This systematic review examined the use of laser therapy for DH in MIH-affected teeth in comparison with other desensitizing treatments such as fluoride varnish, GLUMA, and CPP-ACPF mousse. We planned a priori to conduct a meta-analysis; however, it was not performed due to the substantial heterogeneity in study designs, laser parameters, intervention and comparision protocols, and follow-up durations. Consequently, a qualitative analysis was conducted to synthesize and interpret the findings across studies. In the included studies [17,18,19], laser therapy produced an immediate reduction in DH, although the duration of this effect varied depending on the type of laser, wavelength, and comparator treatment. Overall, no significant difference in DH reduction was observed among the treatments. In this systematic review, heterogeneity was characterized descriptively by examining both methodological and clinical differences across the included studies to ensure a coherent interpretation of the evidence. The three studies [17,18,19] employed distinct laser modalities: two used diode lasers with wavelengths of 808 nm [17] and 980 nm [19], respectively, and one used an Er: YAG laser with a wavelength of 2940 nm [18] operated at 0.4 W, 40 mJ, and 10 Hz as PBM. Substantial variation existed in power settings, irradiation techniques, number of sessions, and treatment application sites. These factors, combined with differences in the comparator treatments, contributed to pronounced clinical and methodological heterogeneity. Such variability not only prevented the execution of a meta-analysis but also limits the comparability of outcomes and reduces confidence in synthesizing unified conclusions regarding the effects of laser therapy for DH in MIH-affected teeth. PBM reduces the chronic cellular inflammation, activates Na⁺/K⁺ pumps, and stimulates tertiary dentin formation, promoting dentinal tubule obliteration [21]. It also provides analgesic, anti-inflammatory, and biomodulatory effects [12, 22], and its use for dentin hypersensitivity (DH) has been widely investigated beyond MIH-affected teeth. Studies indicate that PBM modulates neural responses and stimulates reparative mechanisms in pulp tissue [23, 24], partly due to its action on dental pulp stem cells, enhancing their activation, proliferation, and differentiation [23, 25]. These biomodulatory effects contribute not only to reducing hypersensitivity but also to promoting tissue regeneration through growth factor release and neural activity modulation [24, 25]. Regarding erbium lasers, Er: YAG is unlikely to cause thermal damage due to its high water absorption, which helps protect the pulp and dentin [26]. Its pulsed emission aids in dissipating heat during irradiation and reduces thermal influence on the pulp. The temperature increase generated by Er: YAG laser application promotes melting and recrystallization of dentin, resulting in dentinal tubule occlusion; a mechanism that supports its effectiveness in managing DH. Despite the biological plausibility and immediate clinical effects observed with laser therapy, the comparative effectiveness between laser and other standalone desensitizing strategies remained unclear. Existing evidence on MIH-associated DH has primarily compared laser therapy with placebo or no treatment [11, 13], or has evaluated protocols in which laser therapy was combined with other desensitizing strategies. A recent systematic review [27], reported that the association of LLLT with combined treatments may enhance long-term DH reduction, while LLLT alone provides an immediate effect on MIH-affected teeth. However, these studies did not isolate the performance of desensitizing agents used without laser application. Given this evidence gap, the present systematic review specifically compared laser therapy with desensitizing treatments applied independently, without any combination or adjunctive use of laser. Desensitizing agents reduce pain by either forming a protective coating over dentinal tubules or modifying their contents through mechanisms such as protein precipitation, coagulation, or the formation of insoluble calcium complexes [28]. Fluoride varnish creates a mechanical barrier and promotes dentinal tubule occlusion [29], hereby minimizing the penetration of external stimuli into dentin and reducing the onset of DH. CPP is a casein-derived phosphopeptide capable of binding and stabilizing soluble ACP. Upon application, ACP dissociates into calcium and phosphate ions, creating a state of supersaturation that favors remineralization through hydroxyapatite (HA) precipitation, which occludes dentinal tubules. The synergistic effect of fluoride enhances this process by forming fluorapatite (FA), further contributing to tubule occlusion [30]. However, CPP-ACP–based products cannot be used in individuals with milk protein allergies. GLUMA desensitizer, which contains glutaraldehyde and 2-hydroxyethyl methacrylate (HEMA), induces coagulation of serum albumin within dentinal fluid. This interaction leads to HEMA polymerization and the formation of a coagulation plug, a mechanism comparable to the melted layer produced after laser irradiation [17, 18]. This systematic review has several important limitations that must be considered when interpreting the findings. Although all included studies used comparable outcome measures to assess DH, they involved a relatively small number of participants and evaluated a limited number of teeth, which reduces the generalizability of the results. Across the 131 participants, a total of 462 teeth were analyzed, with the tooth serving as the unit of analysis. However, the handling of multiple teeth from the same participant varied among studies: one study [17] treated teeth as independent observations without accounting for within-subject clustering, whereas the other two studies [18, 19] applied Bonferroni-adjusted comparisons within their respective analytical designs. These inconsistencies in statistical handling raise concerns regarding the observations. Methodological quality among the included studies was limited, with two studies rated at high risk of bias [17, 18] and one presenting some concerns [19]. Although the randomization process, adherence to intended interventions, and completeness of outcome data were adequately reported, evaluator blinding was described in only one study [19], which is notable given that DH is a patient-reported outcome and therefore susceptible to detection bias. Additionally, all studies showed some concerns related to selective reporting. Participants ranged from 6 to 14 years old, which is an important factor because MIH-related hypersensitivity is typically more intense in younger children and tends to diminish with age as dentin matures and teeth are repeatedly exposed to remineralizing agents [31]. Additional variability in laser parameters, treatment protocols, comparator interventions, and follow-up periods, with only one study [18] assessing outcomes at six months, further limits the ability to draw robust conclusions regarding the long-term effectiveness of laser therapy for MIH-related DH. Additionally, although all studies stated that MIH was diagnosed according to EAPD criteria [20], none reported MIH severity distribution, which limits the ability to stratify outcomes by defect severity. Due a meta-analysis could not be conducted, the certainty of the evidence could not be formally assessed, further limiting the strength of the conclusions. Finally, the lack of a gold-standard laser protocol and the variation in device specifications limit comparability across studies. Practical considerations such as device cost and the need for professional training may further restrict clinical applicability. In contrast, desensitizing agents such as fluoride varnish are already widely used in routine care and may represent more accessible alternatives for managing MIH-related DH. Overall, these methodological and clinical limitations highlight the need for well-designed randomized clinical trials with standardized laser parameters, adequate statistical handling of clustered data, blinded outcome assessment, and long-term follow-up to clarify the true efficacy of laser therapy for reducing dentin hypersensitivity in MIH-affected teeth.