Photobiomodulation in the management of oral lesions: a targeted, evidence-based approach

KOTH, Valesca Sander; GABRIEL, Amanda de Farias; DECKMANN, Iohanna; CASTILHO, Rogerio Moraes; NOR, Felipe; LAMERS, Marcelo Lazzaron; FIGUEIREDO, José Antonio Poli de; MARTINS, Manoela Domingues

doi:10.1590/1807-3107bor-2026.vol40suppl1059

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Critical Review/Stomatology • Braz. oral. res. 40 (suppl 1) • 2026 • https://doi.org/10.1590/1807-3107bor-2026.vol40suppl1059 linkcopy

Photobiomodulation in the management of oral lesions: a targeted, evidence-based approach

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This review synthesizes current literature on laser applications in dentistry, with particular emphasis on the biological mechanisms of photobiomodulation (PBM), dosimetric considerations, tissue interactions, and the clinical management of the most prevalent oral lesions. The oral disorders most frequently investigated for the therapeutic use of PBM were: a) oral pain conditions: trigeminal neuralgia, temporomandibular disorders, and burning mouth syndrome; b) oncology-related conditions: oral mucositis and hyposalivation; c) immune-mediated disorders: recurrent aphthous stomatitis and oral lichen planus; and d) viral infections: herpes labialis. A wide range of laser parameters has shown clinical benefits in the treatment of these disorders. These outcomes are attributed to the anti-inflammatory, analgesic, and tissue repair effects of PBM, which may occur immediately and cumulatively over repeated sessions. PBM therapy is a valuable therapeutic resource in contemporary dentistry and may be successfully applied in a wide range of clinical conditions. Clinical effectiveness of PBM depends on appropriate dosimetry and irradiation parameters according to the biological characteristics of each condition and therapeutic target. Therefore further well-designed randomized clinical trials and protocol standardization are still required to strengthen clinical recommendations and optimize reproducibility.

Descriptors
Laser Therapy; Low-Level Light Therapy; Mouth Diseases; Mucositis; Stomatitis

Clinical condition	Wavelength (nm)	Power output (mW)	Energy per point (J)	Fluence (J/cm²)	Treatment frequency	Key consideration
Burning Mouth Syndrome (BMS)	660–975 (preferably 800–975)	60–200	0.78–12 (optimal: 4–6)	1–200 (optimal: 10–50)	1–2 sessions/week for ≤4 weeks	NIR wavelengths show superior pain reduction and improvement of neurosensory symptoms
Trigeminal neuralgia	NIR	Variable	3–16	3–12.73	Multiple sessions	Higher number of sessions shows superior pain reduction
TMD	780–830	Variable	4–24	~6	Every 48 h for 3–4 weeks	NIR lasers demonstrated superior outcomes for pain and mandibular function
Oral mucositis	630–680 / 780–904	~40	0.16–6	1.5–50	Daily during HNRT / HSCT/chemotherapy	Preventive and therapeutic effects supported by MASCC/ISOO and WALT guidelines
Hyposalivation	630–685 / 780–904	Variable	0.5–6	4–50	Variable	Combined red + NIR protocols and major salivary gland irradiation appear to be more effective
RAS	610–980	Variable	0.5–6 (most common: 2–4)	1–75 (most common: 4–10)	Often single session	Similar outcomes observed with fluences below and above 10 J/cm²
OLP	630–980	Variable	0.5–6 (most common: 1–4)	1–150 (most common: 4–10)	Usually >10 sessions	Greater cumulative exposure associated with significant symptom improvement
Herpes Labialis – aPDT (vesicular phase)	660	40–100	0.4–6	100–142.85	Usually single session	Red laser associated with 0.005–0.01% methylene blue or toluidine blue for viral decontamination
Herpes Labialis (crusting/healing)	632–870	15–100	1–4	2.04–48	Daily or every 48 h	Red and NIR PBM accelerate epithelial repair and pain control
Herpes Labialis – Preventive	808	100	1–2	~33.3	Preventive protocol	1 J/point demonstrated superior outcomes compared with 2 J/point in recurrence prevention

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[TFN1] NIR: near-infrared; TMD: temporal mandibular disorders; HNRT/HSCT: head and neck radiotherapy/hematopoietic stem cell transplantation; RAS: recurrent aphtous stomatitis; OLP: oral lichen planus.Values represent ranges reported across randomized clinical trials and systematic reviews. Preferred dosimetric ranges reflect protocols associated with more consistent clinical outcomes.