported reductions in both pain and swelling, as well as trismus (lockjaw) – though specific laser protocols varied a good deal from one study to another. Rather than pointing to one standard protocol, the review reveals a broader pattern: When photobiomodulation is used thoughtfully, it’s often associated with more comfortable recovery during the early healing period.
Altogether, the emphasis has been less on surgical technique, more on observing how tissues behave when supported during a critical window of repair – how the body responds when given conditions that favored healing.
Other studies have sought to understand why light therapy might influence healing in this way. Here’s how it was described in a 2022 review:
The basic mechanism for PBM therapy is that it reacts photochemically with the cells and activates the mitochondria of the cell as it contains chromophores that absorb the photons out of PBM. The chromophores which primarily absorb the red light is the Cytochrome c oxidase (Cco) enzyme which affects the action of several molecules, namely Adenosine triphosphate (ATP), nitr[ic] oxide (NO), reactive oxygen species (ROS), calcium ions.
To put it much more plainly, PBM works when certain colors of light are absorbed by the cell’s mitochondria, the parts that make energy. This nudges the cell to produce more energy and adjust key signaling molecules that may help it function and heal better.
And these effects aren’t just limited to surgical wounds. As a study published last year in the Journal of Clinical Medicine shows, photobiomodulation may be just as helpful in conditions where pain and dysfunction develop over time, such as TMJ disorders.
For this study, the research team focused on a particularly challenging group: patients whose symptoms persisted even after Botox therapy – often a “last resort” treatment in which Botox injections are given in the jaw joints to relieve pain by calming overactive facial muscles.
Ten adults who fit this profile took part and were treated with photobiomodulation once a week for four weeks. The researchers measured pain on a 0-10 scale, tested how much pressure the muscles could tolerate, and checked how wide patients could open their mouths both before and after treatment.
Most patients – 7 out of 10 – had a clear, statistically meaningful reduction in pain. Six in 10 had less popping or clicking in their jaw joints. Most said that their headaches had become less intense, as well. Some improvements in jaw movement were also observed, but these were relatively small.
Ultimately, the authors described their findings as “promising in reducing pain in the masticatory muscles and joint noises, as well as headaches,” but noted that these early results do still need to be confirmed by randomized clinical trials.
All together, studies like these make it quite clear: Whether lasers are being used to support healing after dental treatment or to improve comfort and function in TMJ disorders, the underlying principle is the same – creating conditions in which the body’s natural healing mechanisms can operate more effectively.
