7. Orthodontics
PBM in orthodontics
Activation discomfort and soft-tissue irritation are the practical objectives. Effects on the rate of tooth movement remain heterogeneous in the literature.
Pain after activation, mucosal irritation from appliances, soft-tissue comfort during treatment.
Modulation of the acute inflammatory and nociceptive response in periodontal and mucosal tissue.
Tissue and anatomical targets
- • Periodontal ligament region of activated teeth
- • Buccal and labial mucosa
- • Attached gingiva
Clinical objectives
- • Activation pain modulation
- • Mucosal irritation healing
- • Treatment comfort and adherence
Dosimetric reasoning
- • Multiple low-fluence points over several teeth rather than a single high-dose point.
- • Map points per activated segment; repeat identically after each activation.
Technique
- • Intraoral point-by-point, buccal and lingual where accessible.
- • Non-contact over ulcerated mucosa.
Limitations
- • Does not correct the mechanical cause of irritation.
- • Movement-rate claims are inconsistent across protocols.
- • No effect on adherence to appliance wear.
Common errors
- • Applying PBM while leaving a sharp appliance component untouched.
- • Presenting acceleration of movement as established.
Clinical pearls
- • Fix the mechanical cause first; PBM then supports comfort.
Indications and evidence level
Biphasic dose-response, irradiance and light–tissue interaction were established there. Now apply them to this specialty's tissue thickness, vascularity and inflammatory state.
State the diagnosis and clinical objective before selecting a single parameter, and record the evidence level supporting what you tell the patient.
Eye protection for patient, operator and assistant. PBM does not remove the need for diagnosis, clinical judgment or medical coordination.
Knowledge checkpoint
Adolescent with an ulcer from a protruding archwire. Correct sequence?
Chapter summary
- • The biological principles are unchanged; the target, objective and strategy change.
- • Etiological treatment first; PBM as adjunct where justified.
- • Only claim what the evidence level supports.
- • Systematic reviews and meta-analyses on PBM in dentistry — to be curated by the academic team.
- • International PBM/laser safety guidance applicable in the institution's jurisdiction.
- • Institutional clinical protocol documentation (where authorised).
Linked educational cases
Educational content only. These algorithms are educational decision-support tools and never autonomous medical decision-makers. Clinical decisions remain the responsibility of the treating professional. Certification within OHDR Study™ is not a university award unless an authorised institution has been formally configured.