U.S. patent application number 15/677668 was filed with the patent office on 2017-11-30 for methods and compositions for whitening teeth.
The applicant listed for this patent is ORACEUTICAL LLC. Invention is credited to R. Eric Montgomery.
Application Number | 20170340532 15/677668 |
Document ID | / |
Family ID | 50485646 |
Filed Date | 2017-11-30 |
United States Patent
Application |
20170340532 |
Kind Code |
A1 |
Montgomery; R. Eric |
November 30, 2017 |
METHODS AND COMPOSITIONS FOR WHITENING TEETH
Abstract
Compositions and methods for whitening the teeth of a patient or
subject are described for performing a dental prophylaxis or
cleaning procedure during which at least one tooth whitening
composition is applied to the surface of a stained tooth, said
compositions and methods resulting in a tooth color change that is
noticeable to the patient or subject immediately following the
procedure. The novel procedure allows for a high degree of tooth
whitening to be safely achieved in a short period of time while
under the control of a dentist, dental hygienist, or other dental
professional, and which at least partially coincides with the
performance of a dental prophylaxis or cleaning procedure in order
to save significant clinical operatory chair time compared to
cleaning and whitening procedures that are performed in
non-overlapping time frames or appointments. Light may also be used
to enhance whitening.
Inventors: |
Montgomery; R. Eric; (Lee,
MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
ORACEUTICAL LLC |
Lee |
MA |
US |
|
|
Family ID: |
50485646 |
Appl. No.: |
15/677668 |
Filed: |
August 15, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14542851 |
Nov 17, 2014 |
9775790 |
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15677668 |
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13658517 |
Oct 23, 2012 |
8888489 |
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14542851 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61C 19/004 20130101;
A61N 5/0603 20130101; A61N 2005/0651 20130101; A61K 2800/884
20130101; A61N 5/0624 20130101; A61Q 11/00 20130101; A61C 11/00
20130101; A61K 2800/59 20130101; A61C 19/066 20130101; A61N
2005/0606 20130101; A61C 19/003 20130101; A61K 8/8152 20130101;
A61C 19/06 20130101; A61K 2800/81 20130101; A61C 17/005 20130101;
A61N 2005/0662 20130101; A61K 8/22 20130101 |
International
Class: |
A61K 8/22 20060101
A61K008/22; A61C 19/06 20060101 A61C019/06; A61K 8/81 20060101
A61K008/81; A61N 5/06 20060101 A61N005/06; A61C 17/00 20060101
A61C017/00; A61C 13/15 20060101 A61C013/15; A61Q 11/00 20060101
A61Q011/00 |
Claims
1. A method for simultaneous cleaning and whitening teeth
comprising: applying an oxidizing composition to the surfaces of
the teeth to be whitened; exposing the surfaces of the teeth to be
whitened to light energy; and performing a dental cleaning or
hygiene procedure while the oxidizing composition is in contact
with the teeth, the dental cleaning or hygiene procedure including
at least one of cleaning said teeth, scaling said teeth, and
polishing said teeth
Description
BACKGROUND OF THE INVENTION
[0001] As the connections between healthy teeth and gums, and
general overall health, have become increasingly evident in the
past 100 years, oral care has become an important part of people's
daily health maintenance regimens. In the process, a healthy
looking smile has become representative of one's level of personal
grooming and even social status, with straight, white and well
shaped teeth being promoted in advertising and by cosmetic dentists
as an integral part of one's self-image. Over the past 20 years,
the availability of tooth whitening products and services has
exploded in the marketplace, ranging from low priced
over-the-counter (OTC) self-applied trays, strips, pens,
mouthwashes and toothpastes, to expensive professionally applied or
monitored products and procedures capable of effectively whitening
teeth in as little as 45 minutes. In general, professionally
applied products and services administered to a patient in a dental
office or other clinical setting are seen to achieve the best teeth
whitening results in the shortest amount of time. This is primarily
due to the concentration of active ingredient, usually hydrogen
peroxide or a hydrogen peroxide precursor, found in professionally
applied whitening compositions. Such high concentrations, typically
above 15% hydrogen peroxide by weight and often as high as 50%
hydrogen peroxide by weight, can only be safely administered in a
controlled setting where a professionally trained individual can
isolate soft tissues from contact with these highly oxidative
compositions. Frequent monitoring of a patient's progress over, for
instance, a one-hour period is also critical in maintaining a high
degree of safety when working with such high hydrogen peroxide
concentrations. Optionally, light or heat energy may be applied in
conjunction with these strong oxidizing compositions, in order to
accelerate the process beyond that which is possible using just the
compositions on their own. In general, these
professionally-monitored products and services applied in a dental
office or clinic will be referred to collectively as in-office or
chairside whitening procedures.
[0002] Chairside whitening procedures are generally performed
during a dental appointment scheduled specifically for the purpose
of whitening the patient's teeth, or as an adjunct following a
professional teeth cleaning, formally known as a dental prophylaxis
or "prophy". When tooth whitening is conducted immediately
following a prophy, the total amount of time that the patient must
remain in a dental chair can often exceed two hours.
[0003] A professional tooth cleaning is recommended by the American
Dental Association as a means to prevent gum disease. Gum disease,
or periodontitis, is the primary cause of tooth loss in adults over
the age of 40. Gum disease has also been linked to other health
problems, such as heart disease, osteoporosis, respiratory
diseases, and other more serious systemic diseases. According to
the Center for Disease Control and Prevention, approximately 68% of
adults in the United States have at least one professional tooth
cleaning annually (2008). There is speculation as to the reasons
why so many adults neglect the benefits obtainable from regular
tooth cleanings, ranging from lack of health insurance to the tear
of dental procedures. Lack of patient knowledge is a problem that
can be managed, however studies have shown that better education of
patients only leads to modest changes in behavior and attitudes
towards preventative dentistry.
[0004] In general, a typical teeth cleaning dental appointment
comprises the following procedural steps: [0005] (1) A dental
hygienist or dental assistant may or may not take x-rays of a
patient's teeth. [0006] (2) The dental hygienist or dental
assistant will generally take between 15 and 60 minutes to work on
the teeth and gums (the exact time depending upon both the amount
of accumulation present, as well as the teeth cleaning method
chosen), using a variety of tools, including manual or ultrasonic
scalers to remove the tartar and plaque from the patient's teeth.
[0007] (3) The hygienist will then floss between the teeth and
generally complete the cleaning procedure by polishing the front
(buccal) and back (lingual) surfaces of the teeth with an abrasive
composition known as a prophylaxis ("prophy") paste. Tooth
polishing leaves a smooth tooth surface that is more resistant to
the adhesion and buildup of dental plaque between dental cleaning
appointments.
[0008] Despite the apparent benefits of preventative teeth cleaning
as described above, nearly 80% of the population has some form of
gum disease ranging from early stage gingivitis to advanced
periodontitis. Symptoms of gum disease may include one or more of
the following: bleeding gums, halitosis (bad breath), bad taste in
the mouth, tooth sensitivity, sore gums, loose adult teeth,
abscessed teeth or gums pulling away from the teeth, changes in the
way the teeth fit together or dentures fitting poorly, exudates
between the gums and teeth, sores in the mouth, and actual tooth
loss. Such a high rate of chronic or acute gum disease indicates a
low level of compliance when it comes to scheduling of a regular
dental cleaning, and any means of increasing such compliance would
clearly be beneficial to the patient's general oral health.
BRIEF DESCRIPTION OF THE INVENTION
[0009] The inventive tooth cleaning and whitening method comprises
novel compositions and procedural steps that allow for the
simultaneous performance of a dental prophylaxis and tooth
whitening procedure. The procedure involves steps performed at
least partially in parallel or contemporaneously with a typical
dental prophylaxis procedure during which a significant amount of
plaque, tartar and acquired pellicle are removed. In general, these
steps may include, but are not limited to, chemical, mechanical
and/or chemomechanical tooth surface conditioning, contact or
impregnation of one or more teeth with a catalyst, contact or
impregnation of one or more teeth with an oxidizing agent, exposure
of one or more teeth to actinic energy comprising heat, light,
sound, ultrasound, air or mechanical pressure (and combinations
thereof), and contact or impregnation of one or more teeth with a
tooth remineralizing, opacifying or pigmenting composition.
Combinations of the above procedural steps have been developed that
accomplish significant whitening of stained teeth in less than
about 90 minutes when performed in conjunction with or during a
dental prophylaxis procedure.
[0010] The ability of the inventive compositions and methods to
simultaneously whiten teeth in parallel with a dental cleaning
procedure is highly dependent upon the ability of the oxidizing
agent to penetrate into tooth enamel and dentin. Both tooth enamel
and dentin are composite structures comprising both organic and
inorganic phases as well as interstitial spaces that are occupied
by fluid. These interstitial spaces can accommodate fluid movement,
which is generally in an outward direction, in other words from the
interior of the tooth towards the enamel surface. However, fluids
and other materials in contact with the enamel surface can
influence fluid movement through tooth enamel and dentin with
concentration gradients and/or capillary action, as well as in
conjunction with pressure, heat, light and other external physical
forces that can change the dynamic relationship between the tooth
and the fluid in contact with the tooth.
[0011] Mathematical models have been constructed to predict the
ability of fluids to penetrate into porous substrates. The
Lucas-Washburn equation is one such method of developing a
comparative "Penetration Coefficient" for various fluids, based on
their viscosity, surface tension (with air) and contact angle (with
a porous substrate). The model assumes that the porous solid is a
bundle of open capillaries, so in other words the Penetration
Coefficient is a comparative predictor of capillary flow rate. The
Lucas-Washburn equation
d 2 = ( .gamma. cos .theta. 2 .eta. ) rt ##EQU00001##
predicts the distance (d) traveled by a liquid in a porous
substrate, where the liquid has a surface tension (.gamma.) with
air, a contact angle (.theta.) with the porous substrate surface
and a dynamic viscosity (.eta.), and where (r) is the capillary
pore radius and (t) is the penetration time. The bracketed
component of the Lucas-Washburn equation is the Penetration
Coefficient, expressed as centimeters per second
PC = .gamma. cos .theta. 2 .eta. ##EQU00002##
[0012] The Lucas-Washburn equation predicts that the higher the PC,
the faster a liquid will penetrate into a given porous capillary
substrate. This means that, at least in theory, a high PC can be
achieved for liquids with low viscosities, particularly for
compositions also having a low contact angle (which is often, but
not always, associated with a liquid having a low surface tension
that will lead to efficient wetting of the porous substrate.
[0013] Penetration coefficients have been used recently to design
improved dental materials, specifically sealants and low-viscosity
composites intended to arrest the progression of carious lesions
(Paris, et al, Penetration Coefficients of Commercially Available
and Experimental Composites Intended to Infiltrate Enamel Carious
Lesions, Dental Materials 23 (2007) 742-748). The authors show that
low viscosity materials with high Penetration Coefficients (>50
cm/s) are capable of penetrating enamel carious lesions better than
materials with low PCs (see corresponding patent application US
2006/0264532).
[0014] Prior art tooth whitening compositions have generally been
formulated to have high viscosities for better retention in dental
trays during the bleaching process, which prevents migration of the
whitening composition from the tray due to salivary dilution.
Moderate to high viscosities have also been the norm for chairside
whitening procedures, in order to prevent the whitening composition
from migrating away from the tooth enamel surface. According to the
Lucas-Washburn equation, moderate to high viscosity tooth whitening
compositions (greater than about 100 centipoise at 25 deg C.) will
have low Penetration Coefficients and thus be predicted to have
restricted movement into the whitening target, that is, the porous
enamel substrate. It would thus be advantageous to design a tooth
whitening carrier composition comprising an oxidizing agent with a
low viscosity (<100 cps) and a high Penetration Coefficient
(>50 cm/s) in order to achieve rapid penetration into tooth
enamel and dentin.
[0015] Other factors affecting the ability of a liquid penetrant to
infiltrate enamel and dentin are (1) surface charge effects (which
is related to pH of the micro environment within the tooth, as well
as the pH and counter ion content of the liquid penetrant), (2)
adhesion of the liquid penetrant to the tooth surface (which is
related to the surface tension and wetting ability of the liquid
penetrant), and (3) osmotic effects (which are related to the
direction of diffusion of the interstitial fluid in the tooth
structure in relation to the liquid penetrant in contact with the
tooth). Under certain circumstances, tooth whitening composition
having viscosities in excess of 100 cps are contemplated, for
instance when auxiliary means of increasing the penetration rate
are available. For example, a tooth whitening composition with a
viscosity between 5,000 and 100,000 cps can be utilized if heat
and/or light and/or vibrational energy is used to increase the
penetration rate of the composition into the tooth enamel
structure.
[0016] In general, one aspect of the inventive simultaneous tooth
cleaning and whitening method comprises the following steps,
preferably performed in a sequence of steps comprising: [0017]
applying an oxidizing composition to the surfaces of the teeth to
be whitened; and [0018] performing a dental cleaning or hygiene
procedure while the oxidizing composition is in contact with the
teeth to be whitened.
[0019] In another aspect of the invention, a method for
simultaneously cleaning and whitening teeth comprises the steps of:
[0020] applying a conditioning composition to the teeth surface;
[0021] applying an oxidizing composition to the teeth surface;
[0022] applying a sealant composition to the teeth surface; [0023]
cleaning the teeth surface; [0024] polishing the teeth surface; and
[0025] removing the condition compositions from the teeth.
[0026] In yet another aspect of the invention, a method for
simultaneously cleaning and whitening teeth comprises the steps of:
[0027] applying a composition to the teeth surface, wherein said
composition is comprised of at least a fluid carrier, a tooth
conditioner, an oxidizing agent and a water-resistant polymer,
[0028] cleaning said teeth surface; [0029] polishing said teeth
surface; and [0030] removing said composition.
[0031] There is typically an extensive amount of scraping, scaling,
and other modes of plaque and tartar removal performed during a
dental cleaning or prophylaxis. During the cleaning procedure, the
patient's mouth is usually open for an extended period of time
during which excess saliva may accumulate in the oral cavity and
come in contact with the tooth surfaces. Also, the patient is
typically asked to rinse with water or a mouthwash at various times
during the cleaning procedure in order to clear debris (plaque,
tartar, blood, saliva, etc) from the oral cavity that accumulates
from the cleaning process. It has been found that in order to
achieve a desirable (that is, a noticeable) level of tooth
whitening during said dental cleaning or prophylaxis, it is
advantageous to prevent moisture from saliva or external sources
(such as the rinsing solutions referred to above) from directly
contacting the tooth surfaces that have been previously contacted
with the oxidizing composition. By creating a barrier between
extraneous moisture and the oxidizing composition, said moisture is
prevented or limited in its ability to remove, dilute, neutralize
or otherwise decrease the effectiveness of the oxidizing
composition during the cleaning procedure.
[0032] One means of limiting the contact of external moisture with
the oxidizing composition is to utilize an oxidizing composition
having hydrophobic ("water-repelling") properties when in contact
with the tooth surface.
[0033] An alternative means of preventing moisture contamination of
the oxidizing composition on the tooth surface is to cover the
oxidizing composition with a film of water-insoluble or
water-resistance material. Such materials may include, but are not
limited to, polymer films and water-resistant or water-insoluble
fluids, gels, creams, waxes and solids.
[0034] Yet another alternative means of preventing moisture
contamination of the oxidizing composition on the tooth surface is
to cover the oxidizing composition with a curable composition that
can be converted from a liquid or gel into a higher viscosity
liquid, gel or solid upon exposure to an external source of energy.
Said external energy source may be electromagnetic or light energy,
sound or ultrasound energy, mechanical or vibrational energy,
electrical energy, or combinations thereof.
[0035] A preferred tooth cleaning and whitening method comprises
the following steps [0036] 1) Placing a cheek and lip retraction
means into the oral cavity of a subject. Said means may include a
cheek retractor and/or cotton rolls placed in such a way as to
prevent the soft tissue of the inside of the lips and cheeks from
coming into contact with the tooth surfaces, [0037] 2) Conditioning
of the teeth surfaces to be whitened with a conditioning agent or
conditioning composition, using chemical, mechanical, or
chemo-mechanical means, [0038] 3) Contacting the conditioned tooth
surfaces with one or more compositions comprising an oxidizing
agent, [0039] 4) Contacting the tooth surfaces with a
water-resistant coating or film-forming composition to protect the
oxidizing agent from direct contact with external moisture during
the tooth cleaning process, [0040] 5) Cleaning and scaling of
subject's teeth in proximity to the gum line, gingival margins and
crevicular spaces while the compositions of steps (3) and (4) above
are in contact with the tooth surfaces, [0041] 6) Polishing the
teeth with prophylaxis or polishing paste following completion of
step (5), [0042] 7) Optionally repeating steps (3) and (4), and
[0043] 8) Cleaning and rinsing all residual materials from tooth
and gum surfaces that were applied or produced during the
performance of steps (1) through (7).
[0044] Modifications to the above procedure are possible and are
some cases preferable. For instance, the conditioning agent or
conditioning composition may be combined with the oxidizing
composition of step (3) in order to reduce the amount of time
required to perform the combined cleaning and whitening procedure.
Also, water-resistant properties may be imparted to the oxidizing
composition of step (3) in order to obviate the need for a separate
step (4). Therefore, it is contemplated, but not required, that the
compositions and/or agents of steps (2), (3) and (4) may be
combined into a single composition (a) prior to packaging, (b) just
prior to use, or (c) on the tooth surface during use. Optionally, a
tooth-desensitizing agent, such as potassium nitrate, may be
applied before, during, or after any of the steps outlined above.
Such tooth-desensitizing agent may be applied as a stand-alone
formulation or combined with the conditioning agent, oxidizing
agent, water-resistant or film-forming composition, or any
combination of these.
[0045] It is also contemplated within the scope of this invention
to employ light energy and/or heat energy to accelerate the tooth
whitening process through various means such as increasing the rate
of oxidizing composition penetration into enamel and dentin,
increasing the susceptibility of tooth stain chromogens to
oxidation, and accelerating the oxidation process through advanced
oxidation processes such as the photo-Fenton reaction. An added
benefit of employing light energy, particularly that in the blue
region of the light spectrum (approximately 400-500 nanometers),
during the inventive simultaneous tooth cleaning and whitening
process, is observed by the attenuation and/or killing of
periodontal pathogens within the light energy exposure field. A
particularly useful benefit to reducing the viability of
periodontal pathogens prior to, during and/or after a tooth
cleaning is the reduction in risk associated with a lower bacterial
burden during a moderately invasive procedure (tooth cleaning) that
can sometimes involve bleeding. Reduction of the available numbers
and types of oral pathogens during a tooth cleaning process may be
of significant benefit to the subject's overall oral and whole body
health, since the association between the presence of periodontal
pathogens, such as the black pigmented bacteria species
Fusobacterium nucleatum and Porphyromonas gingivalis, and the
incidence of systemic diseases (such as heart disease) has been
shown in recent years to be quite strong. Light energy employed in
the initial steps of the present inventive method is seen to be
most beneficial, since pathogen reduction prior to the invasive
cleaning process would occur. However, light energy applied at any
point in time during the cleaning and whitening process can be of
significant benefit to the patient's gingival and periodontal
health.
[0046] Particularly useful is light energy having the following
characteristics: wavelengths of between 380 and 700 nanometers
(nm), between 400 and 500 nm, and between 410 and 460 nm; and light
intensity (measured at the target surface, for example the tooth or
gum surfaces, in terms of power density) of between 100 and 5,000
milliwatts per centimeter squared (mW/cm.sup.2), between 100 and
2,000 mW/cm.sup.2, between 500 and 1,500 mW/cm.sup.2, and between
100 and 300 mW/cm.sup.2. Light sources such as light emitting
diodes (LEDs), quartz halogen bulbs, tungsten halogen bulbs, plasma
arc bulbs, and xenon flash lamps, to name a few, are contemplated
to have utility in the present invention. Preferred light sources
are LEDs with emission peaks between 400 and 500 nanometers.
BRIEF DESCRIPTION OF THE DRAWING
[0047] The objects of the invention will be better understood from
the detailed description of its preferred embodiments which follows
below, when taken in conjunction with the accompanying drawings, in
which like numerals and letters refer to like features throughout.
The following is a brief identification of the drawing figures used
in the accompanying detailed description.
[0048] FIG. 1 is a schematic depiction of an over molded lens that
can be attached to a hand-held dental curing lamp for enhancing
whitening in accordance with one aspect of the present
invention.
[0049] FIG. 2 is an isometric view of the over molded lens shown in
FIG. 1.
[0050] Those skilled in the art will readily understand that the
drawings in some instances may not be strictly to scale and that
they may further be schematic in nature, but nevertheless will find
them sufficient, when taken with the detailed descriptions of
preferred embodiments that follow, to make and use the present
invention.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
[0051] The compositions of the present invention are designed to
provide a fast and effective means of whitening the teeth during
the performance of a dental cleaning or prophylaxis. Various
combinations of tooth conditioning compositions, oxidizing
compositions and sealant compositions are envisaged to have utility
in the practice of the inventive method, and the properties of
these individual compositions may be combined into a single
composition for ease of use and application. Alternatively, a tooth
conditioning function may be combined with an oxidizing function
into a single composition. Another alternative is to combine a
tooth sealing function with an oxidizing function to reduce the
number of application steps.
[0052] The tooth conditioning composition may comprise a fluid
carrier and one or more tooth conditioning ingredients. Fluid
carriers include water, ethanol, diethyl ether, methoxypropane
(methyl propyl ether), dimethyl isosorbide and combinations
thereof. The tooth conditioning function, that is the ingredient or
ingredients that remove the acquired pellicle and subsequently open
the enamel porosities for better penetration of the oxidizing
composition, may be provided by ingredients having an acidic and/or
calcium chelating capabilities. Useful acidic compounds include
both inorganic and organic acids such as phosphoric acid,
hydrochloric acid, acetic acid, lactic acid, citric acid, and their
salts. Useful calcium chelating compounds include both inorganic
and organic chelating agents such as ethylenediaminetetraacetic
acid (EDTA), phytic acid, 1-hydroxyethylidene-1,1'-diphosphonic
acid, citric acid, and their salts. The tooth conditioning
composition may also comprise colorants and/or pigments to assist
in the placement and application of the tooth conditioning
composition onto the teeth during the combination whitening and
cleaning procedure.
[0053] The oxidizing composition comprises a fluid carrier and an
oxidizing agent. Fluid carriers include water, ethanol, diethyl
ether, methoxypropane (methyl propyl ether), dimethyl isosorbide
and combinations thereof. Oxidizing agents include peroxides, metal
chlorites, percarbonates, perborates, peroxyacids, hypochlorites
and combinations thereof. Preferred oxidizing agents are hydrogen
peroxide, carbamide peroxide, poly (vinyl pyrrolidone)-hydrogen
peroxide complex (Peroxydone.RTM., ISP Corp, Wayne, N.J.),
peroxyacetic acid, and sodium chlorite. The oxidizing composition
preferably has a viscosity of less than about 100 centipoise and
most preferably less than about 10 centipoise. The oxidizing
composition may also comprise active components further related to
the tooth whitening function (such as stabilizers, a secondary
oxidizing agent, an oxidation catalyst, a pH-adjusting agent, and a
calcium chelating agent), or to a non-tooth whitening function
(such as remineralization of the tooth surface, prevention of tooth
decay, tooth-desensitization, prevention of gingivitis and/or
periodontal disease, and other diseases or conditions of the oral
cavity). In addition, the oxidizing composition may comprise one or
more colorants and/or pigments to assist in the placement and
application of the sealant onto the teeth during the combination
whitening and cleaning procedure. Such colorants and/or pigments
may also be present to provide a stain masking effect that changes
the appearance of the tooth while the oxidizing composition is in
contact with the tooth surface during the procedure.
[0054] Preferred oxidation catalysts are chelated metal complexes,
in particular complexes of iron and manganese. Particularly
preferred chelated metal complexes are the family of
tetraamido-N-macrocyclic ligand (TAML) iron catalysts described in
U.S. Pat. Nos. 7,060,818, 6,241,779, 6,136,223, 6,100,394,
6,054,580, 6,099,586, 6,051,704, 6,011,152, 5,876,625, 5,853,428,
and 5,847,120.
[0055] The oxidizing compositions of the present invention may also
contain a surface active agent in order to lower the surface
tension of the composition to provide for better wetting and
adhesion of the liquid to the surface of the tooth. Anionic,
cationic, non-ionic and zwitterionic surfactants are contemplated
to have utility in providing the oxidizing compositions with a low
surface tension. Preferred surfactants are sulfobetaines (such as
amidosulfobetaine 3-16 and Lonzaine CS) and fluorosurfactants (such
as Capstone 50 and Capstone FS-10).
[0056] Sealant compositions of the present invention may comprise a
water-resistant polymer, copolymer or crosspolymer, and a fluid
carrier. Hereinafter the term "polymer" and "polymers" shall be
used to denote polymer(s), copolymer(s) or crosspolymer(s).
Suitable water-resistant polymers include acrylate polymers,
methacrylate polymers, modified cellulosic polymers, silicone
polymers, urethane polymers, polyamide polymers, vinyl polymers,
vinyl pyrrolidone polymers, maleic acid or itaconic acid polymers,
and others. The water-resistant polymer should be soluble or
dispersible in the fluid carrier. Particularly preferred polymers
are poly (butyl methacrylate-co-(2-dimethylaminoethyl)
methacrylate-co-methyl methacrylate), poly (ethyl
acrylate-co-methyl methacrylate-co-trimethylammonioethyl
methacrylate chloride), ethylcellulose, and esterified or
crosslinked poly (methyl vinyl ether-co-maleic anhydride). The
fluid carrier may be a volatile solvent which will evaporate after
contacting the sealant composition with the tooth surface, leaving
behind a liquid or solid coating or film. Said solvent should have
an evaporation rate equal to or greater than that of water, and
preferably equal to or greater than that of butyl acetate. Suitable
solvents include, but are not limited to, water, ethanol, diethyl
ether, methoxypropane (methyl propyl ether), acetone, ethyl
acetate, and other highly volatile solvents.
[0057] Alternatively, the sealant compositions may be curable
liquids or gels, which are placed on the tooth surface and
subsequently exposed to some form of activating energy which
converts the liquid or gel sealant composition to a solid coating
or film. Curable sealant compositions may also be chemically cured,
whereby two or more components are combined just prior to use and
placed on the tooth surface to cure, in other words, to change from
a liquid or gel into a solid coating or film.
[0058] The sealant composition may also comprise active components
related to a tooth whitening function (such as an oxidizing agent,
an oxidation catalyst, a pH-adjusting agent, and a calcium
chelating agent), or to a non-tooth whitening function (such as
remineralization of the tooth surface, tooth-desensitization,
prevention of tooth decay, prevention of gingivitis and/or
periodontal disease, and other diseases or conditions of the oral
cavity). In addition, the sealant composition may comprise one or
more colorants and/or pigments to assist in the placement and
application of the sealant onto the teeth during the combination
whitening and cleaning procedure. Such colorants and/or pigments
may also be present to provide a stain masking effect that changes
the appearance of the tooth while the sealant composition is
attached to the tooth surface in the form of a coating or film.
[0059] The combination whitening and cleaning method described
herein may also be practiced by employing an additional source of
energy to accelerate the oxidation process and further reduce the
time needed to complete the procedure. External energy sources such
as electromagnetic or light energy, sound or ultrasound energy,
mechanical or vibrational energy, electrical energy, or
combinations thereof may be advantageously employed at any point in
time during the combination whitening and cleaning procedure to
accelerate the process.
EXAMPLES
[0060] In order to achieve a significant degree of tooth whitening
in an abbreviated time frame suitable for integration into the
tooth cleaning (dental prophylaxis) process, ideal conditions for
(1) oxidizer penetration into the tooth and (2) conversion of
initial oxidizer form into active whitening species must be
facilitated.
[0061] Time limitations are imposed on the additional steps
required to achieve whitening during the tooth cleaning process by
the realities of patient scheduling in the typical dental office,
and such additional steps should not exceed 30 minutes beyond or in
addition to the time required to perform a typical dental
prophylaxis. Optimal conditions for penetration of an active
whitening composition into tooth enamel must be present in order to
reduce the amount of time and oxidizer concentration required to
reach intrinsic stain depth. Important factors related to oxidizer
penetration into the tooth are (1) the viscosity of the oxidizing
composition, (2) the surface tension of the oxidizing composition
and (3) the surface free energy (also called the critical surface
tension) of the tooth surface.
[0062] The surface free energy of exposed tooth enamel is generally
in the range of about 50-55 dynes/cm, however the acquired pellicle
can lower this number significantly. In fact, one of the important
functions of the acquired pellicle is to reduce the critical
surface tension of the tooth surface in order to reduce the
adhesion of bacteria. Liquid and gel compositions contacting the
tooth surface penetrate into the tooth structure in relation to
four primary factors: time, viscosity of the liquid or gel, surface
tension of the liquid or gel, and surface free energy of the tooth
at the point of contact.
[0063] The relationship of liquid surface tension to solid surface
free energy, low contact angle (the tangential angle formed by a
droplet deposited on a solid surface) and low viscosity, are all
directly related to the Penetration Coefficient (as derived from
the Lucas-Washburn equation) and must be optimized for the
whitening composition to (1) rapidly wet the surface of tooth
enamel and (2) penetrate the available porosities and channels
through enamel as quickly as physically possible.
Example 1
[0064] The ability of various oxidizing compositions to penetrate
intact enamel and dentin was determined as follows. Extracted molar
and pre-molar teeth were obtained from orthodontists with patient
consent and stored refrigerated in phosphate buffered saline (PBS)
solution at pH 6.8 until use. In order to assess the ability of
various liquid carrier fluids to penetrate tooth enamel, teeth were
sectioned to remove their roots and a 3 mm diameter chamber was
created in the center of the sectioned crown that was filled with
PBS solution. The crowns were partially immersed (chamber with PBS
solution facing up) in various liquid carrier fluids and a small (1
microliter) sample of the PBS solution was drawn every 60 seconds
and placed on a peroxide test strip (EM Quant Strips 10337, EMD
Chemicals, a division of Merck SA, Darmstadt, Germany) to determine
the amount of time required for hydrogen peroxide to penetrate the
tooth enamel and dentin from the outer surface of the crown to the
interior chamber containing PBS.
[0065] Oxidizing compositions in Table 1 below were prepared and
stored in 20 ml glass vials until use.
TABLE-US-00001 TABLE 1 Percent (w/w) Ingredient 1A 1B 1C 1D 1E 1F
1G 1H 1I 1J 1K 1L Water 75.0 65.0 75.0 65.0 85.0 75.0 65.0 75.0
65.0 75.0 65.0 .sup. 100.0 Ethanol 200 10.0 20.0 5.0 15.0 5.0 15.0
Diethyl ether 5.0 5.0 Methoxypropane 5.0 5.0 Acetone 10.0 20.0
Dimethyl isosorbide 10.0 20.0 Hydrogen peroxide 15.0 15.0 15.0 15.0
15.0 15.0 15.0 15.0 15.0 15.0 15.0 .sup. 0.0 Adjusted to pH 4.0
with potassium hydroxide 0.1M Viscosity (cps @ 25 C.) <1 <1
<1 <1 .sup. 1.3 <1 <1 <1 <1 1.5 1.5 1 Surface
tension <40 <40 <40 <40 >50 <40 <40 <40
<40 <40 <40 >50 (dynes/cm) Contact angle (deg) <10
<10 <10 <10 30+ <10 <10 <10 <10 15 15 50+ PC
(calculated) >100 >100 >100 >100 <50 >100 >100
>100 >100 >100 >100 <30 H.sub.2O.sub.2 detection
(min) 13 12 12 10 20 14 12 14 14 15 15 ND* *ND = Not detected
[0066] Oxidizing compositions in Table 1 trended towards faster
penetration of the tooth when both contact angle and viscosity of
the composition was low (Examples 1A, 1B, 1C, 1D, 1F, 1G, 1H, 1I,
1J, and 1K). Oxidizing with high contact angles (greater than 30
degrees) did not seem to penetrate as well as those with contact
angles less than about 10 degrees.
Example 2
[0067] The following multi-step process was developed to provide
for rapid and effective whitening of the teeth during a dental
cleaning procedure.
[0068] Step 1--Acquired Pellicle Removal
[0069] Facilitating oxidizer penetration into the tooth requires a
thorough removal or modification of the acquired pellicle prior to
contact with the oxidizer formulation. Therefore, whether
integrated into a dental prophylaxis procedure or performed as a
stand-alone process, the first step in the abbreviated whitening
process (after determining a starting tooth shade) must be the
removal of the acquired pellicle using chemical, mechanical or
(preferably) chemo-mechanical means. Once the acquired pellicle has
been removed, it is important that the "cleaned" tooth enamel
surface has limited contact with the patient's saliva prior to
application of the oxidizer composition (see Step 2) in order to
prevent reformation of the pellicle film on the exposed enamel
surface. Removal or modification of the acquired pellicle and
optional micro-roughening of the exposed enamel surface will
elevate the enamel surface free energy (preferably above about 60
dyne/cm), which promotes better wetting of the enamel surface by
the oxidizing composition. Surface wetting is a key factor related
to the speed at which a composition penetrates enamel, analogous to
the effects of viscosity and surface tension on the penetration of
bonding adhesives into conditioned enamel and sealants into caries
lesions.
[0070] Step 1a Placement of Cheek Retractor or Other Means of
Preventing Contact of the Lips and Interior Gum Surfaces with the
Teeth.
[0071] Step 1b Application of Conditioner for 30-60 Seconds
[0072] Tooth Conditioner Composition
TABLE-US-00002 Ingredient Percent (w/w) Water 90.0 Poly (methyl
vinyl ether-co-maleic anhydride)* 10.0 *Gantrez S-95 (ISP Corp,
Wayne, NJ) (hydrolyzed, pH 2.0)
[0073] Step 2--Oxidizer Contact and Penetration
[0074] Once the acquired pellicle has been removed, the teeth
surfaces are contacted with a low viscosity oxidizer composition
with a surface tension significantly lower than that of the surface
free energy of the exposed enamel surface. A low viscosity
oxidizing composition that has a low surface tension will have a
very low contact angle when placed on the enamel surface and thus
be better suited to penetrate into the enamel porosities. The
oxidizer composition should comprise hydrogen peroxide in an
aqueous form (or mixed with viscosity-reducing solvents) and at a
concentration between about 1% and 30% by weight (higher amounts
being contemplated in situations where precise control and
placement of the oxidizing composition is possible). The oxidizing
composition should also have a pH within a range similar to that
reported for the isoelectric point of tooth enamel, which is
between about 3.8 and 4.7, although higher pH1 levels are possible
with oxidizing compositions comprising ionized species capable of
counteracting the influence of charged components in tooth enamel.
The oxidizing composition is brushed repeatedly onto the tooth
surfaces to be whitened over the period of about 7-10 minutes to
provide as much full strength hydrogen peroxide at the interface
over the initial treatment phase.
[0075] Step 2a Application of Oxidizing Composition to Buccal and
(Optionally) Lingual Surfaces of Teeth
[0076] Oxidizer Composition
Example 1D
[0077] Step 3--Sealing Enamel Surface Prior to Dental Prophylaxis
Procedure
[0078] In order to prevent dilution or removal of the oxidizing
composition in or from the tooth enamel treated in accordance with
Step 2 above, a water-resistant protective sealant is applied (and
if solvent-based, allowed sufficient time for the carrier solvent
to evaporate). The sealant composition may also comprise an
additional oxidizing agent to provide an additional reservoir of
whitening active, and/or an advanced oxidation catalyst in order to
promote active oxidizing species such as hydroxyl radicals (.OH)
and perhydroxyl anions (--OOH). and/or a desensitizing agent to
reduce or eliminate any tooth sensitivity associated with the
procedure.
[0079] Step 3a Application of Sealant to Buccal and (Optionally)
Lingual Surfaces of Teeth
[0080] Sealant Composition
TABLE-US-00003 Ingredient Percent (w/w) Ethanol 200 proof 90.0 Poly
(butyl methacrylate-co-(2-dimethylaminoethyl) 10.0
methacrylate-co-methyl methacrylate)* *Eudragit E100 or EPO (Evonik
Rohm GmbH, Darmstadt, Germany)
[0081] The sealant composition is applied onto the surfaces of the
teeth previously contacted with the oxidizing composition and
allowed to fully dry before proceeding to Step 4.
[0082] Step 4--Performance of the Dental Prophylaxis Procedure
[0083] Following the sealing process, a dental prophylaxis is
performed using standard protocols and materials. Care should be
taken to avoid excessive disruption of the sealant on the buccal
and lingual (if coated) surfaces of the teeth during the cleaning
procedure. The dental prophylaxis is otherwise performed in a
standard fashion, including polishing of the teeth with a standard
prophy paste (which will remove the Sealant applied in Step 3). A
final tooth shade may be taken at this time.
[0084] Step 5--Final Treatment
[0085] If time permits, Steps 2 and 3 are repeated after prophy
cleanup. No further intervention is required to remove the Sealant
if applied after completion of the dental prophylaxis and dismissal
of the patient. The Sealant may remain in place after the patient
leaves the office and will slowly erode over time. The patient may
also be supplied with a home-use version of the oxidizing
composition and the sealant as an option for continued improvement
in tooth color.
[0086] The above steps were performed on extracted molars and
premolars (n=25) obtained through orthodontists with patient
consent and stored refrigerated in phosphate buffered saline (PBS)
solution at pH 6.8 until use. Individual teeth were removed from
the PBS solution, allowed to air dry for 60 seconds and the roots
inserted up to the cementoenamel junction into a high viscosity
aqueous gel to keep the roots hydrated during the procedure. An
initial tooth shade was taken using a Minolta CM504i chromameter
(Konica-Minolta) and recorded. Steps 2 (total treatment time of 10
minutes) and 3 (total treatment time of 120 seconds) were performed
on the extracted teeth, and a 32 minute period was allowed to
elapse during which the teeth were rinsed with water every 8
minutes to simulate the rinsing process that typically occurs
during the cleaning process. After the simulated cleaning process
time had elapsed, the teeth were polished with a medium grit prophy
paste using a slow speed handpiece and prophy cup. Teeth were
rinsed with water and a final tooth shade was taken using the
method described above and recorded in Table 2 below (L, a,
b=Initial color readings, L*, a*, b*=final color readings).
TABLE-US-00004 TABLE 2 Tooth L a b L* a* b* Delta L Delta a Delta b
Delta E 1 76.10 3.14 15.98 78.11 1.61 13.13 2.01 -1.53 -2.85 3.81 2
76.90 3.44 12.45 80.98 2.40 13.01 4.08 -1.04 0.56 4.25 3 74.23 3.32
16.05 78.33 1.98 12.77 4.10 -1.34 -3.28 5.42 4 74.25 2.00 16.21
77.21 1.74 12.12 2.96 -0.26 -4.09 5.06 5 78.21 3.24 14.76 80.43
1.99 11.26 2.22 -1.25 -3.50 4.33 6 75.21 3.01 15.90 77.77 2.45
14.01 2.56 -0.56 -1.89 3.23 7 74.79 1.82 13.88 78.23 1.43 13.20
3.44 -0.39 -0.68 3.53 8 72.24 3.32 16.43 75.20 2.99 13.95 2.96
-0.33 -2.48 3.88 9 73.19 3.87 15.81 78.81 2.33 10.32 5.62 -1.54
-5.49 8.01 10 77.31 3.66 14.73 77.60 1.84 9.99 0.29 -1.82 -4.74
5.09 11 71.89 3.97 17.68 76.39 2.77 14.02 4.50 -1.20 -3.66 5.92 12
74.54 3.58 14.32 78.40 2.87 13.13 3.86 -0.71 -1.19 4.10 13 73.29
3.82 14.65 78.41 2.02 13.03 5.12 -1.80 -1.62 5.66 14 74.03 3.92
16.33 76.75 2.36 14.56 2.72 -1.56 -1.77 3.60 15 71.99 2.98 15.03
77.90 1.75 11.82 5.91 -1.23 -3.21 6.84 16 73.98 3.92 15.57 78.02
1.99 11.08 4.04 -1.93 -4.49 6.34 17 73.12 3.22 16.23 76.19 1.56
13.84 3.07 -1.66 -2.39 4.23 18 76.00 3.42 15.48 78.88 1.98 10.63
2.88 -1.44 -4.85 5.82 19 73.94 3.73 14.14 78.58 2.02 10.73 4.64
-1.71 -3.41 6.01 20 74.74 3.46 15.02 77.33 2.38 13.05 2.59 -1.08
-1.97 3.43 21 70.95 3.98 17.43 75.02 2.97 12.83 4.07 -1.01 -4.60
6.22 22 73.49 4.03 16.55 77.91 3.13 13.43 4.42 -0.90 -3.12 5.48 23
76.03 3.10 18.30 78.73 1.57 13.22 2.70 -1.53 -5.08 5.95 24 73.83
3.28 17.43 77.00 1.22 10.15 3.17 -2.06 -7.28 8.20 25 74.17 2.98
15.12 78.36 2.09 11.03 4.19 -0.89 -4.09 5.92 Average 73.84 3.46
16.03 77.63 2.06 11.98 3.79 -1.40 -4.04 5.72
Example 3
[0087] The following whitening method was used to demonstrate the
ability of a high viscosity tooth whitening composition to remove
an artificial stain from the surface of a bovine enamel substrate
in vitro when light energy is use to enhance penetration.
[0088] Staining of Bovine Enamel Slabs
[0089] 1. Substrates [0090] a. 10 mm.times.10 mm bovine incisor
(enamel) fragments mounted in clear resin [0091] b. 600 grit
finished surface [0092] c. Unsealed
[0093] 2. Storage of Substrates [0094] a. Always store substrates
at 100% relative humidity, or at 4.degree. C. in Double Distilled
H.sub.2O or Phosphate Buffered Saline solution [0095] b. Never
allow substrates to fully dry out as surface will change, dry only
as part of staining procedure and never for extended periods.
[0096] 3. Staining Solution [0097] a. 3 g of fine ground leaf Tea
[0098] b. 3 g of fine ground Coffee [0099] c. 300 ml of boiling
ddH.sub.2O [0100] d. Infuse for 10 min with stirring (use magnetic
stirrer) [0101] e. Filter solution through tea strainer with
additional filter paper [0102] f. Cool to 37.degree. C.
[0103] 4. Preparation of Tooth Samples [0104] a. Labelling: Label
the bovine samples on one side of the resin with permanent marker
(to track the samples if using more than one) [0105] b. Rub the
surface of the enamel with wet wipe and then grit finish is on the
wet surface with orbital motion covering the whole surface for
nearly 10 sec [0106] c. Wash the surface with water and make it dry
with Kimwipe [0107] d. Sealing: Seal all the surfaces of the resin,
excluding the enamel surface of bovine fragment (i.e., all four
sides and bottom) with clear nail varnish [0108] e. Leave it on
bench top for air drying with the enamel surface touching the
bottom for 30-45 min [0109] f. Etching: sequential immersion in 0.2
m HCl saturated Na.sub.2CO.sub.3, 1% Phytic Acid (30 seconds each)
and finally rinse with double distilled H.sub.2O) [0110] g. Make it
dry with Kimwipe and then they are ready for staining
[0111] 5. L*a*b Measurement [0112] Measurement before and after
staining.
[0113] 6. Staining Procedure [0114] a. Prepare the staining broth
(Section 3) and fill a glass bottle with 200 ml of the broth [0115]
b. Keep the samples to be stained in the broth continuously for
four days [0116] c. Tighten the cap of the bottle to ensure that
the broth is not evaporating from the bottle [0117] d. Gently mix
the broth every day to make sure that the particles are not
settling at the bottom of the bottle [0118] e. After staining the
samples, rinse substrate with Millipore water (wipe it) and measure
LAB values
[0119] Samples of the stained bovine enamel slabs were contacted
with a tooth whitening composition shown in Table 3.
TABLE-US-00005 TABLE 3 Ingredient Percent Deionized water 35.40
Glycerin 20.00 Etidronic acid 0.30 Potassium stannate 0.10 Hydrogen
peroxide 12.00 Carbopol 974P-NF 2.00 Sucralose 0.30 PEG-60
hydrogenated castor oil 3.00 Flavor 1.00 Ammonium Hydroxide 29% (to
pH 5.0) 1.10 Total 100.00
[0120] The above composition is a transparent gel having a
viscosity of approximately 10,000 cps @ 25 deg C. and a pH of
5.0.
[0121] The tooth whitening composition of Table 3 was brushed on to
the surfaces of stained bovine enamel slabs prepared as described
above. Immediately after contacting the slabs with the tooth
whitening composition, light energy was applied using a hand-held
dental curing light with a high-powered LED emitting approximately
500 mW/cm.sup.2 of blue light with a peak wavelength of
approximately 450 nm. The hand-held curing light used a lens cup 10
depicted schematically in FIGS. 1 and 2 as having a lens 12 over
which a thermoplastic elastomer cup 14 was molded to provide a
mechanism for spacing the curing light energy L (represented
notionally in FIG. 1) at the same distance from the surface of the
bovine slab for each sample. The over molded cup forms a small
chamber that controls the positioning and movement of the gel on
the tooth surface, while simultaneously emitting light energy
through the lens onto the tooth surface to accelerate the
penetration of the tooth whitening composition into the tooth
structure.
[0122] The resulting changes in L, a and b values, together with
the composite delta E change in tooth color, is shown in Table 4
below.
TABLE-US-00006 TABLE 4 dL da db dE*ab tooth 1 8.15 -4.17 -6.17
11.04 tooth 2 6.91 -3.56 -5.71 9.65 tooth 3 2.69 -1.76 -5.18 6.09
tooth 4 5.53 -2.89 -2.45 6.71
[0123] As can be seen by the changes in L, a and b values, as well
as the composite delta E value changes, significant tooth color
changes may be effected by utilizing a high viscosity tooth
whitening composition when combined with a high intensity light
source adapted with a lens comprising an over molded thermoplastic
elastomer spacer cup. It is anticipated that the inclusion of a
light exposure step, as demonstrated in the Example, would be of
significant advantage in improving the tooth whitening effect
observed in Examples 1 and 2. Exposing the tooth surfaces and their
surrounding soft tissue will also lead to an improvement in
periodontal health through the reduction of periodontal pathogens
such as black pigmented bacteria.
SUMMARY
[0124] It will be understood that the embodiments of the invention
described above can be modified in myriad ways other than those
specifically discussed without departing from the scope of the
invention. General variations to these embodiments may include
different tooth whitening compositions, light sources, methods of
applying compositions and/or light, and contact and/or exposure
time of tooth whitening compositions and/or light on the tooth
surface.
[0125] Those skilled in the art will readily recognize that only
selected preferred embodiments of the invention have been depicted
and described, and it will be understood that various changes and
modifications can be made other than those specifically mentioned
above without departing from the spirit and scope of the invention,
which is defined solely by the claims that follow.
* * * * *