The antimicrobial effect of aPDT is based on the principle that light as such activates a
non-toxic, photosensitive molecule, generating reactive oxygen species that kill the
bacterium. Applications of aPDT in dentistry include the treatment of bacterial and
fungal infections and the diagnosis of lesions. In dental treatment, regular photodynamic
treatment with dual-light has been shown to be beneficial for the gingival health of
dental implants and to reduce the amount of visible plaque (VPI). Photodynamic treatment
has also been shown to slow down the amount of biofilm re-forming in the mouth.
The simultaneous use of blue light and near-infrared light operating at 810 nm and 405 nm
has been shown to reduce Staphylococcus aureus more effectively than using only a single
light source. The use of indocyanine green as a photosensitizer in dual-light
phototherapy has also been shown to be effective in eliminating Streptococcus oralis.
Indocyanine green has otherwise low toxicity to dental restorative materials and to
non-target host tissue. Indocyanine green is also very suitable as a photosensitizer due
to its high absorption peak. Indocyanine green-mediated photodynamic therapy as an
adjunct to non-surgical periodontal treatment has been shown to improve treatment
outcomes for dental adhesive tissue diseases with statistically significant results at 3
months and 6 months after treatment with periodontitis patients. There is in vitro
evidence for the efficacy of indocyanine green specifically against periodontal
pathogens.
Tooth decay, gingivitis and periodontitis are common oral infections associated with
tooth extraction and are caused by bacteria living in the mouth. In total, more than 500
different species of bacteria can be found in the mouth. The normal flora of a healthy
mouth is rich in a variety of microbes that start to multiply from birth.
Bacteria of different species form biofilms, or plaques (bacterial communities), on the
tooth surfaces, some of which mutate to become pro-inflammatory. Most oral diseases are
multifactorial. A high-sugar diet, poor oral hygiene, general diseases, dry mouth,
ill-fitting dentures or antimicrobial therapy can affect the microbial balance in the
mouth and thus contribute to the development of oral diseases. Locally, oral areas are
affected by possible plaque overgrowth, orthodontic appliances, open caries deposits and
partially erupted wisdom teeth, which provide an easy attachment site for bacterial
pathogens and a challenging area to clean.
As biofilm accumulates at the gum line over several days, it causes the tissue to release
inflammatory neurotransmitters that call on defense cells from the bloodstream to destroy
bacteria. Inflammation of the gums appears as swelling, redness and bleeding on cleaning.
If gingivitis becomes chronic, it is a risk for periodontitis, which is the inflammation
and tissue destruction of the attachment tissues. Periodontitis is manifested in the
mouth as inflammation of the attachment tissues, with deepening of the gum pockets around
the tooth, increased tooth mobility, and alveolar leakage on X-rays.
Careful, daily self-care and regular dental hygiene are the most important preventive
measures for oral and jaw infections and dental infections. The surface of the tooth does
not clean itself like the surface of the mucous membrane or skin through natural taming,
so it must be cleaned mechanically. It is recommended to brush the teeth twice a day for
two minutes with fluoride toothpaste and to brush the interdental spaces every 24 hours
with a suitable instrument.
Lumoral® is a powerful LED light device with a mouthpiece operating blue light at 405 nm
and near-infrared light at 810 nm. The Lumoral® treatment involves a combination of the
use of mouth rinse inculding indocyanine green , Lumorinse®, and the Lumoral® dual-light
mouthpiece. A tablet of Lumorinse® is dissolved in 30 millilitres of water to form a
mouthwash, which is swished around the oral cavity for 60 seconds. After using the
mouthwash, the Lu-moral® mouthpiece is placed in the mouth for 10 minutes of light
activation. After use, the teeth are cleaned by brushing and cleaning the interdental
spaces.
The active photosensitive substance of Lumorinse® adheres to the surface of the dental
plaque, and the targeted light from the mouthpiece produces an antibacterial effect in
the mouth. Lumoral® does not cause bacterial resistance, making it suitable for regular
use. The treatment is bacterio-selective, meaning that it targets only harmful microbes
in the mouth and does not affect the normal oral flora.
The purpose of this study is to investigate the amount of residual biofilm by comparing
conventional tooth cleaning with the additional cleaning of teeth with Lumoral®. The aim
is to determine whether Lumoral® treatment reduces the amount of residual biofilm in the
mouth in adults in general good oral health.