Not enough evidence to support the use of low-level laser to minimize pain,swelling, and reduced mouth-opening after third molar removal


The removal of third molars is one of the commonest surgical procedures undertaken and the majority of patients develop some degree ofpain, swelling, and trismus after the surgery. Some investigators have stated that low-level laser energy irradiation (LLEI) decreases pain and swelling after surgery, and that it would contribute to a faster recovery. The aim of this review was to assess the efficacy and safety of LLEI for decreasing postoperative complications in patients undergoing surgical removal of  impacted third molars (IMTMs).

The authors searched Medline, Embase, and the Central Register of Controlled Trials of the Cochrane Library as part of a good search strategy. They included randomized and quasi-randomized clinical trials comparing the efficacy of LLEI with placebo for decreasing the severity of complications after IMTM surgical removal, with a minimum follow-up period of 3 days and reporting the results of any of the outcomes (pain, swelling, trismus, and adverse effects) of interest were included.  A random-effects model meta-analysis was used to estimate the mean difference of trismus between the groups. Heterogeneity was assessed using Cochran χ2 and I2.

Ten trials were included. Because of heterogeneity in the intervention and outcomes assessments, pain and swelling outcomes were only qualitatively summarized and indicated no beneficial effects of LLEI over placebo.  Patients receiving LLEI had an average of 4.2 mm (95% confidence interval, 1.2 to 7.2) and 5.2 mm (95% confidence interval, 1.8 to 8.2) less trismus than patients receiving no active treatment on the second and seventh day after the surgery, respectively.

The authors concluded

There was no benefit of LLEI on pain or swelling and a moderate benefit on trismus after removal of IMTMs. It is necessary to standardize the intervention and outcomes assessment and to conduct adequately powered, well-designed trials to evaluate the efficacy of LLEI.

Brignardello-Petersen R, Carrasco-Labra A, Araya I, Yanine N, Beyene J, Shah PS. Is Adjuvant Laser Therapy Effective for Preventing Pain, Swelling, and Trismus After Surgical Removal of Impacted Mandibular Third Molars? A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg. 2012 Mar 5. [Epub ahead ofprint] PubMed PMID: 22398186.




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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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