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Lasers to prevent dental caries: a systematic review
Stefano Pagano1, Guido Lombardo1, Massimiliano Orso2
1Department of Surgical and Biomedical Sciences, Unit of Paediatric Dentistry, University of Perugia, Perugia, Italy.
BMJ Open
|October 29, 2020
Summary
Laser treatments show promise in reducing caries when combined with traditional methods, improving sealant retention and fluoride uptake. However, more high-quality research is needed to confirm their effectiveness in caries prevention.
Area of Science:
- Dental science
- Biomedical engineering
- Preventive dentistry
Background:
- Dental caries remains a significant public health concern.
- Traditional prophylactic interventions (TPIs) are standard for caries prevention.
- Lasers offer a novel approach to dental treatments, including caries prevention.
Purpose of the Study:
- To evaluate the efficacy of lasers, used at sub-ablative parameters, in reducing caries incidence.
- To compare laser interventions with traditional prophylactic interventions (TPIs) alone or in combination.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) was conducted.
- Studies published up to December 2019 were sourced from major databases (Medline, Embase, Web of Science, Cochrane Library).
- Data on caries incidence, sealant retention, fluoride uptake, and adverse events were extracted and analyzed narratively due to study heterogeneity.
Main Results:
- Lasers, particularly Er:YAG and CO2 lasers when combined with TPIs, demonstrated effectiveness in reducing caries compared to untreated teeth or TPIs alone.
- Argon lasers significantly enhanced fluoride uptake in enamel.
- Sealant retention improved when enamel fissures were pre-treated with CO2 or Er:YAG lasers before acid etching.
Conclusions:
- While lasers show potential in caries prevention and enhancing TPIs, the current evidence base is limited by a high risk of bias in included studies.
- Further high-quality research is necessary to establish definitive conclusions on laser effectiveness for caries prevention.
