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 . 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 a 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 . 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 ®, 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 desensitivation , 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 . 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 , 719 , 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 . 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 ). 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 . 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 . 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 desensitivation , 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 . 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 . 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 . 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 . 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 . 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 . 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 place 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 . oxidizing compositions in table 1 below were prepared and stored in 20 ml glass vials until use . 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 . the following multi - step process was developed to provide for rapid and effective whitening of the teeth during a dental cleaning procedure . 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 &# 39 ; 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 . step 1a placement of cheek retractor or other means of preventing contact of the lips and interior gum surfaces with the teeth 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 ph 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 . step 2a application of oxidizing composition to buccal and ( optionally ) lingual surfaces of teeth 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 . step 3a application of sealant to buccal and ( optionally ) lingual surfaces of teeth 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 . 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 . 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 . 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 rinse 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 rinse 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 ).
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 .