A dental brush having a flexible fibrous tip with internal cannula to allow medicament, such as tetracycline, chlorhexidine or stannous fluoride, or combinations thereof to flow through the fibrous tip. The flexible fibrous tip includes a nonwoven tufted surface that completely covers the tip to remove plaque. The applicator tip fits between the teeth and the gum line and delivers both physical and chemical treatment to interproximal periodontal pockets. The medicament solution is stored in a disposable sealed and sterile cartridge and is held in the base of the device. A pump built into the base provides pressure to push the medicament through the cannula to the fibrous brush tip to provide site-specific dosage-controlled treatment. The brush tip is disposable and provides effective interproximal subgingival debridement and site-specific application of medication to infected areas.

CROSS-REFERENCE TO RELATED APPLICATIONS 
This application is based on Provisional Application Ser. No. 60/015,413 
filed Apr. 12, 1996. 
FIELD OF THE INVENTION 
This invention relates to dental instruments, and more particularly to a 
dental instrument that includes a fibrous interproximal brush tip which 
provides medication and debridement treatments to infected areas of teeth 
and gums. 
BACKGROUND OF THE INVENTION 
Plaque is an uncalcified mucoprotein material which acts as a growing 
medium for bacteria. Many types of bacteria and the plaque in which they 
grow are the cause of tooth decay and periodontal disease affecting 
approximately 90% of the adult population. To reduce the incidence of 
periodontal disease, it is generally recommended that plaque be removed at 
least once a day. Common methods for removing plaque include 
toothbrushing, flossing, and mouthwash. Regular toothbrushing, even with 
the various available electric devices, cleans approximately 80% of the 
total exposed tooth surface. The remaining 20% interproximally are in the 
area where the most severe and involved periodontal disease occurs. 
Mouthwash is a means for delivering medicaments to diseased areas. 
However, mouthwashes suffer from an inability to penetrate significantly 
below the gum line, and therefore may not contact the diseased areas. 
While many devices have been manufactured to clean teeth, including rotary 
and sonic toothbrushes, none are capable of penetrating well into the 
periodontal pocket. 
A considerable body of evidence shows that debridement, i.e., removal of 
calculus and plaque from the surface of the tooth, in the infected areas 
is not enough to effectively remove the cause of periodontal disease. The 
real issue in effective treatment in periodontal disease is detoxification 
and removal of bacterial endotoxins on the tooth root surface. Moreover, 
as the periodontal pocket deepens (exposing more root surface) the 
efficacy of penetrating and treating the area diminishes significantly. 
U.S. Pat. No. 5,283,924 to Kaminski et al. discloses a dental instrument 
including a foam coated tip for use in oral hygiene. However, foam does 
not have the capability to remove plaque from deep within the periodontal 
pocket. 
SUMMARY OF THE INVENTION 
The invention is a disposable fibrous dental applicator tip that is fed 
medicament via a cannula from the body or base of the instrument. The tip 
of the invention includes a flexible cannula core which is completely 
covered with a nonwoven, tufted surface which is capable of removing 
plaque. The fibrous applicator tip is specifically designed to massage the 
interproximal root surfaces and simultaneously deliver medication directed 
at the sources of periodontal diseases, such as bacteria and endotoxins in 
the gingival sulcus between the teeth. The various medicaments are 
dispensed through a hole or holes located in a flexible probe in the 
cannula to chemically detoxify the affected areas. The types of 
medicaments which could be applied include anti-microbials, 
anti-inflammatories, surfactants, sealants, and other therapeutic 
medicaments which may be available by prescription or over-the-counter. 
Exemplary medicaments include tetracycline, chlorhexidine and stannous 
fluoride. The combination of agitation by the fibrous applicator tip along 
with application of medicaments directly to the affected area permits 
effective, site-specific treatment of periodontal diseases. The 
medicaments used in conjunction with the device are contained in sealed 
sterile disposable cartridges. A pump built into the base provides 
pressure to force the medicament through the tip for application directly 
to the affected area. 
The site-specific applicator tip of the invention affords the user more 
control over the application of the medicament, particularly when 
prescription medicaments are used. The additional control afforded by the 
applicator tip of the invention also permits the dentist to better 
prescribe and control both dosage and dosage frequency, as well as 
duration of the treatment. Although designed primarily for home use, a 
doctor or dentist may prescribe various medications and dosages for 
specific needs and effectiveness of treatment. 
The design of the tip for penetration and scrub as well as the delivery of 
medication makes the device highly effective in removing plaque and 
neutralizing endotoxins and collagenases found in the periodontal pocket. 
As used herein, the term "scrub" refers to mechanical removal of plaque. 
In addition, the choice and dosage of medication is virtually limitless. 
Drugs now available and future drugs could be adapted for use with the 
present invention.

DETAILED DESCRIPTION OF THE INVENTION 
FIG. 1 shows an external view of an embodiment of the invention. The device 
10 includes an applicator base 12, a curved tip 20, and a swivel 
connection 27 connecting the tip 20 to the applicator base 12. A snap-on 
cover cap 14 may also be included to cover the tip 20. The applicator base 
12 may assume any shape, however the ends are preferably cylindrical. 
There may be indented or flattened areas on the applicator base 12 to 
facilitate grip by the user. 
The tip 20 comprises an angled section 16 and an exposed flexible probe 24. 
Nonwoven tufted scrub material 18, comprised of materials such as nylon, 
polyurethane foams or polyolefins is attached to the flexible probe 24 by 
an suitable adhesive, or other bonding or manufacturing method known in 
the art. Alternatively, the material may be comanufactured during the 
fabrication of the tip. The material is preferably a nonwoven tufted 
material that completely surrounds the probe 24. In contrast to brush 
bristles, several features of the scrub material 18 make it suitable for 
use in the invention. Preferably, the scrub material 18 is rugged enough 
to scrub away plaque on the root surface of a tooth, dense enough to 
protect the cannula core, and soft enough to be non-irritating to gingival 
tissue, yet porous to allow medicament to flow through it. The scrub 
material 18 may be of any stiffness or length appropriate for the 
particular application. In one embodiment, the scrub material has a nap in 
the range of 0.25 to 1.0 mm. As shown in FIG. 1, the angled section 16 of 
the applicator tip is bent at approximately 70.degree.. However, other 
angles are possible to configure the invention to suit the needs of 
individual patients. The cover cap 14 fits over the applicator tip 20 and 
protects the tip from damage when the device is not in use. 
FIG. 2 shows an enlarged cross-sectional view of the applicator tip 20 of 
the invention. The applicator tip 20 is preferably manufactured as a 
single piece of plastic, plastic over metal, or other material to provide 
a lightweight, durable instrument that is easy to control by the user. The 
applicator tip 20 is preferably a disposable, screw-on tip with a cannula 
22, and a flexible probe 24 covered with a nonwoven tufted scrub material 
18 at one end. In one embodiment, a screw connection 28 at the opposite 
end can permit the applicator tip to be attached to the base. Other 
connection means may also be used. 
The cannula 22 directs medicaments to flow from a medicament reservoir to a 
flexible portion 24 of the applicator tip 20 that is covered with nonwoven 
tufted scrub material 18. Medicament contained in the reservoir flows 
through the flexible probe 24 and exits through one or more holes 26 to 
saturate the scrub fibers 18. For clarity, a single hole is shown in FIG. 
2. The size and flexible nature of the flexible probe 24 permits insertion 
of the fibers into tight recesses between teeth or between the gum line 
and the tooth. Accordingly, the applicator tip 20, cannula core 24, and 
scrub fibers 18 may be made in any size that is appropriate for 
implementation into a particular dental application. For example, if a 
patient has larger gaps between teeth, or the interproximal periodontal 
pocket is deeper than normal, a larger tip will be more useful for optimal 
interproximal penetration. In one embodiment, the cannula core 24 is 4 mm 
in length, 1.5 mm in diameter at the proximal end and 1 mm in diameter at 
the distal end. Preferably, the entire length of the flexible probe 24 is 
covered with the scrub fibers 18. Moreover, the cannula core may take a 
variety of shapes, such as oval, curved, etc., in order to provide optimum 
debridement. 
During use, the scrub fibers 18 become saturated with medicament, and as 
the tooth is scrubbed, the medicament is simultaneously applied to the 
neck of the tooth and below the gum line. Thus, the tip 20 of the 
invention can penetrate into periodontal pocket areas to provide 
concurrent plaque debridement and medication. Although an approximate 
70.degree. angle is shown in FIG. 2, it is possible that tips with a 
variety of angles could be manufactured and used on the same base to 
facilitate access to hard-to-reach areas. 
FIG. 3 shows a swivel connection 27 that may be included on the applicator 
tip 20 to allow easy, accurate, and secure assembly of the screw 
connection 28 onto the applicator base 12. The swivel is preferably 
internally threaded to facilitate attachment of the tip 20 on the screw 
connection 28, the cannula 22 extends beyond the lower edge 31 of the 
screw connection 28 to provide fluid communication between the fluid 
reservoir and the cannula tip as described hereinbelow. 
FIG. 4 shows a cross-sectional view of the base of the instrument. The 
applicator base 12 includes an airtight, rigid casing 29 that is capable 
of holding a medicament reservoir 30. The swivel connection 27 attaches to 
the applicator base 12 at one end, and the end of the cannula 41 mates 
with an extension cannula 37. In one embodiment, the cannula 41 and the 
extension cannula 37 are connected by a friction grip. The extension 
cannula 37 fits over the end of the cannula 41 and extends into the 
interior of the medicament reservoir 30, terminating in a sharp end 43 
that is capable of piercing the medicament reservoir. The opposite end of 
the base includes an end hub 44 that may be opened to replace the 
reservoir cartridges and seal the cartridges in the chamber. 
A finger pump 32 is incorporated into the applicator base 12 to allow the 
user to apply pressure from any compressible fluid to the reservoir and 
force the medicament from the reservoir into the tip of the instrument. In 
one embodiment, finger pump 32 pressurizes air in an air bladder 34 and 
the compressed air is forced into the space 36 between the casing 29 and 
the reservoir wall 38. One-way valves 40 and 42 maintain the air pressure 
generated by the finger pump 32 so that the reservoir wall gradually 
collapses and forces the medicament through the cannula and into the tip 
of the instrument. Preferably, the medicament reservoir 30 is made from a 
soft, collapsible, disposable material such as light, clear polyethylene, 
polypropylene, or other suitable material known in the art. Preferably, 
the reservoir has more thickness at the puncture end to maintain a seal 
between the extension cannula 37 and the reservoir when in use. The 
puncture end may be colored and is preferably 2-3 mm in thickness. The 
other sides of the reservoir are of the appropriate thickness to permit 
the reservoir to collapse when air pressure is generated in the base. 
The replaceable nature of the reservoir allows the user to select a variety 
of medications for therapeutic application. To replace the medicament 
reservoir 30, the user opens the end hub 44 and extracts the empty 
reservoir cartridge. The new reservoir cartridge with the appropriate 
medicament is inserted into the applicator base 12 and the end of the 
reservoir is punctured by the sharp end 43 of the extension cannula 37. A 
seal forms between the extension cannula 37 and the wall of the reservoir, 
and the end hub 44 is replaced. Actuation of the finger pump 32 
repressurizes the instrument to allow new medicament to flow. 
Alternatively, the cannula may be constructed of a single piece of 
material, and include a polycarbonate needle or a trocar. Additionally, a 
one-way valve may be used. 
Medicaments useful with the present invention include, but are not limited 
to, keratinizing agents, topical anesthetic or desensitizing agents, 
antimicrobial agents, antiviral agents, surfactants, sealants, 
chlorhexidine, antibiotics, stannous fluoride, or other medicament that is 
capable of moving through the instrument. Preferably, such medicaments are 
in liquid or nonviscous gel form, soluble in water, and do not precipitate 
in suspension. 
Although the invention has been shown and described with respect to an 
illustrative embodiment thereof, it should be appreciated that the 
foregoing and various other changes, omissions, and additions in the form 
and detail thereof may be made without departing from the spirit and scope 
of the invention as delineated in the claims.