Dental Asia March/April 2024

CLINICAL FEATURE
Revolutionising oral
mucositis treatment:
Antibacterial light-activated
therapy in future protocols
By Dr Matti Mauramo and Prof Tuomas Waltimo
INTRODUCTION
Oral mucositis, an inflammation
of the oral mucosa, often occurs
in association with cancer
treatments, particularly radiation and
chemotherapy. It manifests as severe
pain, redness, and swelling in the
patient’s mouth, potentially impacting
the success of cancer therapy. To date,
no existing medication has effectively
prevented the development of
mucositis. Recent research suggests
that antibacterial dual light therapy
may be an effective method to manage
the symptoms of this condition.
Traditional approaches to treating oral
mucositis include preventive measures
such as maintaining good oral hygiene
and ice therapy during chemotherapy.
If bacterial infection is present, the
use of antibiotics may be considered
by the physician. Corticosteroids are
also a treatment option to alleviate
pain and the inflammatory response
associated with mucositis. However,
corticosteroid use poses risks, as it
can suppress the immune system,
making cancer patients more
susceptible to infections. 1,2
Ongoing research explores novel
methods for preventing and treating
oral mucositis. Mitochondriastimulating
red-light therapy has
proven to be very effective in treating
oral mucositis, particularly as a
preventive measure. Although light
therapy is estimated to be the most
effective treatment modality, its
widespread implementation faces
challenges such as availability and
practical issues. 3
The latest studies investigate
antibacterial treatments to preventively
address oral mucosal ulcers
originating from mucositis, aiming
to mitigate the adverse effects of
aggressive cancer treatments.
IMPROVING PATIENT QUALITY OF
LIFE
In the bachelor’s thesis from the
Faculty of Medicine at the University
of Helsinki titled ‘Oral Mucositis
– Antibacterial Dual Light in the
Treatment of Oral Mucositis’, medical
student Jessica Hentilä explores the
effects of antibacterial photodynamic
therapy (aPDT) and antibacterial blue
light (aBL) on mucositis ulcers as local
treatments. 3
Hentilä’s research evaluates the
efficacy of dual light therapy against
Streptococcus Oralis — a common
bacterium in the oral microbiome.
Bacterial colonies form over ulcers on
the oral mucosa from the mouth’s own
bacterial flora.
Drawing of the mechanism of action
of aPDT, the study indicates that
antibacterial dual light, a combination
of aPDT and aBL, not only effectively
targets streptococcal infections found
in mucositis-induced ulcers but provides
red light therapy simultaneously (Fig. 1).
The target tissue is treated with a
selected photosensitiser and is irradiated
with visible light. The photosensitiser
absorbs the photon of visible light and
is raised to a higher energy state from
Fig. 1: After this cycle, the photosensitiser
is back in the ground state and ready to
absorb a new photon
DENTAL ASIA MARCH / APRIL 2024 33