Pediatr Dent. 2026 Sep 15;48(5):352-359.
ABSTRACT
Purpose: To evaluate effectiveness of photobiomodulation therapy (PBMT) in reducing physiological stress (as measured by heart rate [HR] change), self-reported pain, and anxiety during cold pulp testing and routine gingival probing in healthy school-aged children. Methods: This prospective, randomized, split-mouth clinical trial enrolled 30 children aged 7 to 12 years at the University of Maryland pediatric dental clinics from July 2025 to January 2026. Each participant received PBMT (multiwavelength LED device, Nuralyte™) on 1 primary molar and no treatment on the contralateral control tooth. Following a 2-minute waiting period, cold testing and gingival probing were performed. Primary outcomes were HR changes from baseline measured via pulse oximetry. Secondary outcomes included self-reported pain (Wong-Baker FACES Pain Rating Scale), anxiety (0 to 10 numeric rating scale), cold perception, cooperation level (Frankl scale), and duration of analgesia. Paired t-tests and Wilcoxon signed-rank tests were used for split-mouth comparisons. Results: PBMT significantly reduced HR changes during cold testing compared to control (2.23±8.95 versus 6.07±8.70 beats per minute [bpm]; mean difference=-3.83 bpm, 95% confidence interval=-6.89 to -0.77, P=0.016). For gingival probing, self-reported pain was significantly lower with PBMT (median within-subject difference -2.0 points, P=0.004). Sensory perception was preserved in both groups (93.3% positive cold response). Analgesic effects remained stable through 20 minutes post-application. No adverse events occurred. Conclusion: PBMT with a multi-wavelength near-infrared device reduced physiological stress and self-reported pain during pediatric dental diagnostic procedures while preserving sensory function, supporting its use as a promising nonpharmacological behavior guidance option.
PMID:42947294
