Laser Interventions For Accelerated Healing

Overview

In medicine, lasers have been used with great success. Since the latter part of the 1960s, many people today are aware of applications such as laser eye surgery (known commonly as Lasik).¹ However, laser therapy can be much more than just using a laser beam to avoid bleeding when cutting and removing tissue. 

Llow-level laser therapy (LLLT) or photobiomodulation (PBM) has been used to relieve pain and stimulate cell functions, bringing many benefits to patients.¹ A few of the most common conditions that can benefit from laser interventions are oral mucositis and chronic joint diseases (like rheumatoid arthritis).² But how does it work? And what benefits can laser interventions bring to the table?

How laser therapy works

The term “laser” is an acronym for “light amplification by stimulated emission of radiation”, meaning that a laser is a very powerful and uniform beam of light.³ In physics, light is a type of wave: it has a wavelength and frequency just like any other type of wave-like microwaves or radio waves, though the light is also unique as it can be seen because it has wavelength and frequency of a specific range that our eyes can perceive.¹

LLLT lasers, aside from being visible to our eyes, can also cause direct effects on our cells and tissues. Therefore, they have medical applications.³ The LLLT laser promotes a photochemical reaction in our cells: when a photon (a light particle) of laser is absorbed by a target molecule inside the cell (known as a chromophore), this creates a more chemically excited version of the chromophore that stores up the “excess” energy and uses it to perform its cellular tasks, boosting the cell’s function.³

There is strong scientific evidence that LLLT lasers stimulate the mitochondria, an organelle inside our cells: the mitochondria are responsible for producing energy (in the form of adenosine triphosphate, ATP) and modulating reactive oxygen species (ROS) that can damage our cells when uncontrolled³. Another function of the mitochondria is the induction of transcription factors: these transcription factors help produce proteins that stimulate cell growth and proliferation, modulate inflammation and increase local oxygenation of the tissue.³

Specific cells can also be activated by LLLT, such as fibroblasts, which are cells that can produce collagen fibres and promote the healing of wounds. Fibroblasts can be stimulated by photobiomodulation with laser; this increases their rate of proliferation, maturation and motility; since the laser also affects epithelial cells and stimulates their motility, this combination further promotes quicker healing of wounds.³ Another group of cells highly affected by laser therapy are the white blood cells (leukocytes), responsible for immunity and defence against diseases. LLLT activates leukocytes and stimulates their proliferation.³

Applications of laser therapy

LLLT has been widely used to treat wounds, promote quicker healing and reduce pain.¹ A few conditions that benefit from photobiomodulation (PBM) are:

• Oral mucositis (OM): is a type of inflammation and ulceration of the oral mucous membrane due to radiotherapy or chemotherapy⁴ the condition commonly occurs when patients with head and neck cancers are treated with radiation therapy. Being one of the most well-known side effects, it greatly impacts the quality of life of cancer patients since it impairs functions such as eating and speaking and causes great pain. Laser therapy has been used as it is safe and practical, has minimal side effects, and is highly efficient.⁴ PBM has been used to prevent and treat oral mucositis with great success.⁴ Lasers have been in use in dentistry for decades, with impressive results: you can read more here to understand other applications of lasers besides oral mucositis in dentistry and oral health.
• Rheumatoid arthritis (RA): is an autoimmune disease that causes painful swelling of the joints.² PBM has been used to increase mobility, function and grip strength, as well as reduce pain and stiffness.²
• Chronic joint diseases: other conditions such as osteoarthritis (OA) that cause chronic pain involving joints have been treated with LLLT with success before.⁵ More studies need to be performed in order to better understand how the process works, but there is evidence of pain reduction and improved health status of the joints after laser therapy.⁵
• Temporomandibular disorder (TMD): temporomandibular joint (TMJ) dysfunction causes pain and reduced movement of the jaws and can severely impact a patient’s quality of life.⁶ Clinical studies have found that the use of LLLT can significantly increase the amplitude of movement of the jaws.⁶
• Hair loss: LLLT has been studied to treat male pattern hair loss (androgenic alopecia), and recent reviews have found it to be quite successful in achieving hair growth.⁷ Evidence also suggests that PBM can be used as an adjuvant therapy for hair loss along with minoxidil or finasteride.⁷

Limitations

Some of the limitations of LLLT are directly caused by how tentative scientific evidence currently is: there is still a long way to go before protocols are established for most diseases that can be treated by PBM therapy.² Direct comparative studies between different protocols of laser application and between different treatment alternatives are still scarce.³ There are many possibilities to discuss when it comes to laser therapy: is it capable of solving issues alone? Can it be used with other forms of therapy, like drugs? Is the combination of different treatment options better or worse for the patient? These are still questions that need to be answered.

There is also, unfortunately, bias against laser therapy: it had been viewed as a “fluke” or placebo for many years until scientific evidence was found to legitimise it as a treatment option¹. Currently, there is no denying that PBM is a form of treatment with scientific evidence backing it up, as we now understand how it works and why it works.³ Moreover, it has been increasingly more accepted as a valid treatment for many conditions: one of the most pressing is oral mucositis, in which guidelines for use of LLLT have been developed to aid treatment as scientific evidence has been streamlined into a protocol.⁴ Public opinion has also been more accepting of non-pharmacological intervention (treatment options that don’t include drugs), such as acupuncture, and view it as a complementary treatment against diseases.³

What can be concluded is that LLLT is safe, has minimal to no side effects, and has been deemed useful and effective against many diseases.³ Though in some cases there needs to be a better understanding of the extent to which it works, in other cases, protocols have already been established, and LLLT has been pushed as a safer, more effective option when compared to other possibilities.³

Summary

Laser intervention for wound healing consists of low-level laser therapy (LLLT), also known as photobiomodulation (PBM): this type of therapy uses a light source (a laser beam) to stimulate specific molecules inside our cells to produce more energy and complete their tasks more efficiently, promoting cell growth and proliferation as well as quicker healing. LLLT was once disregarded as a fluke or placebo effect: however, as more studies have been performed, its effects have been better understood, and there is no denying today that it is a legitimate form of therapy with perceptible physical benefits. Some of the most well-known applications of LLLT include prevention and treatment of oral mucositis (a side effect of head and neck radiotherapy and chemotherapy), chronic joint disorders such as rheumatoid arthritis, osteoarthritis, temporomandibular joint dysfunction, and even hair loss. Scientific evidence has found benefits of using LLLT as it is effective, safe, non-invasive and has minimal to no side effects, which makes it comfortable and viable to patients.