Navigating the Spectrum of Cariology: Laser-Mediated Theranostics in Pediatric and Adult Populations

Laser technology has broadened the scope of dental caries management, supporting diagnosis, prevention, and treatment within a single minimally invasive framework, but its performance depends on operator expertise and on parameters matched to the tissue and the patient. This narrative review synthesizes contemporary evidence on laser-mediated theranostics in pediatric and adult cariology, comparing age-specific diagnostic and therapeutic applications and their impact on patient-centered, minimally invasive care. Peer-reviewed systematic reviews, randomized controlled trials, and observational studies from the last five years were identified in PubMed and Scopus. Across the evidence, laser-assisted approaches offer distinct benefits in each population. In primary dentition, laser fluorescence improves the detection of early enamel demineralization when dentition-specific thresholds are applied, while erbium-doped yttrium aluminum garnet (Er:YAG) systems reduce pain, anxiety, and the need for local anesthesia, improving cooperation. In permanent dentition, erbium lasers support conservative management of secondary caries, decontamination of affected tissue, and preservation of existing restorations. Antimicrobial photodynamic therapy (aPDT) consistently reduces cariogenic biofilms in both populations, with particular value in adults presenting more complex periodontal and restorative conditions. Taken together, the evidence supports tailoring laser-assisted diagnosis and treatment to dentition type, lesion characteristics, and clinical objectives rather than relying on a single standardized approach; laser therapy is an effective, conservative option for caries management in both dentitions that improves patient comfort, although standardized clinical protocols are still needed.