Photodynamic therapy for caries management: mechanisms, applications, and perspectives

Dental caries poses a severe threat to oral health. However, conventional mechanical and chemical therapies have notable limitations, including incomplete eradication of dental plaque biofilms, difficulty in eliminating deep-seated bacteria, and the emergence of antimicrobial resistance. Photodynamic therapy (PDT), a therapeutic strategy with highly efficient broad-spectrum antimicrobial activity, is widely used to treat oral infections. Notably, PDT has tremendous potential for the prevention and treatment of dental caries, particularly by disrupting cariogenic biofilms. Furthermore, with continued advancement, PDT shows strong potential to promote remineralization and repair of dental hard tissues. However, current reviews on PDT for dental caries fail to provide an in-depth analysis of the biological mechanisms or comprehensively map the mechanistic chain of PDT in caries prevention and management. This review focuses on elucidating how PDT precisely disrupts the progression of cariogenic biofilms across various pathological stages of caries development while also exploring its therapeutic potential to induce dental tissue remineralization and repair. It aims to provide insights into further research and clinical use of PDT against dental caries and to present prospects for developing new targeted photosensitizers and adjusting light parameters to improve caries prevention and management.