Lasers in Medical Science

, Volume 34, Issue 3, pp 479–485 | Cite as

Clinical study on the efficacy of LED phototherapy for pain control in an orthodontic procedure

  • I. Z. Figueira
  • A. P. C Sousa
  • A. W Machado
  • F. A. L. Habib
  • L. G. P. Soares
  • A. L. B. PinheiroEmail author
Original Article


Pain is an unpleasant and emotional subjective sensory experience that occurs during orthodontic procedures. Currently, LED phototherapy is an alternative to the use of laser light as analgesic agent due to similarity of response and lower cost. This case-control, quantitative, qualitative, and longitudinal study aimed to investigate the effect of IR LED phototherapy (λ846 ± 20 nm) in pain during the process of tooth separation during orthodontic treatment. After approval by the Institution Ethics Committee, 40 patients (30 female/10 male, 20–30 years old, average age 24.5 ± 2.6 years old) fulfilling the inclusion criteria entered the study and received a set of four visual analog scales (VAS) for scoring pain immediately, 48 h, 72 h, and 7 days after the insertion of the separating elastics. The patients were randomly distributed into two groups (experimental and control). The patients of experimental group received LED phototherapy (180 mW, 22 s, 4 J, 8 J/cm2, 0.36 W/cm2, spot of 0.5 cm2, spot diameter 0.8 cm) at the same times in which VAS was performed, and control patients were not irradiated. It was found that, in both groups, there was an increase in pain 48 h after insertion of the elastic tooth separator, decreasing 72 h after its installation and reached the lowest level of pain after 7 days. Comparison between groups showed that pain level in the LED group was always statistically significantly lower (p < 0.05), except for the time of installation (T1). The use of LED light was effective in significantly reducing the level of pain after insertion of the elastic tooth separators when compared to the control group.


Phototherapy Toothache LED Malocclusion 


Compliance with ethical standards

This case-control, quantitative and qualitative, longitudinal study was approved by the Ethics Committee of the School of Dentistry of the Federal University of Bahia (Proc. 34159014.30000.5024).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

The authors hereby confirm that this work followed the Brazilian Resolution CNS 196/96 and was approved by the institution’s Ethics Committee (Proc 34159014.3.0000.524).


  1. 1.
    Carroll JD (2014) Tooth movement in orthodontic treatment systematic review omitted significant articles. Photomed Laser Surg 32:310–311CrossRefPubMedGoogle Scholar
  2. 2.
    Krishnan V (2007) Orthodontic pain: from causes to management- a review. Eur J Orthod 29:170–179CrossRefPubMedGoogle Scholar
  3. 3.
    Burstone CJ, Choy K (2017) Fundamentos Biomecânicos da Clínica Ortodôntica. Quintessence, São PauloGoogle Scholar
  4. 4.
    Almeida VL, Gois VLA, Andrade RNM, Cesar CPHAR, Albuquerque-Junior RLC et al (2016) Efficiency of low-level laser therapy within induced dental movement: a systematic review and meta-analysis. J Photochem Photobiol B Biol 158:258–266CrossRefGoogle Scholar
  5. 5.
    Higashi DT, Andrello AC, Tondelli PM, Filho DOT, Ramos SP (2017) Three consecutive days of application of LED therapy is necessary to inhibit experimentally induced root resorption in rats: a microtomographic study. Lasers Med Sci 32(1):181–187CrossRefPubMedGoogle Scholar
  6. 6.
    Lim HM, Lew KK, Tay DK (1995) A clinical investigation of the low-level laser therapy in reducing orthodontic post adjustment pain. Am J Orthod Dentofac Orthop 108:614–622CrossRefGoogle Scholar
  7. 7.
    Carroll JD, Milward MR, Cooper PR, Hadis M, Palin WM (2014) Developments in low level light therapy (LLLT) for dentistry. Dent Mater 30:465–475CrossRefPubMedGoogle Scholar
  8. 8.
    Law SLS, Southard KA, Law AS, Logan HL, Jakobsen J (2000) An evaluation of preoperative ibuprofen for treatment of pain associated with orthodontic separator placement. Am J Orthod Dentofac Orthop 118:629–635CrossRefGoogle Scholar
  9. 9.
    Bernhardt MK, Southard KA, Batterson KD, Logan HL, Baker KA, Jakobsen JR (2001) The effect of preoperative and/or postoperative ibuprofen therapy for orthodontic pain. Am J Orthod Dentofac Orthop 120:20–27CrossRefGoogle Scholar
  10. 10.
    Polat O, Karaman AL (2005) Pain control during fixed orthodontic appliance therapy. Angle Orthod 75:210–215Google Scholar
  11. 11.
    Turhani D, Scheriau M, Kapral D, Benesch T, Jonke E, Bantleon HP (2006) Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofac Orthop 130:371–377CrossRefGoogle Scholar
  12. 12.
    Bird SE, Williams K, Kula K (2007) Preoperative acetaminophen vs ibuprofen for control of pain after orthodontic separator placement. Am J Orthod Dentofac Orthop 132:504–510CrossRefGoogle Scholar
  13. 13.
    Bergius M, Brogerg AG, Hakeberg M, Berggren U (2008) Prediction of prolonged pain experiences during orthodontic treatment. Am J Orthod Dentofac Orthop 133(3):339.e1-8CrossRefGoogle Scholar
  14. 14.
    Ren C, McGrath C, Yang Y (2015) The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis. Lasers Med Sci 30:1881–1893CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Pinheiro ALB, Bittencourt MAV, Filho RFAF (2008) Avaliação clínica da ação antiálgica do laser de baixa potência após instalação de separadores ortodônticos. Rev Assoc Paul Cir Dent 62:98–104Google Scholar
  16. 16.
    Youssef M, Ashkar S, Hamade E, Gutknecht N, Lampert F, Mir M (2008) The effect of low-level laser therapy during orthodontic movement: a preliminary study. Lasers Med Sci 23:27–33CrossRefPubMedGoogle Scholar
  17. 17.
    Tortamano A, Lenzi DC, Haddad AC, Bottino MC, Dominguez GC, Vigorito JW (2009) Low-level laser for pain caused by placement of the first orthodontic arch wire. A randomized clinical trial. Am J Orthod Dentofacial Ortho 136:662–667CrossRefGoogle Scholar
  18. 18.
    Stein S, Korbmacher-Steiner H, Popovic N, Braun A (2015) Pain reduced by low-level laser therapy during use of orthodontic separators in early mixed dentition. J Orofac Orthop 76:431–439CrossRefPubMedGoogle Scholar
  19. 19.
    Borzabadi-Farahani A, Cronshaw M (2017) Lasers in orthodontics. In: Coluzzi D, Parker S (eds) Lasers in dentistry—current concepts. Textbooks in Contemporary Dentistry. Springer, ChamGoogle Scholar
  20. 20.
    Furquim RD, Pascotto RC, Neto JR, Cardoso JR, Ramos AL (2015) Low-level laser therapy effects on pain perception related to the use of orthodontic elastomeric separators. Dental Press J Orthod 20(3):37–42CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA (2006) Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 24(2):158–168CrossRefPubMedGoogle Scholar
  22. 22.
    Mizutani K, Musya Y, Wakae K, Kobayashi T, Tobe M, Taira K, Harada T (2004) A clinical study on serum prostaglandin E2 with low-level laser therapy. Photomed Laser Surg 22(6):537–539CrossRefPubMedGoogle Scholar
  23. 23.
    Polat O (2007) Pain and discomfort after orthodontic appointments. Semin Orthod 13(4):292–300CrossRefGoogle Scholar
  24. 24.
    Esper MALR, Nicolau RA, Arisawa EALS (2011) The effect of two phototherapy protocols on pain control in orthodontic procedure—a preliminary clinical study. Lasers Med Sci 26:657–663CrossRefPubMedGoogle Scholar
  25. 25.
    Sant’Anna EF, Araújo MTS, Nojima LI, Cunha AC, Silveira BL, Marquezan M (2017) High-intensity laser application in orthodontics. Dental Press J Orthod 22(6):99–109CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Habib FAL, Gama SKC, Ramalho LMP et al (2010) Laser-induced alveolar bone changes during orthodontic movement: a histological study on rodents. Photomed Laser Surg 28:823–830CrossRefPubMedGoogle Scholar
  27. 27.
    AlSayed HMMA, Sultan K, Hamadah O (2016) Low-level laser therapy effectiveness in accelerating orthodontic tooth movement: a randomized controlled clinical trial. Angle Orthod 87(4):499–504CrossRefGoogle Scholar
  28. 28.
    Bondemark L, Fredriksson K, Ilros S (2004) Separation effect and perception of pain and discomfort from two types of orthodontic separators. World J Orthod 5:172–176PubMedGoogle Scholar
  29. 29.
    Gallagher EJ, Liebman M, Bijur PE (2001) Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 38:633–638CrossRefPubMedGoogle Scholar
  30. 30.
    Topolski F, Moro A, Correr GM, Schimim SC (2018) Optimal management of orthodontic pain. J Pain Res 11:589–598CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Lobato PC, Garcia VJ, Kasem K, Torrent JMU, Walton VT, Céspedes CM (2014) Tooth movement in orthodontic treatment with low-level laser therapy: a systematic review of human and animal studies. Photomed Laser Surg 32:302–309CrossRefGoogle Scholar
  32. 32.
    Sousa MVS, Pinzan A, Consolaro A, Henriques JFC, Freitas MR (2014) Systematic literature review: influence of low-level laser on orthodontic movement and pain control in humans. Photomed Laser Surg 32:592–599CrossRefPubMedGoogle Scholar
  33. 33.
    Barbosa KGN, Sampaio TPD, Rebouças PRM, Catão MHCV, Gomes DQC, Pereira JV (2013) Analgesia during orthodontic treatment with low intensity laser: systematic review. Rev Dor 14(2):137–141CrossRefGoogle Scholar
  34. 34.
    Brugnera A Jr (2009) Laser phototherapy in dentistry. Photomed Laser Surg 27:533–534CrossRefGoogle Scholar
  35. 35.
    Enwemeka CS (2009) Intricacies of dose in laser phototherapy for tissue repair and pain relief. Photomed Laser Surg 27:387–393CrossRefPubMedGoogle Scholar
  36. 36.
    Qamruddin I, Alam MK, Fida M, Khan AG (2016) Effect of a single dose of low-level laser therapy on spontaneous and chewing pain caused by elastomeric separators. Am J Orthod Dentofac Orthoped 149(1):62–66CrossRefGoogle Scholar
  37. 37.
    Seifi M, Shafeei HA, Daneshdoost S, Mir M (2007) Effects of two types of low-level laser wavelengths (850 and 690nm) on the orthodontic tooth movements in rabbits. Lasers Med Sci 22:261–264CrossRefPubMedGoogle Scholar
  38. 38.
    Fujita S, Yamaguchi M, Utsunomiya T, Yamamoto H, Kasai K (2008) Low-energy laser stimulates tooth movement velocity via expression of RANK and RANKL. Orthod Craniofacial Res 11:143–155CrossRefGoogle Scholar
  39. 39.
    Almallha MME, Almahdi WH, Hajeer MY (2016) Evaluation of low level laser therapy on pain perception following orthodontic elastomeric separation: a randomized controlled trial. J Clin Diagn Res 10:23–28Google Scholar
  40. 40.
    Goulart CS, Nouer PR, Mouramartins L, Garbin IU, de Fátima ZLR (2006) Photoradiation and orthodontic movement: experimental study with canines. Photomed Laser Surg 24:192–196CrossRefPubMedGoogle Scholar
  41. 41.
    Shi Q, Yang S, Jia F, Xu J (2015) Does low-level laser therapy relieves the pain caused by the placement of the orthodontic separators? A meta-analysis. Head Face Med 11:28CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Farias RD, Closs LQ, Jr SAQM (2016) Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: a randomized split-mouth clinical trial. Angle Orthod 86(2):193–198CrossRefPubMedGoogle Scholar
  43. 43.
    Eslamian L, Farahani AB, Azhiri AH, Badiee MR, Fekrazad R (2014) The effect of 810nm low-level laser therapy on pain caused by orthodontic elastomeric separators. Lasers Med Sci 29:559–564CrossRefPubMedGoogle Scholar
  44. 44.
    Marini I, Bartolucci ML, Bartolotti F, Innoceti G, Gatto MR, Bonetti GA (2013) The effect of diode superpulsed low-level laser therapy on experimental orthodontic pain caused by elastomeric separator: a randomized controlled clinical trial. Lasers Med Sci 30:35–41CrossRefPubMedGoogle Scholar
  45. 45.
    Nóbrega C, Silva EMK, Macedo CR (2013) Low-level laser therapy for treatment of pain associated with orthodontic elastomeric separator placement: a placebo-controlled randomized double blind clinical-trial. Photomed Laser Surg 31(1):10–17CrossRefPubMedGoogle Scholar
  46. 46.
    Erdinç AME, Dinçer B (2004) Perception of pain during orthodontic treatment with fixed appliances. Eur J Orthod 26:79–85CrossRefPubMedGoogle Scholar
  47. 47.
    Kim WT, Bayome M, Park JB, Park JH, Baek SH, Kook YA (2013) Effect of frequent laser irradiation on orthodontic pain. A single-blind randomized clinical trial. Angle Orthod 83(4):611–616CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Prof. José Martins Soares Édimo Center for Orthodontics and Dentofacial Orthopedics, School of DentistryFederal University of Bahia – UFBASalvadorBrazil
  2. 2.Center of Biophotonics, School of DentistryFederal University of Bahia – UFBASalvadorBrazil
  3. 3.National Institute of Basic Optics and Applied to Life Sciences, Physics Institute of São CarlosUniversity of São PauloSão CarlosBrazil
  4. 4.Biomedical Engineering InstituteUniversidade BrasilSão PauloBrazil

Personalised recommendations