Synergic antibacterial effect between visible light and hydrogen peroxide on Streptococcus mutans

Objectives: To evaluate the possibility of enhancing the phototoxic effect on Streptococcus mutans using a potentially antibacterial synergic effect between blue light and hydrogen peroxide (H2O2), and to investigate the antibacterial mechanism involved. Methods: Growth of S. mutans samples was determined after exposure to light in the presence and absence of H2O2. The effect of such light on H2O2 degradation, on reactive oxygen species (ROS) generation and on the exposed-medium temperature was examined. Results: The combination of light exposure for 20 s (similar to 23 J/cm(2)) and a concentration of 0.3 mM H2O2 yielded 96% growth inhibition, whereas, when applied separately, light exposure decreased bacterial growth by 3% and H2O2 by 30% compared with the control. The results showed no direct effect of the light on H2O2 degradation, a partial protective effect of ROS scavengers on S. mutans and a non-lethal increase in the medium temperature after light exposure. Conclusions: An antibacterial synergic effect between blue light and H2O2 was observed. The mechanism of the phototoxic effect on S. mutans was basically a photochemical process, in which ROS were involved. Application of such light in combination with H2O2 to an infected tooth could be an alternative to or serve as an additional minimally invasive antibacterial treatment.