The orthodontic appliance environment favors plaque maturation, inflammatory changes, and enamel demineralization between visits

A clear aligner, worn 22 hours a day, is not a neutral device. Like other orthodontic appliances, including braces and accessories, it creates plaque-retentive areas where oral hygiene becomes more demanding. It seals the tooth surface, reduces salivary clearance over the enamel, and creates a microenvironment where plaque accumulates at the edges of the appliances, in cervical zones, and in the interproximal spaces between teeth.

Aligners create a closed biofilm environment and braces are difficult to keep completely clean.

22 hours of daily aligner wear reduces natural saliva clearance and increases the risk of plaque accumulation, inflammation, and demineralization between control visits.

  • White spot lesions
    Demineralization around aligner edges can compromise the aesthetic end result.
  • Gingival inflammation
    Inflammation affects tissue, comfort, and aligner adaptation.
  • Tracking loss
    Inflamed tissue can reduce tracking accuracy and increase the need for refinements.
  • Caries risk
    Acidogenic bacteria under the aligner increase the risk of caries.

The risk lies in the residual biofilm

Lumoral addresses a clinically significant gap in orthodontic hygiene: the residual biofilm that remains between visits despite tooth brushing. Used as a supplementary home treatment, it is intended to reduce plaque accumulation before it progresses to marginal inflammation, acid-driven demineralisation, and the tissue changes that can complicate aligner tracking and control of orthodontic treatment.

Lumoral®

Biofilm control designed for daily use

Lumoral combines antibacterial blue light with photodynamic therapy to control plaque and inflammatory load throughout the aligner treatment.

ABL · 405 nm

Targets plaque-associated bacteria using antibacterial blue light.

APDT · 810 nm + ICG

ICG binds selectively to plaque and is activated by near-infrared light.

No resistance · No staining

Suitable for continuous use throughout the treatment period.

An alternative to long-term chlorhexidine use

Problems with CHX

  • staining
  • dysgeusia
  • microbiome disruption
  • poor compliance

Lumoral®

  • no staining
  • no resistance
  • no microbiome disruption
  • designed for long-term use
  • compatible with aligners
85% maintained BOP ≤10%

N = 40 · RANDOMIZED · SUBMITTED MANUSCRIPT · DATA ON FILE

In a single-site, randomized, assessor-blinded clinical study of adolescents starting fixed orthodontic treatment, home-applied dual-light aPDT used alongside standard hygiene supported better plaque and inflammation control over 12 weeks than standard hygiene alone. VPI decreased 1.8× more with dual-light aPDT than in controls (-7.65% vs -4.22%). A higher proportion of participants in the dual-light group maintained BOP ≤10% compared with controls (85% vs 58%), and fewer participants showed an increase in BOP values (35.0% vs 78.9%).

Hashemi-Elses et al. ClinicalTrials.gov ID: NCT05825742

51% with BOP<10% 

N = 200 · RANDOMIZED, PEER-REVIEWED · 2026 

In Stage I–III periodontitis patients on supportive periodontal care (SPC), reductions in key measurements were greater with home-applied dual-light therapy as an adjunct to SPC than with SPC alone. At 6 months, 51% of participants with SPC+dual-light had BOP<10%, versus 23% with SPC alone. At 6 months, 63% had visible plaque (VPI) <10% with SPC+dual-light, versus 38% with SPC alone. The number of sites with PPD ≥4 mm was also lower with SPC+dual-light.

Pakarinen S et al. Journal of Periodontology. 2026. DOI: 10.1002/jper.70082 

PISA reduction 50.4%

N = 31 · RANDOMIZED, MULTI-CENTER, PEER-REVIEWED (IN PRESS) · 2026

In a multicenter, Stage I–III periodontitis study on supportive periodontal care (SPC), inflammation and plaque reduction were greater with SPC+home-applied dual-light therapy than with SPC alone. At 6 months, the inflamed periodontal epithelial surface area (PISA) reduced from 385 to 191 mm2 (p=0.034) with SPC-dual-light, versus 226 to 174 mm2 (p=non-significant). Mean visual plaque index (VPI) reduced from 20.9 to 10.6% with SPC-dual-light, versus 19.6 to 15.7% with SPC only.

Tegelberg P et al. Preprint available at medRxiv. 2025. DOI: 10.1101/2025.03.25.25324596

Plaque reduction -21.2%

N = 30 · CROSSOVER, PEER-REVIEWED · 2025

In a crossover study of healthy adults aged 20–25, when participants were using Lumoral, the Greene-Vermilion plaque scores reduced by 21.2% (significant reduction, p < 0.0001), and 6.5% (p = 0.107) with conventional home-care. This is the closest age profile to many aligner patients.

Gusseva L, Lill LL. Journal of Dentistry. 2026. DOI: 10.1016/j.dent.2026.106641 

A structured 3-phase aligner protocol

1. Before Treatment

  • Stabilize gingiva
  • Reduce BOP
  • Create a healthy baseline before scanning

2. Active treatment

  • 3 times weekly or daily in high-risk cases
  • Reduce plaque around aligners
  • Support tracking accuracy

3. Case completion

  • Document tissue health
  • Reduce white spot lesions
  • Support the retention phase

Orthodontic protocol

Download the brochure for more detailed information on the points from this page.

Download the brochure in Danish Download the brochure in English

Example of Lumoral® products for Orthodontic treatment

The Lumoral® dental care package consists of a starter kit + 90 Lumorinse®, and is intended for a 6-month treatment period with 3 weekly uses of Lumoral®. After this, the patient acquires more Lumorinse®.

Against caries and gingivitis

1.393,00 DKKInkl. moms
Number of packages
Number of packages: 1 package

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Let us help you get started with incorporating Lumoral® into your orthodontic treatments!

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