Laser Interventions for Intraoral Halitosis: A Systematic Review of Randomized Controlled Trials

Background: This systematic review evaluated the efficacy of laser therapies and antimicrobial photodynamic therapy (aPDT) for the treatment of intraoral halitosis by synthesizing randomized controlled trials. Methods: A comprehensive search of the PubMed, Embase, Scopus, and Cochrane Library databases identified 14 eligible RCTs. Results: Laser-based interventions, including diode lasers and Er,Cr:YSGG lasers, and aPDT using photosensitizers such as methylene blue, toluidine blue, and Bixa orellana (annatto), effectively reduced volatile sulfur compound levels and associated bacterial populations compared to traditional methods like tongue scraping and antiseptic rinses. Combination treatments consistently demonstrated superior short-term efficacy, although treatment outcomes often declined after 7-14 days, indicating the necessity for repeated sessions or adjunctive oral hygiene measures. Conclusions: Methodological heterogeneity across studies regarding laser parameters, photosensitizer types, and outcome measurements highlighted the need for standardized protocols. Future research should focus on multicenter trials with extended follow-up and standardized microbiological evaluations to further validate these promising treatments and integrate them effectively into clinical practice.