Evaluation of the effect of Low-Level LASER Therapy on Anxiety Level in 6 to 12-year-old Children undergoing Dental Treatment under Local Anesthesia: A Randomized Controlled Trial
Main Article Content
Abstract
Background: Dental anxiety is a common challenge in pediatric dentistry and can negatively affect cooperation and treatment outcomes, particularly during procedures involving local anesthesia. Safe, non-invasive interventions that reduce anxiety are therefore of clinical interest. The present study aimed to evaluate the effect of low-level laser therapy (LLLT) delivered as laser acupuncture on anxiety levels in children undergoing dental treatment under local anesthesia.
Materials and Methods: This randomized controlled in vivo study included 80 children aged 6–12 years who required dental treatment under local anesthesia. Participants were randomly allocated to an LLLT group (n = 40) or a placebo control group (n = 40). Laser acupuncture was applied at auricular and hand Shenmen points 15 minutes before anesthesia in the intervention group, while the control group received a sham procedure. Anxiety was assessed using physiological parameters (pulse rate and oxygen saturation) and a psychological measure (Facial Image Scale, FIS). Statistical analysis was performed with a significance level set at p < 0.05.
Results: Baseline pulse rate and oxygen saturation were comparable between groups (p > 0.05). Post-intervention, the LLLT group showed a significantly greater reduction in pulse rate (−4.13 ± 5.66 bpm) compared with the control group (−0.23 ± 3.24 bpm; p = 0.0003). Oxygen saturation increased in the LLLT group (+0.40 ± 1.13%) but decreased slightly in controls (−0.20 ± 1.36%; p = 0.035). Mean FIS scores were significantly lower in the LLLT group (1.85 ± 0.95) than in the control group (2.25 ± 1.01; p = 0.03).
Conclusion: Pre-procedural low-level laser acupuncture significantly reduced both physiological and subjective indicators of dental anxiety in children undergoing treatment under local anesthesia, supporting its use as a practical adjunct in pediatric dental care.
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Abdrabuh RE, El Meligy OA, Felemban OM, Farsi NM. Evaluation of the erbium-doped yttrium aluminum garnet laser and the conventional method on pain perception and anxiety level in children during caries removal: A randomized split-mouth study. International Journal of Clinical Pediatric Dentistry. 2023 Aug;16(Suppl 1):S39.
Al Homoud RA, Alshellatie AK, Alzumaie AS, Al‐Bayati SA. Behavior and anxiety levels in pediatric patients: The behavioral changes and anxiety of pediatric patients in the dental clinic. Clinical and experimental dental research. 2023 Dec;9(6):1223-31.
Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clinical, cosmetic and investigational dentistry. 2016 Mar 10:35-50.
Bahrami R, Pourhajibagher M, Gharibpour F, Hosseini S, Bahador A. The impact of low-level laser therapy (photobiomodulation) on the complications associated with conventional dental treatments and oral disorders: A literature review. Journal of Dental Sciences. 2025 Apr 1;20(2):901-10.
Besiroglu-Turgut E, Kayaalti-Yuksek S, Bulut M. Evaluation of the relationship between dental anxiety and oral health status of mothers and their children. BMC Oral Health. 2024 Jun 28;24(1):749.
Bologa E, Tărăboanță-Gamen AC, Tărăboanță I, Boișteanu O, Platon AL, Stelea ȘO, Simionescu AM, Grădinariu AI, Jehac A, Bologa C, Stelea CG. Assessment of Anxiety and Local Anesthesia Experiences in Dental Students Using the Modified Dental Anxiety Scale (MDAS). Dentistry Journal. 2025 Sep 28;13(10):445.
Elbay ÜŞ, Tak Ö, Elbay M, Uğurluel C, Kaya C. Efficacy of low-level laser therapy in the management of postoperative pain in children after primary teeth extraction: A randomized clinical trial. Photomedicine and Laser Surgery. 2016 Apr;34(4):171-7.
Goel H, Mathur S, Sandhu M, Jhingan P, Sachdev V. Effect of low-level laser therapy on P6 acupoint to control gag reflex in children: a clinical trial. Journal of acupuncture and meridian studies. 2017 Oct 1;10(5):317-23.
Kumari P, Dhull KS, Devraj IM, Agrawal PK, Thakre UA, Khan H, Thakkar PK, Surana P. Future of laser pediatric dentistry: Emerging technologies and clinical applications. Bioinformation. 2025 Aug 31;21(8):2304.
Liu JF, Lai YL, Shu WY, Lee SY. Acceptance and efficiency of Er: YAG laser for cavity preparation in children. Photomedicine and laser surgery. 2006 Aug;24(4):489-93.
Pooja B, Kamatham R, Anchala K, Avisa P. Effectiveness of low-level laser therapy in reducing pain perception of children during dental local anesthetic administration using laser acupuncture pen on the LI4 point: a randomized clinical trial. European Archives of Paediatric Dentistry. 2023 Apr;24(2):219-27.
Sachelarie L, Cristea R, Burlui E, Hurjui LL. Laser technology in dentistry: from clinical applications to future innovations. Dentistry journal. 2024 Dec 23;12(12):420.
Seraj B, Bavaghar A, Hakimiha N, Hosseini Z, Kharazifard MJ, Ghadimi S. Effect of photobiomodulation therapy with an 810-nm diode laser on pain perception associated with dental injections in children: a double-blind randomized controlled clinical trial. Journal of Lasers in Medical Sciences. 2023 Jun 19;14:e19.
Shekarchi F, Hartoonian S, Fekrazad R, Mirebeigi-Jamasbi SS. The role of photobiomodulation in minimizing pain during dental injections in adults and children: a systematic review and meta-analysis. Lasers in Medical Science. 2025 Jul 16;40(1):318.
Tunç SK, Yayli NZ, Talmaç AC, Feslihan E, Kaplan V. Evaluation of Dental Anxiety in Patients Undergoing Second-Stage Surgery with Er, Cr: YSGG Laser Treatment: Randomized Clinical Trial. Eastern Journal of Medicine. 2020 Jan 1;25(1):45-54.
Winkler CH, Bjelopavlovic M, Lehmann KM, Petrowski K, Irmscher L, Berth H. Impact of dental anxiety on dental care routine and oral-health-related quality of life in a German adult population—a cross-sectional study. Journal of Clinical Medicine. 2023 Aug 14;12(16):5291.