Radiation in Contemporary Dentistry: Health Hazards and Oral Microbiome Implications

Modern dentistry increasingly relies on light-curing units (LCUs) and lasers in essential clinical procedures such as composite resin polymerization, caries treatment, and periodontal therapy. This review aims to outline the evolution of light-emitting technologies and to assess their potential biological risks, with particular emphasis on effects on the visual system, oral tissues, and microbiome. The development of curing devices is presented chronologically, from the first-generation ultraviolet (UV-A) lamps introduced in the 1970s to current light-emitting diode (LED-LCU) systems and dental lasers (e.g., Er:YAG, Nd:YAG). The progressive increase in light intensity—now exceeding 3000 mW/cm2—has shortened curing times but simultaneously raised safety concerns. Major hazards include the so-called blue-light hazard, where exposure to high-energy visible (HEV) blue light may accelerate macular degeneration, and temperature elevations in the pulp chamber, which may damage the dentin–pulp complex. Laser radiation also exerts significant microbiological effects: Er:YAG and diode lasers demonstrate bactericidal activity against biofilms and oral pathogens (e.g., P. gingivalis), although therapeutic outcomes depend on wavelength, dose, and exposure time. Suboptimal parameters may lead to microbiome disturbances, whereas low-level laser therapy (LLLT; 600–1200 nm) supports tissue regeneration and helps restore microbial balance. The individualization of irradiation parameters, combined with thorough theoretical knowledge, operator expertise, and technical understanding of LCUs and lasers, is essential for maximizing clinical benefits while minimizing health risks and preserving oral microbiome homeostasis.