The invention relates to medical, in particular dental, instruments (1) having a lighting device (3 - 3G; 50, 50'), to production methods for such instruments (1), and to various lighting devices (3 - 3G; 50, 50') having an optical semiconductor element (7, 5). The lighting devices (3 - 3G) comprise, for example, a body (6), at least one radiation emission surface (8) at a radiation emission end (9) of the body (6), and at least one fluid channel (10, 10', 40) provided in the body (6) of the lighting device (3 - 3G), which fluid channel connects at least one opening (11) provided at the radiation emission end (9) for discharging fluid to one or more fluid sources. The lighting devices (50, 50') comprise, for example, a hollow, metal sleeve (51), a transparent window (53) for emitting electromagnetic radiation, and a base (54) on which at least one optical semiconductor element (55) is arranged, wherein the base (54) is made of ceramic material or glass ceramic material or glass and is connected to the hollow, metal sleeve (51) by a material (57) having metal and glass.