LOW-LEVEL LASER THERAPY AND DENTAL INJECTION PAIN IN CHILDREN: A SYSTEMATIC REVIEW AND META-ANALYSIS

Managing pain effectively during dental procedures is crucial, especially for children undergoing local anesthetic injections. Low-level laser therapy (LLLT), or photobiomodulation therapy (PBMT), has been investigated as a non-invasive method to reduce injection discomfort.

A comprehensive search of PubMed, Scopus, Cochrane Library, Embase, and Web of Science was conducted up to June 2024 to identify randomized controlled trials (RCTs) evaluating PBMT for pain reduction. Study quality was assessed using the Cochrane Risk of Bias Assessment Tool 2 (RoB2) by 2 independent reviewers. Meta-analysis was performed using STATA version 17 on data from studies. Heterogeneity was assessed using chi-squared, tau, and I² statistics. A random-effects model was employed, and publication bias was evaluated using funnel plots and Begg and Egger's tests.

Eight articles met the inclusion criteria, with 6 included in the meta-analysis. The analysis showed a significant reduction in Wong-Baker pain score in children receiving PBMT compared to control groups (mean difference = -1.25, 95% confidence interval (CI): -2.43 to -0.07, P = .039). Meta-analysis based on a specific range of wavelength (960 nm) and consistent control groups (anesthetic gel with an inactive laser), confirmed a significant reduction in Wong-Baker (mean difference = -1.30, 95% CI: -2.17 to -0.43, P < .001) and face, legs, activity, cry, and consolability (FLACC) scale (mean difference = -1.06, 95% CI: -1.68 to -0.45, P < .001) pain scores.

PBMT was found to be effective in reducing pain during anesthetic injections in children. The application of PBMT (960 nm) compared to a gel-inactive laser control group shows promise based on the Wong-Baker and FLACC scales.