Tanya S. et al. - Photobiomodulation of Orofacial Conditions in Older Adults: A Systematic Review of Randomized Trials

Photobiomodulation appears to be a safe and clinically useful adjunctive therapy for several orofacial conditions in people aged 60 and older, particularly oral mucositis associated with cancer treatments. This systematic review includes 23 randomized trials; however, the heterogeneity of the parameters precludes any direct comparison, and no meta-analysis was conducted.

What this study measured

The authors evaluated the clinical efficacy and safety of photobiomodulation in the management of orofacial conditions in older adults. The search covered PubMed, Embase, Scopus, and Google Scholar, and included only randomized controlled trials published between January 2000 and March 2025. Participants had to be 60 years of age or older and receive photobiomodulation for an orofacial condition. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and the results were synthesized narratively. A total of 23 randomized controlled trials were included. Neither a PROSPERO registration nor the total number of participants is reported in the abstract.

Key Findings

The conditions studied are represented very unevenly, and the results are described qualitatively rather than in terms of quantified effect sizes.

• Oral mucositis caused by cancer treatments: 8 trials, showing consistent reductions in lesion severity and pain.
• Burning Mouth Syndrome: 7 trials, with symptomatic improvements generally reported, but a placebo effect noted by the authors.
• Hyposialia: 2 trials, with symptomatic improvements also reported.
• Postoperative pain: 2 trials. Oral lichen planus: 1 trial. Peri-implant conditions: 1 trial. Implant osseointegration: 2 trials.
• No clinically significant adverse events were reported in any of the included trials.

How photobiomodulation works for this indication

The proposed mechanisms remain hypothetical and are not measured here. Red and near-infrared light is thought to be absorbed by mitochondrial cytochrome c oxidase, which could support ATP production and tissue repair processes. Modulation of oxidative stress and inflammatory mediators has also been suggested as an explanation for the reduced severity of mucosal lesions. In implant applications, an effect on peri-implant bone remodeling is sometimes suggested, but only two trials have focused on osseointegration. In older adults, the reduced capacity for healing makes these hypotheses intriguing, though they remain unvalidated.

Limits You Should Know

This review does not include a meta-analysis: the synthesis is narrative, which precludes any overall quantitative estimate of the effect. The authors emphasize the heterogeneity of photobiomodulation parameters and outcome measures, which limits comparability among trials. A placebo effect is explicitly noted for burning mouth syndrome, an indication that is nevertheless based on 7 trials. Several indications are supported by only one or two trials, which makes any conclusion unreliable. Neither the number of participants nor the duration of follow-up is specified.

What This Means in Practice

The strongest evidence pertains to oral mucositis in elderly patients undergoing cancer treatment. For other indications, the data are too limited to guide decision-making. The absence of clinically significant adverse events across 23 trials supports the drug’s safety, but says nothing about its efficacy. The authors call for standardized protocols to determine the optimal parameters. Any use in a geriatric setting should be discussed with the healthcare team caring for the patient.

Frequently Asked Questions

Is photobiomodulation safe for older adults?

In this review of 23 randomized controlled trials conducted in adults aged 60 and older, no clinically significant adverse events were reported. This finding pertains to the protocols used in these trials and their follow-up periods, which were not specified in the abstract. It does not replace the need for professional advice before use.

For which oral condition is there the most data?

Oral mucositis induced by cancer treatments ranks first with 8 trials, followed by burning mouth syndrome with 7 trials. The other indications—hyposialia, postoperative pain, oral lichen planus, peri-implant conditions, and osseointegration—have only one or two trials each.

Does this review provide a percentage for the improvement?

No. The authors chose a narrative synthesis due to the heterogeneity of the parameters and outcome measures. Therefore, no overall effect size or confidence interval is available. The results are described in terms of trends and consistency across trials.

Reference

Tanya S, Srisilapanan P. Clinical Efficacy and Safety of Photobiomodulation Therapy for Orofacial Conditions in Older Adults: A Systematic Review of Randomized Controlled Trials. Dentistry Journal, 2026. PMID 42041684. View the study on PubMed

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.