The possible ocular hazards of LED dental illumination applications.

The use of high-intensity illumination via Light-Emitting Diode (LED) headlamps is gaining in popularity with dentists and student dentists. Practitioners are using LED headlamps together with magnifying loupes, overhead LED illumination and fiber-optic dental handpieces for long periods of time. Although most manufacturers of these LED illuminators advertise that their devices emit "white" light, these still consist of two spectral bands - the blue spectral band, with its peak at 445 nm, and the green with its peak at 555 nm. While manufacturers suggest that their devices emit "white" light, spectral components of LED lights from different companies are significantly different. Dental headlamp manufacturers strive to create a white LED, and they advertise that this type of light emitted from their product offers bright white-light illumination. However, the manufacturing of a white LED light is done through selection of a white LED-type based on the peak blue strength in combination with the green peak strength and thus creating a beam-forming optic, which determines the beam quality. Some LED illuminators have a strong blue-light component versus the green-light component. Blue-light is highly energized and is close in the color spectrum to ultraviolet-light. The hazards of retinal damage with the use of high-intensity blue-lights has been well-documented. There is limited research regarding the possible ocular hazards of usage of high-intensity illuminating LED devices. Furthermore, the authors have found little research, standards, or guidelines examining the possible safety issues regarding the unique dental practice setting consisting of the combined use of LED illumination systems. Another unexamined component is the effect of high-intensity light reflective glare and magnification back to the practitioner's eyes due to the use of water during dental procedures. Based on the result of Dr. Janet Harrison's observations of beginning dental students in a laboratory setting, the aim of this review is to raise awareness of the potential risk for eye damage when singular or combinations of LED illumination are used.