Abstract:
The present disclosure relates to a phototherapy device that can deliver light to tissues to activate photoactive agents that have been applied to the tissues or that are included within a fiber optic tip member of the device which may be coupled to a light source using a sleeve. The present disclosure also relates to methods of phototherapy using the phototherapy device such as anti-bactericidal treatment, anti-fungal treatment, anti-parasitic treatment, anti-viral treatment.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of U.S. Provisional Application No. 61/653,288, filed May 30, 2012, the entire contents of which are incorporated herein by reference. 
    
    
     BACKGROUND OF THE DISCLOSURE 
     Phototherapy has recently been recognized as having a wide range of applications in both the medical, cosmetic and dental fields for use in surgeries, therapies and examinations. Phototherapy is commonly used as a means of disinfecting target sites. Phototherapeutic techniques have been applied to kill bacteria in the oral cavity and for whitening teeth. Phototherapy is also used to promote wound healing, skin rejuvenation and to treat skin conditions such as acne. These techniques typically rely on the use of laser light sources. Lasers, however, can be very dangerous, particularly in clinical settings, and are typically expensive, large, cumbersome and complicated to use. Accordingly, there is a need for an improved phototherapy device. 
     SUMMARY OF THE DISCLOSURE 
     The present disclosure provides devices and methods useful in phototherapy including phototherapy device members and phototherapy kits that can utilize any light source, not necessarily lasers, but still provide effective treatment. The use of common clinical light sources such as LEDs or halogen bulbs may be more desirable for phototherapy than lasers due to the cost and other disadvantages associated with lasers. Thereby the phototherapy devices, device members, kits and methods of the present disclosure may simplify, complement and/or improve phototherapy regimens, such as for periodontal treatment, wound healing, collagen modulation, anti-bactericidal treatment, anti-fungal treatment, anti-parasitic treatment, anti-viral treatment, or anti-inflammatory treatment. 
     In certain embodiments, the present disclosure relates to a phototherapy device that can deliver light to the periodontal regions of the mouth to activate photoactive reagents that have been applied in periodontal pockets, e.g. between the gum and the tooth. The phototherapy device may comprise a fiber optic tip suitable for delivering light from a light source, such as a light emitting diode (LED), to periodontal regions of the mouth. The tip may be coupled to the light source using a sleeve that may help to maintain optical alignment. The present disclosure also relates to methods of treating and preventing periodontal disease using the phototherapy device to kill bacteria in a periodontal treatment region. 
     For purposes of clarity, and not by way of limitation, the devices, kits and methods of the present disclosure are described herein in the context of providing phototherapy for treatment or prevention of periodontal disease. However, it will be appreciated that the principles described herein may be adapted to a wide range of applications, such as for example in post extractive sockets, endodontic treatment in dental root canals, teeth whitening treatment, wound healing, key hole surgery/treatment or any antimicrobial or therapeutic application in hard to reach places of the body where a fiber optic may be useful. Uses for devices, methods and kits of the present disclosure also include for collagen modulation, anti-bactericidal treatment, anti-fungal treatment, anti-parasitic treatment, anti-viral treatment, or anti-inflammatory treatment. For example, the principles of this disclosure may be applied to phototherapeutic antibacterial treatment or tooth whitening between teeth. In addition, the principles may be applied to phototherapeutics in connection with orthodontics. More generally, the devices and methods described herein may be employed in any phototherapeutic treatment that requires the application of focused light, and in some cases, the application of light in generally closed and hard to reach sites of the mouth or other parts of the body. Accordingly, the devices, kits and methods disclosed herein may be performed instead of or in addition to conventional treatment methods, including subgingival debridement, supergingival debridement, scaling/root planning, wound healing, skin disorder treatment, topical and systemic treatments. 
     One aspect of the present disclosure provides a phototherapeutic device member. In some embodiments, the phototherapeutic device member comprises a flexible fiber optic tip member and an elastic tubular connector sleeve for mechanically coupling the flexible tip member to a light source. The flexible fiber optic tip member functions as a waveguide and transmits light along its length. The flexible fiber optic tip member may have a polymer core for transmitting light. The flexible fiber optic tip member may be made of any suitable material which can transmit light and has appropriate optical properties, such as a glass. The flexible fiber optic tip member can include a proximal end and a distal end, wherein the diameter of the proximal end is greater than the diameter of the distal end, and wherein the proximal end is curved to cause light entering the flexible tip member through the proximal end to converge. The elastic tubular connecting sleeve may include a proximal end having an opening and a distal end having an opening, the proximal end configured to be stretched and mechanically coupled to the light source. In use, the flexible fiber optic tip may be partially disposed within the elastic tubular connecting sleeve such that the distal end of the flexible fiber optic tip member extends distally through the opening in the distal end of the sleeve, and the proximal end of the flexible fiber optic tip member is disposed within the sleeve and between the proximal and distal ends of the sleeve, thereby positioning the flexible fiber optic tip member near the light source. The sleeve is configured to receive the flexible fiber optic tip such that the distal end of the flexible fiber optic tip member extends distally through the opening in the distal end of the sleeve, and the proximal end of the flexible fiber optic tip member is disposed within the sleeve and between the proximal and distal ends of the sleeve, thereby positioning the flexible fiber optic tip member near the light source. 
     The flexible fiber optic tip may be unitarily formed. The flexible fiber optic tip may be formed by moulding. Optionally, the flexible fiber optic tip is cut from a single block of polymer material. In some embodiments, the flexible fiber optic tip member has a rough surface formed such as by grating. The flexible fiber optic tip member may include a rough outer surface configured to allow a portion of light transmitted through the core to diffuse out through the outer surface. The flexible fiber optic tip can include an optical axis extending through the center of the polymer core from the proximal end to the distal end, and wherein light passing through the tip member travels along at least a portion of the optical axis. The polymer core of the flexible fiber optic tip may comprise polycarbonate or polymethymethacrylate. The flexible fiber optic tip may further comprise a photoactive agent which can absorb and emit light. 
     In some embodiments, an interior surface of the elastic tubular connector sleeve includes a plurality of ribs extending radially inwards (circumferentially) and configured to grip the light source or a catheter. The elastic tubular connector sleeve can be stretched around the light source or catheter and held in place by the ribs. In certain embodiments, the flexible fiber optic tip member is removable from the elastic tubular connector sleeve. 
     In some embodiments, a proximal region of the flexible fiber optic tip member is substantially conical having a base along the proximal end. The proximal end of the flexible fiber optic tip member may be convex shaped relative to the proximal portion of the flexible fiber optic tip member. A distal region of the tip member may be substantially cylindrical. The length from the proximal end to a distal end of the flexible fiber optic tip member is between about 10 mm and about 30 mm. The length may be much longer than this if a catheter is used. In which case the length of the flexible fiber optic tip member will be as long as the length of the catheter. The diameter at the distal end of the flexible fiber optic tip member is optionally between about 500 micron and about 1500 micron. Further, the diameter can vary along the length of the flexible fiber optic tip member. The diameter of the distal end of the flexible fiber optic tip members can vary according to the use. In certain embodiments, the distal end of the flexible fiber optic tip member may comprise a plurality of bristles, e.g. like brush. This may be useful in applications where debridement may be useful such as cleaning teeth, cleaning wounds, cleaning skin and the like. 
     In some embodiments, the light source to which the flexible fiber optic tip is coupled includes one or more light emitting diodes. Alternatively, the light source may include a halogen lamp. In some embodiments, the flexible fiber optic tip may be coupled to an end of a catheter. 
     A second aspect of the present disclosure, provides a device for phototherapy. In some embodiments, the device comprises a light source, a probe member having a flexible fiber optic tip member and an elastic tubular connector sleeve for mechanically coupling the probe member to the light source. The proximal end of the flexible fiber optic tip member may be curved to cause light entering the tip member through the proximal end to converge. The proximal end of the sleeve may be configured to be stretched and mechanically coupled to the light source. Optionally, the tip member is partially disposed within the sleeve and extends distally through a distal opening of the sleeve. The device may be used for treating/preventing periodontitis, in which case a distal end of the flexible fiber optic tip member is sized and/or shaped to be received in periodontal pockets. The device may also be used for treating tissues in hard to reach places, internal tissues and cavities such as through key-hole surgery, in which case the proximal end of the sleeve may be configured to be stretched and mechanically coupled to an end of a catheter. In this case, the flexible fiber optic tip member may extend along the length of the catheter and be attached to a light source at a proximal end of the catheter. A further sleeve according to the present disclosure may be provided for attaching to the light source at the proximal end of the catheter. 
     The flexible fiber optic tip may be unitarily formed. The flexible fiber optic tip may be formed by moulding. Optionally, the flexible fiber optic tip is cut from a single block of polymer material. In some embodiments, the flexible fiber optic tip member is grated to generate a rough surface. The flexible fiber optic tip member may include a rough outer surface configured to allow a portion of light transmitted through the core to diffuse out through the outer surface. The flexible fiber optic tip can include an optical axis extending through the center of the polymer core from the proximal end to the distal end, and wherein light passing through the tip member travels along a portion of the optical axis. The polymer core of the flexible fiber optic tip may comprise polycarbonate or polymethymethacrylate. The flexible fiber optic tip may further comprise a photoactive agent which can absorb light and emit as energy. 
     In some embodiments, an interior surface of the elastic tubular connector sleeve includes a plurality of ribs extending radially inwards (circumferentially) and configured to grip the light source. In certain embodiments, the flexible fiber optic tip member is removable from the sleeve. 
     In some embodiments, a proximal region of the flexible fiber optic tip member is substantially conical having a base along the proximal end. A distal region of the tip member may be substantially cylindrical. The length from the proximal end to a distal end of the flexible fiber optic tip member is between about 10 mm and about 30 mm. The length may be much longer than this if a catheter is used. In which case the length of the flexible fiber optic tip member will be as long as the length of the catheter. The diameter at the distal end of the flexible fiber optic tip member is optionally between about 500 micron and about 1500 micron. Further, the diameter can vary along the length of the flexible fiber optic tip member. The proximal end of the flexible fiber optic tip member may be convex shaped relative to the proximal portion of the flexible fiber optic tip member. Further, the diameter can vary along the length of the flexible fiber optic tip member. The diameter of the distal end of the flexible fiber optic tip members can vary according to the use. In certain embodiments, the distal end of the flexible fiber optic tip member may comprise a plurality of bristles, e.g. like brush. This may be useful in applications where debridement may be useful such as cleaning teeth, cleaning wounds, cleaning skin and the like. 
     In some embodiments, the device further comprises an actuating mechanism for moving at least the flexible fiber optic tip member relative to a treatment surface. For example, the actuating mechanism may further comprise a motor in communication with the flexible fiber optic tip member to move the flexible fiber optic tip member backwards and forwards across the treatment surface (substantially perpendicular to the optical axis), or to cause the flexible fiber optic tip member to vibrate. 
     In some embodiments, the light source to which the flexible fiber optic tip is coupled includes one or more light emitting diodes. Alternatively, the light source may include a halogen lamp. In some embodiments, the flexible fiber optic tip may be coupled to an end of a catheter. 
     Another aspect of the present disclosure provides a method=of treating and/or preventing periodontal disease. In some embodiments, the method comprises attaching to a light source having one or more light-emitting diodes a periodontal probe member, which comprises a flexible fiber optic tip member with a polymer or glass core for transmitting light, and an elastic tubular connector sleeve, for mechanically coupling the flexible tip member to a light source; introducing a composition comprising a photoactivating agent and oxygen-releasing agent into a periodontal treatment region; introducing the flexible fiber optic tip into the periodontal treatment region; and applying light through the flexible fiber optic tip member to activate the photoactivating agent in the periodontal treatment region. By “photoactivating agent” is meant a chemical compound which, when contacted by light irradiation, is capable of absorbing the light. The photoactivating agent readily undergoes photoexcitation and can then transfer its energy to other molecules or emit it as light. The terms “photoactivating agent”, “photoactive agent” and “chromophore” are used herein interchangeably herein. 
     Another aspect of the present disclosure provides a method for treating wounds. In some embodiments, the method comprises attaching to a light source having one or more light-emitting diodes a probe member, which comprises a flexible fiber optic tip member with a polymer or glass core for transmitting light, and an elastic tubular connector sleeve, for mechanically coupling the flexible tip member to a light source or a catheter; introducing a composition comprising a photoactivating agent and oxygen-releasing agent into a treatment region; introducing the flexible fiber optic tip member into the treatment region; and applying light through the flexible fiber optic tip member to activate the photoactivating agent in the treatment region. 
     Another aspect of the present disclosure provides a method for antibacterial treatment of a tissue site. In some embodiments, the method comprises attaching to a light source having one or more light-emitting diodes a probe member, which comprises a flexible fiber optic tip member with a polymer or glass core for transmitting light, and an elastic tubular connector sleeve, for mechanically coupling the flexible tip member to a light source or a catheter; introducing a composition comprising a photoactivating agent and an oxygen-releasing agent into a the tissue site; introducing the flexible fiber optic tip member into the tissue site; and applying light through the flexible fiber optic tip member to activate the photoactivating agent in the tissue site. The flexible fiber optic tip may be unitarily formed, such as by moulding. Optionally, the flexible fiber optic tip is cut from a single block of polymer material. In some embodiments, the flexible fiber optic tip member is grated to generate a rough surface. The flexible fiber optic tip member may include a rough outer surface configured to allow a portion of light transmitted through the core to diffuse out through the outer surface. The flexible fiber optic tip can include an optical axis extending through the center of the polymer core from the proximal end to the distal end, and wherein light passing through the tip member travels along a portion of the optical axis. The polymer core of the flexible fiber optic tip may comprise polycarbonate or polymethymethacrylate. 
     In some embodiments, an interior surface of the elastic tubular connector sleeve includes a plurality of ribs extending radially inwards (circumferentially) and configured to grip the light source or the catheter. In certain embodiments, the flexible fiber optic tip member is removable. 
     In some embodiments, a proximal region of the flexible fiber optic tip member is substantially conical having a base along the proximal end. The proximal end of the flexible fiber optic tip member may be convex shaped relative to the proximal portion of the flexible fiber optic tip member. A distal region of the tip member may be substantially cylindrical. The length from the proximal end to a distal end of the flexible fiber optic tip member is between about 10 mm and about 30 mm. The length may be much longer than this if a catheter is used. In which case the length of the flexible fiber optic tip member will be as long as the length of the catheter. The diameter at the distal end of the flexible fiber optic tip member is optionally between about 500 micron and about 1500 micron. Further, the diameter can vary along the length of the flexible fiber optic tip member. The diameter of the distal end of the flexible fiber optic tip members can vary according to the use. In certain embodiments, the distal end of the flexible fiber optic tip member may comprise a plurality of bristles, e.g. like brush. This may be useful in applications where debridement may be useful such as cleaning teeth, cleaning wounds, cleaning skin and the like. 
     The periodontal treatment region can be exposed to the light for a period of less than five minutes, such as between one minute and five minutes. The method may comprise exposing the periodontal treatment region to light for about 1-30 minutes, about 1-25 minutes, about 1-20 minutes, about 1-15 minutes, about 1-10 minutes. The method may be performed over several distinct periodontal treatment regions within the oral cavity. In such cases, each periodontal treatment region exposed to the light for a period of less than five minutes, such as between one minute and five minutes. The light may have a wavelength between about 400 nm and about 800 nm. 
     The composition may be introduced on a gingiva within the oral cavity, or a portion thereon. The composition may be introduced near at least one tooth, preferably on at least one tooth. The composition may be introduced between a gingiva and a tooth. 
     The oxygen-releasing agent may be hydrogen peroxide, carbamide peroxide or benzoyl peroxide. The photoactivating agent can be xanthene derivative dye, an azo dye, a biological stain or a carotenoid. Xanthene derivative dyes may be a fluorene dye, a fluorone dye or a rhodole dye. Optionally, the fluorene dye is a pyronine dye, such as pyronine Y or pyronine B, or a rhodamine dye, such as rhodamine B, rhodamine G or rhodamine WT. In some embodiments, the fluorone dye is fluorescein or a fluorescein derivative, such as phloxine B, rose Bengal, merbromine, eosin Y, eosin B or erthrosine B, preferably eosin Y. Optionally, the azo dye is methyl violet, neutral red, para red, amaranth, carmoisine, allura red AC, tartrazine, orange G, ponceau 4R, methyl red or murexide-ammonium purpurate. The biological stain may be saffranin O, basic fuchsin, acid fuchsin, 3,3′ dihexylocarbocyanine iodide, carminic acid or indocyanine green. In some embodiments, the carotenoid is crocetin, a-crocin, zeaxanthine, lycopene, α-carotene, β-carotene, bixin, fucoxanthine, or a mixture of carotenoid compounds, such as saffron red powder, annatto extract or brown algae extract. 
     Another aspect of the present disclosure provides a method for phototherapeutic treatment, and which differs from the above method in that the flexible fiber optic tip member comprises a photoactive agent in the polymer or glass core. In some embodiments, the method comprises attaching to a light source having one or more light-emitting diodes a probe member, which comprises a flexible fiber optic tip member with a polymer or glass core for transmitting light and a photoactive agent, and an elastic tubular connector sleeve, for mechanically coupling the flexible tip member to a light source; introducing the flexible fiber optic tip member into the treatment region; and applying light through the flexible fiber optic tip member to activate the photoactive agent. When the photoactive agent is activated by the light, the flexible fiber optic tip member may fluoresce and or activate oxygen-releasing agents in the treatment region. 
     From a yet further aspect, there is provided a kit for phototherapy comprising a plurality of flexible fiber optic tip members, having a polymer or a glass core for transmitting light, the flexible tip member including a proximal end and a distal end, wherein the diameter of the proximal end is greater than the diameter of the distal end, and wherein the proximal end is curved to cause light entering the flexible tip member through the proximal end to converge; and an elastic tubular connector sleeve, for receiving at least a portion of one of the plurality of flexible fiber optic tip members and for mechanically coupling the flexible tip member to a light source, wherein the sleeve includes a proximal end having a first opening and a distal end having a second opening, the proximal end configured to be stretched and mechanically coupled to the light source. 
     The plurality of flexible fiber optic tip members may have different size and shape distal ends suitable for different applications. The plurality of flexible fiber optic tip members may include a photoactive agent in a polymer matrix. In certain embodiments, the kit further comprises a biophotonic composition comprising a photoactive agent. The composition may optionally include an oxygen-releasing agent. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  depicts a phototherapeutic device, according to an illustrative embodiment of the present disclosure. 
         FIG. 2A  depicts a flexible fiber optic tip member of the device of  FIG. 1 , according to an illustrative embodiment of the present disclosure. 
         FIG. 2B-2C  depict a flexible fiber optic tip member, of the device of  FIG. 1 , having a ridge, according to an illustrative embodiment of the present disclosure. 
         FIG. 2D  depicts a flexible fiber optic tip member, of the device of  FIG. 1 , having a rough surface portion, according to an illustrative embodiment of the present disclosure. 
         FIG. 3A  depicts the coupling of the flexible fiber optic tip member to a light source using an elastic tubular connector sleeve, according to an illustrative embodiment of the present disclosure. 
         FIG. 3B  depicts a zoomed-in view of an elastic tubular connector sleeve of the device of  FIG. 1 , according to an illustrative embodiment of the present disclosure. 
         FIG. 4  is a flow chart outlining a process of treating periodontal disease using the device of  FIG. 1 , according to an illustrative embodiment of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION 
     The devices, kits and methods described herein will now be described with reference to certain illustrative embodiments. However, the disclosure is not to be limited to these illustrated embodiments which are provided merely for the purpose of describing the devices, kits and methods of the disclosure and are not to be understood as limiting in anyway. 
       FIG. 1  depicts a phototherapeutic device in accordance with present disclosure. The phototherapeutic device comprises a flexible fiber optic tip member  100  coupled to a light source  300  with an elastic tubular connector sleeve  200 . The flexible fiber optic tip member  100  will be discussed in greater detail in the descriptions of  FIG. 2A - FIG. 2D . The elastic tubular connector sleeve will be discussed in greater detail in the descriptions of  FIG. 3A  and  FIG. 3B . 
     The light source  300  may be any light source commonly found in a clinical setting, including, for example, light sources for photocuring. In some embodiments, the light source  300  comprises an elongated cable of a suitable length to permit a dental professional to work in a patient&#39;s mouth. Optionally, the light source  300  provides actinic light. In some embodiments, the light source  300  comprises light emitting diodes. Alternatively, the light source  300  may comprise a halogen lamp. In some embodiments, the light source  300  is configured to provide light at a wavelength that will activate a photoactivating agent. By “actinic light” is meant light energy emitted from a specific light source (e.g., lamp, LED, or laser) and capable of being absorbed by matter (e.g. the photoactivating agent). In a preferred embodiment, the actinic light is visible light. The light source  300  may provide visible light or ultraviolet light. In some embodiments, the light source  300  provides visible light having a wavelength between about 400 nm and about 800 nm. Furthermore, the light source  300  should have a suitable power density. Suitable power density for non-collimated light sources (LED, halogen or plasma lamps) are in the range from about 50 mW/cm 2  to about 200 mW/cm 2 , about 30-150 mW/cm 2 , A light beam from the light source  300  may travel from the light source to the proximal end  110  of a flexible fiber optic tip member  100  along the optical axis  190  to the distal end  120  for delivery to a periodontal treatment region. In certain embodiments, the light source  300  may emit a continuous beam of light or a pulsed beam of light. 
     The light source  300  may additionally include a control box attached to a flexible fiber optic waveguide to allow a dental professional to place the free end of the fiber optic waveguide in or near a patient&#39;s mouth. The control box of light source  300  may include a lamp, a transformer and a control board, which allows dental professionals to control variables such as light intensity and voltage. Light source  300  may be controlled by a foot pedal, which leaves the dental professionals hands free to operate the fiber optic waveguide in addition to any other dental tools. Light source  300  may also include a time-delay, such that the light transmitted through the fiber optic wave guide stays on after the foot pedal is released. 
       FIG. 2A  depicts a flexible fiber optic tip member  100  in accordance with the present disclosure. The flexible fiber optic tip member  100  has a polymer core along with a proximal end  110  configured for coupling to the light source  300  and a distal end  120  configured for insertion into a periodontal treatment region. The flexible fiber optic tip member  100  is configured to have a conical portion  140  proximal to a cylindrical portion  150 . The conical portion  140  may have its base at the proximal end  110 . The conical portion  140  will be configured to comprise a curved structure  130  to focus the light transmitted from the light source  300  into the cylindrical portion  150 . Further, the flexible fiber optic tip member  100  is configured such at that light traverses through the polymer core along the optical axis  190 . 
       FIG. 2B  depicts an additional flexible fiber optic tip member  100  in accordance with the present disclosure. The flexible fiber optic tip member  100  in  FIG. 2B  comprises a ridge feature  160 , which may be configured to be disposed in the distal opening  250  of the elastic tubular connecting sleeve to help the flexible fiber optic tip member  100  in place near the light source  300 . The flexible fiber optic tip member  100  has a polymer core along with a proximal end  110  configured for coupling to the light source  300  and a distal end  120  configured for insertion into a periodontal treatment region. The flexible fiber optic tip member  100  is configured to have a conical portion  140  proximal to a cylindrical portion  150 . The cylindrical portion  150  can be configured to comprise a ridge  160  proximal to a flexible portion  170  which terminates at the distal end  120 . The distal end  120  may comprise a rounded tip  121 . The conical portion  140  may have its base at the proximal end  110 . The conical portion  140  will be configured to comprise a curved structure  130  to focus the light transmitted from the light source  300  into the cylindrical portion  150 . Further, the flexible fiber optic tip member  100  is configured such at that light traverses through the polymer core along the optical axis  190 . 
       FIG. 2C  depicts a further flexible fiber optic tip member  100  in accordance with the present disclosure. The flexible fiber optic tip member  100  in  FIG. 2C  comprises a ridge feature  160 , which may be configured to be disposed in the distal opening  250  of the elastic tubular connecting sleeve to help the flexible fiber optic tip member  100  in place near the light source  300 . Further the flexible fiber optic tip member  100  in  FIG. 2C  comprises a narrowing region  180 , along which the diameter of the cylindrical portion  150  varies along the length of the cylindrical portion  150 . The flexible fiber optic tip member  100  has a polymer core along with a proximal end  110  configured for coupling to the light source  300  and a distal end  120  configured for insertion into a periodontal treatment region. The flexible fiber optic tip member  100  is configured to have a conical portion  140  proximal to a cylindrical portion  150 . The cylindrical portion  150  can be configured to comprise a ridge  160  proximal to a flexible portion  170  which terminates at the distal end  120 . The flexible portion  170  may contain a narrowing region  180 , wherein the diameter of the proximal end of the narrowing region  180  is greater than the diameter of the distal end for the narrowing region  180 . The narrowing region  180  may traverse the entire length for the flexible portion  170 , running from the ridge  160  to the distal end  120 . The conical portion  140  may have its base at the proximal end  110 . The conical portion  140  will be configured to comprise a curved structure  130  to focus the light transmitted from the light source  300  into the cylindrical portion  150 . Further, the flexible fiber optic tip member  100  is configured such at that light traverses through the polymer core along the optical axis  190 . 
       FIG. 2D  depicts another flexible fiber optic tip member  100  in accordance with the present disclosure. The flexible fiber optic tip member  100  in  FIG. 2D  comprises a rough outer surface  123  and a rough tip  122 , which allows light traversing through the flexible fiber optic tip member  100  to diffuse. The flexible fiber optic tip member  100  has a polymer core along with a proximal end  110  configured for coupling to the light source  300  and a distal end  120  configured for insertion into a periodontal treatment region. The flexible fiber optic tip member  100  is configured to have a conical portion  140  proximal to a cylindrical portion  150 . The cylindrical portion  150  can be configured to comprise a ridge  160  proximal to a flexible portion  170  which terminates at the distal end  120 . The distal portion of flexible portion  170  may include a rough outer surface  123  configured to allow a portion of light transmitted through the flexible portion  170  to diffuse out through the rough outer surface  123 . Similarly, the distal end  120  may comprise a rough tip  122  configured to allow a portion of light transmitted through the distal end  120  to diffuse out through the rough tip  122 . The flexible fiber optic tip member  100  may be grated to generate the rough outer surface  123  or the rough tip  122 . The conical portion  140  may have its base at the proximal end  110 . The conical portion  140  will be configured to comprise a curved structure  130  to focus the light transmitted from the light source  300  into the cylindrical portion  150 . Further, the flexible fiber optic tip member  100  is configured such at that light traverses through the polymer core along the optical axis  190 . 
     Regarding any of  FIG. 2A-2D , the flexible fiber optic tip member  100  may be unitarily formed. In some embodiments, the flexible fiber optic tip member is cut from a single block of polymer material. In some embodiments, the polymer core includes polycarbonate. In some embodiments, the flexible fiber optic tip member  100  comprises polymeric materials such as, for example, any of polycarbonate, polystyrene, polyacrylate and polymethylmethacrylate materials. In some embodiments, the flexible fiber optic tip member  100  comprises glass materials such as, for example, any of quartz, silica glass, borosilicate glass, lead glass, and fluoride glass materials. 
     The rough outer surface  123  or rough tip  122  of the flexible fiber optic tip member  100  may be generated by any suitable method, including sandpapering and/or grating the surface of the flexible fiber optic tip member  100 . The rough outer surface  123  or rough tip  122  of the flexible fiber optic tip member  100  may be generated by sandblasting techniques. 
     In certain embodiments, flexible fiber optic tip member  100  may be removed from phototherapeutic periodontal device and disposed of, to be replaced by a fresh flexible fiber optic tip member  100  in order to avoid cross contamination, for example, between different periodontal diseased tissue or between patients. The length of the flexible fiber optic tip member  100  may be between about 10 mm and about 30 mm. The length of the flexible fiber optic tip member  100  may be between longer than about 30 mm, and be trimmed to size by the user. 
     Still referring to any of  FIG. 2A-2D , the curved structure  130  may be convex relative to the proximal end  110 . In other words, the curved structure  130  curves toward from the light source  300 , which allows the flexible fiber optic tip member  100  to focus light received from the light source  300  along the optical axis  190  for traversal along the cylindrical portion  150  of the flexible fiber optic tip member  100 . Any suitable degree of curvature may be used as desired so that light is allowed to propagate and focus into the optical fiber. In some embodiments, the diameter of the proximal end  100  of the flexible fiber optic tip member is the same size as the diameter of the light source  300 . In some embodiments, the diameter of the proximal end  100  of the flexible fiber optic tip member is the greater than the diameter of the light source  300 , which allows the flexible fiber optic tip member  100  to prevent any light from escaping. In certain embodiments, the distance between the curved surface  130  and the light source  300  may be selected such that light from the light source  300  is focused into the fiber optic tip member  100 . For example, the curved surface  130  may be touching or in minimal contact or in near proximity to the light source  300 . 
     Still referring to any of  FIG. 2A-2D , the cylindrical portion  150  of the flexible fiber optic tip member  100  may have a diameter of about 0.75-1.0 mm at its proximal end and a diameter of about 0.05-0.2 mm at its distal end  120 . In some embodiments, the diameter at the distal end  120  of the flexible fiber optic tip member  100  is between about 500 micron and about 1500 micron. The cylindrical portion  150  and/or the flexible portion  170  of the flexible fiber optic tip member  100  may be sufficiently flexible so as to allow insertion of the distal end  120  into small spaces such as periodontal pockets, dental root canals, tooth cavities, oral lesions, and other hard to reach sites. The flexible fiber optic tip member  100  and, in particular, the distal end  120  may be configured to deliver and focus light directly to a periodontal treatment region to provide treatment, and/or to activate a photoactivating agent in a composition as will be described below. In certain embodiments, the flexible fiber optic tip member  100  and, in particular, the distal end  120  may be configured to disperse light in all directions and from both the distal end  120  and/or along a portion of the cylindrical portion  150  or the flexible portion  170  to aid in treatment. In some embodiments, the dispersal light in all directions is achieved by providing a rough end  122  or a rough outer surface  123 , as shown in  FIG. 2D . 
     Still referring to any of  FIG. 2A-2D , the ridge  160  may be configured to be partially disposed within the distal opening  250  of the elastic tubular connecting sleeve  200 . In some embodiments, the diameter of the proximal end of the ridge  160  is greater than the diameter of the distal opening  250  of the elastic tubular connecting sleeve  200 . In some embodiments, the diameter of the distal end of the ridge  160  is less than the diameter of the distal opening  250  of the elastic tubular connecting sleeve  200 . In some embodiments, the diameter of the ridge  160  may be between 5 mm and 10 mm. 
       FIG. 3A  depicts the assembly of a phototherapeutic device in accordance with the present disclosure. The proximal end  110  of the flexible fiber optic tip member  100  is coupled to the light source  300 . The distal end  120  of the flexible fiber optic tip member  100  passes through the elastic tubular connector sleeve  200  and extends beyond the distal end  220  of the elastic tubular connector sleeve  200 . The proximal end  210  of the elastic tubular connector sleeve  200  will extend beyond the proximal end  110  of the flexible fiber optic tip member  100  and will couple to the light source  300 . The elastic tubular connector sleeve  200  will have one or more flexible ridges  230  which will allow for attachment to the light source  300  and will firmly hold the flexible fiber optic tip member  100  in place. When full assembled, the proximal end  110  of the flexible fiber optic tip member  100  will be disposed within the elastic tubular connector sleeve  200 , such that the proximal end  110  of the flexible fiber optic tip member  100  is between the proximal end  210  and the distal end  220  of the elastic tubular connector sleeve  200 . 
       FIG. 3B  depicts an elastic tubular connector sleeve  200  in accordance with the present disclosure. The elastic tubular connector sleeve  200  comprises a proximal end  210 , configured for coupling to a light source  300 , and a distal end  220 , configured to house the cylindrical portion  150  of a flexible fiber optic tip member  100 . The proximal end  210  comprises a proximal opening  240  and the distal end  220  comprises a distal opening  250 . A light source  300  will be coupled to the elastic tubular connector sleeve through the proximal opening  240 . The cylindrical portion  150  and distal end  120  of a flexible fiber optic tip will extend through the distal opening  250 . The tubular connector sleeve comprises one or more flexible ridges  230  which will allow for attachment to the light source  300  and may help hold the flexible fiber optic tip member  100  firmly in place. 
     The proximal end  210  of the elastic tubular connector sleeve  200  is configured for coupling to a light source  300 , such that the light source  300  passes through the proximal opening  240  and is partially disposed within the elastic tubular connector sleeve  200 . The proximal end  210  may be elastic, such that the diameter of the proximal opening  240  can be increased by mechanical stretching. Accordingly, the diameter of the proximal opening  240  may be the same or smaller than the diameter of the light source  300 , such that the proximal end  210  must be stretched to dispose the light source  300  in the proximal opening  240 . Alternatively, the proximal end  210  may be rigid, such that the diameter of the proximal opening  240  is greater than the diameter of the light source  300 . In such embodiments, the one or more flexible ridges  230  keep the light source  300  partial disposed within the elastic tubular connector sleeve  200 . In some embodiments, the elastic tubular connector sleeve  200  has multiple layers, including a rigid outer layer and an elastic inner layer that firmly grasps the light source  300 . 
     The distal end  220  of the elastic tubular connector sleeve  200  is configured to allow the flexible fiber optic member  100  to extend through the distal opening  250 . The distal end  220  may be configured such that the cylindrical portion  150  of the flexible fiber optic member  100  passes through the distal opening  250 . Alternatively, the distal end  220  may be configured such that the conical portion  140  of the flexible fiber optic member  100  passes through the distal opening  250 . In further embodiments, the distal end  220  may be configured such that the ridge  160  of the flexible fiber optic member  100  is partially disposed in the distal opening  250 . In some embodiments, the distal end  220  is elastic, such that the diameter of distal opening  250  may be increased by mechanical stretching. In such embodiments, the diameter of the distal opening  250  may be the same or smaller than the diameter of the conical portion  140  or the cylindrical portion  150  of the flexible fiber optic tip member  100 , such that the distal end  220  must be stretched to extend flexible fiber optic tip member  100  through the distal opening  250 . Alternatively, the distal end  220  may be rigid, such that the diameter of the distal opening  250  is greater than the diameter of the conical portion  140  or the cylindrical portion  150  of the flexible fiber optic tip member  100 . In such embodiments, the one or more flexible ridges  230  may keep the flexible fiber optic tip member  100  firmly disposed within the elastic tubular connector sleeve  200 . Alternatively, the length of the elastic tubular connecting sleeve  200  may be short enough that when the flexible fiber optic tip member  100  is partial disposed within the connecting sleeve  200  and the connecting sleeve  200  is coupled to the light source  300 , the flexible fiber optic tip  100  does not have room to move and is firmly held in place within the connecting sleeve  200 . In some embodiments, the flexible fiber optic tip  100  is contacting the light source  300 . In other embodiments, the flexible fiber optic tip  100  is contacting the light source  300 , such as less than about 1 mm away from the light source  300 . 
     The one or more flexible ridges  230  may be concentrically disposed within the elastic tubular connecting sleeve  200 . Alternatively, the flexible ridge  230  may be a single ridge helically disposed within the elastic tubular connecting sleeve  200 . The one or more flexible ridges  230  may be rigid. In such embodiments, the elastic tubular connecting sleeve  200  may be snapped onto the light source using a lip/clip method. Alternatively, the elastic tubular connecting sleeve  200  may be screwed on to the light source  300  using a threaded system. Alternatively, the one of more flexible ridges  230  may be elastic, such that the proximal end  210  of the elastic tubular connecting sleeve  200  may be mechanically stretched for coupling to the light source  300 . 
       FIG. 4  depicts a process of treating or preventing periodontal disease  400  in accordance with the present disclosure. The process  400  comprises an attachment  401 , wherein a flexible fiber optic tip  100  is attached to a periodontal light source  300  to generate a phototherapeutic device. Preferably, an elastic tubular connecting sleeve  200  is used to attach the flexible fiber optic tip  100  to the light source  300 , as shown in  FIG. 1  and  FIG. 3A . The process  400  further comprises a composition introduction  402 , wherein a composition comprising a photoactivating agent and optionally an oxygen-releasing agent is introduced into a periodontal treatment region. The process  400  further comprises a flexible tip member introduction  403 , wherein the flexible fiber optic tip member  100  of the phototherapeutic device is inserted into the periodontal treatment region. The process  400  further comprises an activation  404 , wherein light from the flexible fiber optic tip member  100  activates the photoactivating agent. 
     In one example, upon activation with light from the flexible fiber optic tip  100 , the photoactivating agent absorbs energy from the light and releases some of the absorbed light energy as a fluorescent light. Without being bound to theory, it is thought that fluorescent light emitted by photoactivated chromophores may have therapeutic properties due to its femto-second or pico-second emission properties which may be recognized by biological cells and tissues, leading to favourable biomodulation. Furthermore, the emitted fluorescent light has a longer wavelength and hence a deeper penetration into the tissue than the activating light. Irradiating tissue with such a broad range of wavelength, including in some embodiments the activating light which passes through the composition, may have different and complementary therapeutic effects on the cells and tissues. 
     In another example, the composition also comprises an oxygen-releasing agent. In this case, the photoactivating agent may transfer at least some of the absorbed light energy to the oxygen-releasing agent, which in turn can produce oxygen radicals such as singlet oxygen. These are distinct applications of these agents and differs from the use of chromophores as simple stains or as a catalyst for photo-polymerization. 
     Suitable photoactivating agents include fluorescent dyes (or stains), biological dyes, histological dyes, food colorings, naturally occurring photoactive agents and carotenoids. 
     Suitable photoactivating agents include, but are not limited to, the following: 
     Chlorophyll Dyes 
     Exemplary chlorophyll dyes include but are not limited to chlorophyll a; chlorophyll b; oil soluble chlorophyll; bacteriochlorophyll a; bacteriochlorophyll b; bacteriochlorophyll c; bacteriochlorophyll d; protochlorophyll; protochlorophyll a; amphiphilic chlorophyll derivative 1; amphiphilic chlorophyll derivative 2, phycobiliproteins. 
     Xanthene Derivatives 
     Exemplary xanthene dyes include but are not limited to Eosin B (4′,5′-dibromo,2′,7′-dinitr-o-fluorescein, dianion); eosin Y; eosin Y (2′,4′,5′,7′-tetrabromo-fluoresc-ein, dianion); eosin (2′,4′,5′,7′-tetrabromo-fluorescein, dianion); eosin (2′,4′,5′,7′-tetrabromo-fluorescein, dianion) methyl ester; eosin (2′,4′,5′,7′-tetrabromo-fluorescein, monoanion) p-isopropylbenzyl ester; eosin derivative (2′,7′-dibromo-fluorescein, dianion); eosin derivative (4′,5′-dibromo-fluorescein, dianion); eosin derivative (2′,7′-dichloro-fluorescein, dianion); eosin derivative (4′,5′-dichloro-fluorescein, dianion); eosin derivative (2′,7′-diiodo-fluorescein, dianion); eosin derivative (4′,5′-diiodo-fluorescein, dianion); eosin derivative (tribromo-fluorescein, dianion); eosin derivative (2′,4′,5′,7′-tetrachlor-o-fluorescein, dianion); eosin; eosin dicetylpyridinium chloride ion pair; erythrosin B (2′,4′,5′,7′-tetraiodo-fluorescein, dianion); erythrosin; erythrosin dianion; erythiosin B; fluorescein; fluorescein dianion; phloxin B (2′,4′,5′,7′-tetrabromo-3,4,5,6-tetrachloro-fluorescein, dianion); phloxin B (tetrachloro-tetrabromo-fluorescein); phloxine B; rose bengal (3,4,5,6-tetrachloro-2′,4′,5′,7′-tetraiodofluorescein, dianion); pyronin G, pyronin J, pyronin Y; Rhodamine dyes such as rhodamines include 4,5-dibromo-rhodamine methyl ester; 4,5-dibromo-rhodamine n-butyl ester; rhodamine 101 methyl ester; rhodamine 123; rhodamine 6G; rhodamine 6G hexyl ester; tetrabromo-rhodamine 123; and tetramethyl-rhodamine ethyl ester. 
     Methylene Blue Dyes 
     Exemplary methylene blue derivatives include but are not limited to 1-methyl methylene blue; 1,9-dimethyl methylene blue; methylene blue; methylene blue (16 .mu.M); methylene blue (14 .mu.M); methylene violet; bromomethylene violet; 4-iodomethylene violet; 1,9-dimethyl-3-dimethyl-amino-7-diethyl-a-mino-phenothiazine; and 1,9-dimethyl-3-diethylamino-7-dibutyl-amino-phenot-hiazine. 
     Azo Dyes 
     Exemplary azo (or diazo-) dyes include but are not limited to methyl violet, neutral red, para red (pigment red 1), amaranth (Azorubine S), Carmoisine (azorubine, food red 3, acid red 14), allura red AC (FD&amp;C 40), tartrazine (FD&amp;C Yellow 5), orange G (acid orange 10), Ponceau 4R (food red 7), methyl red (acid red 2), and murexide-ammonium purpurate. 
     In some aspects of the disclosure, the one or more photoactivating agents of the biophotonic composition disclosed herein can be independently selected from any of Acid black 1, Acid blue 22, Acid blue 93, Acid fuchsin, Acid green, Acid green 1, Acid green 5, Acid magenta, Acid orange 10, Acid red 26, Acid red 29, Acid red 44, Acid red 51, Acid red 66, Acid red 87, Acid red 91, Acid red 92, Acid red 94, Acid red 101, Acid red 103, Acid roseine, Acid rubin, Acid violet 19, Acid yellow 1, Acid yellow 9, Acid yellow 23, Acid yellow 24, Acid yellow 36, Acid yellow 73, Acid yellow S, Acridine orange, Acriflavine, Alcian blue, Alcian yellow, Alcohol soluble eosin, Allophycocyanin (APC), Alizarin, Alizarin blue 2RC, Alizarin carmine, Alizarin cyanin BBS, Alizarol cyanin R, Alizarin red S, Alizarin purpurin, Aluminon, Amido black 10B, Amidoschwarz, Aniline blue WS, Anthracene blue SWR, Auramine O, Azocannine B, Azocarmine G, Azoic diazo 5, Azoic diazo 48, Azure A, Azure B, Azure C, Basic blue 8, Basic blue 9, Basic blue 12, Basic blue 15, Basic blue 17, Basic blue 20, Basic blue 26, Basic brown 1, Basic fuchsin, Basic green 4, Basic orange 14, Basic red 2, Basic red 5, Basic red 9, Basic violet 2, Basic violet 3, Basic violet 4, Basic violet 10, Basic violet 14, Basic yellow 1, Basic yellow 2, Biebrich scarlet, Bismarck brown Y, Brilliant crystal scarlet 6R, Calcium red, Carmine, Carminic acid, Celestine blue B, China blue, Cochineal, Coelestine blue, Chrome violet CG, Chromotrope 2R, Chromoxane cyanin R, Congo corinth, Congo red, Cotton blue, Cotton red, Croceine scarlet, Crocin, Crystal ponceau 6R, Crystal violet, Dahlia, Diamond green B, Direct blue 14, Direct blue 58, Direct red, Direct red 10, Direct red 28, Direct red 80, Direct yellow 7, Eosin B, Eosin Bluish, Eosin, Eosin Y, Eosin yellowish, Eosinol, Erie garnet B, Eriochrome cyanin R, Erythrosin B, Ethyl eosin, Ethyl green, Ethyl violet, Evans blue, Fast blue B, Fast green FCF, Fast red B, Fast yellow, Fluorescein, Food green 3, Gallein, Gallamine blue, Gallocyanin, Gentian violet, Haematein, Haematine, Haematoxylin, Helio fast rubin BBL, Helvetia blue, Hematein, Hematine, Hematoxylin, Hoffman&#39;s violet, Indocyanin green, Imperial red, Ingrain blue, Ingrain blue 1, Ingrain yellow 1, INT, Kermes, Kermesic acid, Kernechtrot, Lac, Laccaic acid, Lauth&#39;s violet, Light green, Lissamine green SF, Luxol fast blue, Magenta 0, Magenta I, Magenta II, Magenta III, Malachite green, Manchester brown, Martius yellow, Merbromin, Mercurochrome, Metanil yellow, Methylene azure A, Methylene azure B, Methylene azure C, Methylene blue, Methyl blue, Methyl green, Methyl violet, Methyl violet 2B, Methyl violet 10B, Mordant blue 3, Mordant blue 10, Mordant blue 14, Mordant blue 23, Mordant blue 32, Mordant blue 45, Mordant red 3, Mordant red 11, Mordant violet 25, Mordant violet 39 Naphthol blue black, Naphthol green B, Naphthol yellow S, Natural black 1, Natural red, Natural red 3, Natural red 4, Natural red 8, Natural red 16, Natural red 25, Natural red 28, Natural yellow 6, NBT, Neutral red, New fuchsin, Niagara blue 3B, Night blue, Nile blue, Nile blue A, Nile blue oxazone, Nile blue sulphate, Nile red, Nitro BT, Nitro blue tetrazolium, Nuclear fast red, Oil red O, Orange G, Orcein, Pararosanilin, Phloxine B, Phycocyanins, Phycoerythrins. Phycoerythrincyanin (PEC), Phthalocyanines, Picric acid, Ponceau 2R, Ponceau 6R, Ponceau B, Ponceau de Xylidine, Ponceau S, Primula, Purpurin, Pyronin B, Pyronin G, Pyronin Y, Rhodamine B, Rosanilin, Rose bengal, Saffron, Safranin O, Scarlet R, Scarlet red, Scharlach R, Shellac, Sirius red F3B, Solochrome cyanin R, Soluble blue, Solvent black 3, Solvent blue 38, Solvent red 23, Solvent red 24, Solvent red 27, Solvent red 45, Solvent yellow 94, Spirit soluble eosin, Sudan III, Sudan IV, Sudan black B, Sulfur yellow S, Swiss blue, Tartrazine, Thioflavine S, Thioflavine T, Thionin, Toluidine blue, Toluyline red, Tropaeolin G, Trypaflavine, Trypan blue, Uranin, Victoria blue 4R, Victoria blue B, Victoria green B, Water blue I, Water soluble eosin, Xylidine ponceau, or Yellowish eosin. 
     In certain embodiments, the composition of the present disclosure includes any of the chromophores listed above, or a combination thereof, so as to provide a biophotonic impact at the application site. Photoactive agent compositions may increase photo-absorption by the combined dye molecules or may enhance photo-biomodulation selectivity. In some embodiments, the combination of photoactive agents may be synergistic. In some embodiments, the two or more photoactive agents are both xanthene dyes, for example, Eosin Y as a first chromophore and any one or more of Rose Bengal, Erythrosin, Phloxine B as a second chromophore. It is believed that these combinations have a synergistic effect as Eosin Y can transfer energy to Rose Bengal, Erythrosin or Phloxine B when activated. This transferred energy is then emitted as fluorescence or by production of reactive oxygen species. By means of synergistic effects of the chromophore combinations in the composition, chromophores which cannot normally be activated by an activating light (such as a blue light from an LED) can be activated through energy transfer from chromophores which are activated by the activating light. In this way, the different properties of photoactivated chromophores can be harnessed and tailored according to the cosmetic or the medical therapy required. 
     As discussed above, the photoactivating agent stimulates the oxygen-releasing agent in the composition to produce oxygen radicals. Bacteria are extremely sensitive to exposure to oxygen radicals, such that the production of oxygen radicals converts the composition into a bactericidal composition. Peroxide compounds are oxygen-releasing agents that contain the peroxy group (R—O—O—R), which is a chainlike structure containing two oxygen atoms, each of which is bonded to the other and a radical or some element. When a biophotonic composition of the present disclosure comprising an oxygen-releasing agent is illuminated with light, the chromophores are excited to a higher energy state. When the chromophores&#39; electrons return to a lower energy state, they emit photons with a lower energy level, thus causing the emission of light of a longer wavelength (Stokes&#39; shift). In the proper environment, some of this energy transfer is transferred to oxygen or the reactive hydrogen peroxide and causes the formation of oxygen radicals, such as singlet oxygen. The singlet oxygen and other reactive oxygen species generated by the activation of the biophotonic composition are thought to operate in a hormetic fashion. That is, a health beneficial effect that is brought about by the low exposure to a normally toxic stimuli (e.g. reactive oxygen), by stimulating and modulating stress response pathways in cells of the targeted tissues. Endogenous response to exogenous generated free radicals (reactive oxygen species) is modulated in increased defense capacity against the exogenous free radicals and induces acceleration of healing and regenerative processes. Furthermore, activation of the composition will also produce an antibacterial effect. The extreme sensitivity of bacteria to exposure to free radicals makes the composition of the present disclosure a de facto bactericidal composition. 
     Suitable oxygen-releasing agents for preparation of the active medium include, but are not limited to: 
     Hydrogen peroxide (H 2 O 2 ) is the starting material to prepare organic peroxides. H 2 O 2  is a powerful oxidizing agent, and the unique property of hydrogen peroxide is that it breaks down into water and oxygen and does not form any persistent, toxic residual compound. Hydrogen peroxide for use in this composition can be used in a gel, for example with 6% hydrogen peroxide. A suitable range of concentration over which hydrogen peroxide can be used in the present composition is from about 0.1% to about 6%. 
     Urea hydrogen peroxide (also known as urea peroxide, carbamide peroxide or percarbamide) is soluble in water and contains approximately 35% hydrogen peroxide. Carbamide peroxide for use in this composition can be used as a gel, for example with 16% carbamide peroxide that represents 5.6% hydrogen peroxide. A suitable range of concentration over which urea peroxide can be used in the present composition is from about 0.3% to about 16%. Urea peroxide brakes down to urea and hydrogen peroxide in a slow-release fashion that can be accelerated with heat or photochemical reactions. The released urea [carbamide, (NH 2 )CO 2 )], is highly soluble in water and is a powerful protein denaturant. It increases solubility of some proteins and enhances rehydration of the skin and/or mucosa. 
     Benzoyl peroxide consists of two benzoyl groups (benzoic acid with the H of the carboxylic acid removed) joined by a peroxide group. It is found in treatments for acne, in concentrations varying from 2.5% to 10%. The released peroxide groups are effective at killing bacteria. Benzoyl peroxide also promotes skin turnover and clearing of pores, which further contributes to decreasing bacterial counts and reduce acne. Benzoyl peroxide breaks down to benzoic acid and oxygen upon contact with skin, neither of which is toxic. A suitable range of concentration over which benzoyl peroxide can be used in the present composition is from about 2.5% to about 5%. 
     Specific oxygen-releasing agents that that are preferably used in the materials or methods of this disclosure include, but are not limited to hydrogen peroxide, carbamide peroxide, or benzoyl peroxide. Inclusion of other forms of peroxides (e.g. organic or inorganic peroxides) should be avoided due to their increased toxicity and their unpredictable reaction with the photodynamic energy transfer. 
     In certain embodiments, the photoactivating agent may be incorporated in the matrix of the flexible fiber optic tip. In this way, the flexible fiber optic tip can be made to fluoresce on activation with a light. An oxygen-releasing agent may also be included within the matrix of the flexible fiber optic tip. The concentration of the photoactive agent to be used can be selected based on the desired intensity and duration of the biophotonic activity from the flexible fiber optic tip. For example, some dyes such as xanthene dyes (e.g. Eosin Y and Fluorescein) reach a ‘saturation concentration’ after which further increases in concentration do not provide substantially higher emitted fluorescence. Further increasing the photoactive agent concentration above the saturation concentration can reduce the amount of activating light passing through the solid biophotonic. Therefore, if more fluorescence is required for a certain application than activating light, a high ‘saturation’ concentration of the photoactive agent can be used. However, if a balance is required between the emitted fluorescence and the activating light, a concentration close to or lower than the saturation concentration can be chosen.