Advanced Lasers and Their Applications in Dentistry

By Dr. Noopur JainReviewed by Louis CastelDec 19 2025

In a recent article published in Dentistry journal, researchers provided an overview of the pivotal role lasers play in contemporary dentistry, covering a broad range of clinical applications from caries management and pulp-related interventions to the treatment of periodontal diseases and oral mucosal conditions.

Image Credit: Lee Charlie/Shutterstock.com

Background

Lasers are increasingly integrated into contemporary dental care, spanning a broad spectrum of clinical applications. In terms of fundamental operation, lasers are utilized to modify the surfaces of various dental biomaterials, including implants and ceramics, to enhance their optical, tribological, and biological surface properties. For instance, laser modification of implants has been shown to improve osseointegration and reduce the incidence of peri-implant inflammation. In therapeutic applications, lasers are used for biostimulation through photobiomodulation therapy (PBM), which activates regenerative and healing processes, thereby minimizing post-operative pain and inflammation. Another powerful optical technique is photodynamic therapy (PDT), a non-invasive approach effectively used to eliminate pathogenic microorganisms and undesirable eukaryotic cells in the treatment of pre-neoplastic and neoplastic diseases within the oral cavity. High-power lasers have also gained acceptance in therapeutic protocols due to their ability to facilitate less invasive dental procedures.

Studies Highlighted in This Review

The review highlights numerous applications across various oral disease categories, emphasizing the specific laser types and their optical effects on tissue. Laser fluorescence serves as a diagnostic tool for early caries detection and monitoring the carious process over time due to its high reproducibility. Therapeutically, lasers are applied for caries removal, cavity preparation, and remineralization promotion.

Lasers are crucial in managing dentine hypersensitivity and performing vital or non-vital pulp therapies. Laser Doppler flowmetry is used as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. In root canal disinfection, various laser therapies, especially when combined with common antimicrobial irrigants through antimicrobial photodynamic therapy (aPDT), provide a synergistic effect against persistent infections. However, defining the optimal parameters for laser therapy in root canal disinfection remains a challenge, necessitating more standardized protocols.

Periodontal diseases (like periodontitis) and peri-implant diseases (like peri-implantitis) are managed using anti-infective strategies, where lasers play a diagnostic and therapeutic role. Lasers can detect subgingival calculus using fluorescence. For non-surgical and surgical therapies, different laser types, including CO₂, Diode, Er,Cr:YSGG, Er:YAG, and Nd:YAG lasers, are employed. These lasers are used for calculus removal, reduction of bacteria (via aPDT), anti-inflammation (via PBM), and surgical tasks such as incising gingiva, ablating bone tissue, and promoting tissue healing.

Lasers are utilized for surgical treatment of common mucosal diseases, premalignant lesions, and oral malignancies. Photodynamic therapy has been highlighted as an effective approach in treating pre-neoplastic and neoplastic diseases. Lasers also play a preventative role in managing oral mucosal diseases in specific cancer patient populations.

In orthodontics, lasers are used for soft tissue surgery, accelerating dental alignment, and improving bracket bonding strength. Furthermore, laser technology is employed to accelerate bone regeneration.

Discussion

While laser technology offers enhanced precision, minimal invasiveness, and improved outcomes, its adoption faces significant limitations and challenges.

A primary concern is establishing and maintaining a safe environment for both patients and staff. This requires comprehensive knowledge of laser standards, hazard identification, risk assessment, and implementing appropriate control measures. Risk levels vary significantly based on the laser system, delivery device, power parameters, target tissues, and operator experience. Eye protection is critical, as damage to ocular structures depends heavily on the laser's specific wavelength. Clinicians must possess a solid understanding of laser science, including laser types, applications, and safety protocols, as improper settings or use can lead to adverse effects like thermal injury, erythema, hyperpigmentation, and eye damage.

Clinicians often find that achieving proficiency in laser technology requires considerable time and effort, and integrating laser systems into conventional practice workflows can be complex and disruptive. A crucial limitation is the lack of standardized protocols for laser applications across various oral diseases.  Furthermore, the high costs associated with laser procedures frequently result in higher out-of-pocket expenses for patients because insurance may not cover them. Research must continue to better understand tissue response to laser therapy to establish standardized protocols.

Conclusion

Lasers are versatile instruments, applicable across detection, prevention, and restoration for caries; pulp vitality testing and therapy; management of periodontal and peri-implant diseases; treatment of mucosal conditions and malignancies; and even applications in orthodontic therapy. The effectiveness of these optical methods is driven by specific laser-tissue interactions, such as high absorption coefficients (CO₂ lasers in hard tissue), fluorescence for diagnosis, and photothermal or photobiomodulatory effects for therapy. However, the full potential of lasers is currently constrained by the need for more standardized clinical protocols, further research into tissue responses, and addressing the training, safety, and financial challenges associated with integrating this advanced technology into widespread dental practice.