Patent Publication Number: US-2011067190-A1

Title: Tooth shade indicator apparatus and method for evaluating tooth shade

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority from U.S. provisional application Ser. No. 61/243,525 filed on Sep. 17, 2009, incorporated herein by reference in its entirety. 
    
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     Not Applicable 
     INCORPORATION-BY-REFERENCE OF MATERIAL SUBMITTED ON A COMPACT DISC 
     Not Applicable 
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     This invention pertains generally to scales and gauges, and more particularly to toothbrushes with tooth whiteness indicia. 
     2. Description of Related Art 
     The desire for straight white teeth has created a large market for whitening preparations and dental practitioners. Teeth are an important part of ones cosmetic appearance. Tooth discoloration may result from the presence of substances that are found in food, beverages, medicines, tobacco, blood and salivary fluid. Traumatic injuries may also destroy associated nerves causing the injured tooth to darken. Such discoloration is likely to remain on the teeth without external intervention. 
     The tooth structures that can have a stained appearance are enamel, dentin, and the acquired tooth surface pellicle. The enamel of the tooth is primarily formed from inorganic material in the form of hydroxyapatite crystals and normally contains a small percentage of organic material in the form of collagen. 
     Dentin, in the other hand, is composed of about 20% protein including collagen and the rest consisting of inorganic material, predominantly hydroxyapatite crystals, similar to that found in the enamel. The acquired pellicle consists of a proteinaceous layer that forms on the surface of the tooth enamel that can be removed with intensive tooth cleaning. The pellicle readily reforms after a period of time after brushing. Artificial dental structures such as crowns or dentures can also be stained if the pellicle adheres to the surface or by exposure to compounds that react with the artificial structure. 
     Staining of the overlying pellicle can result from exposure to compounds such as tannins and other polyphenolic compounds that can become trapped and tightly bound to the pellicle layer on the surface of the teeth. Removal of the pellicle through mechanical tooth cleaning will usually remove staining of the pellicle. 
     Tooth staining can also occur when the enamel or dentin is penetrated by staining compounds from external exposures or from sources within the tooth. For example, acid etching can occur on the surface of a tooth or artificial dental structure from exposure to tomatoes or acidic fruit juices and the like that roughen the surface of the tooth and change the color of the tooth. These types of stains cannot be removed by simple mechanical methods of tooth cleaning. Chemical preparations that are capable of penetrating into the structure of the tooth are required to eliminate the stains. Staining of the enamel or dentin is generally more intractable and difficult to remove than staining of the pellicle. However, some intrinsic staining that occurs with teeth or artificial dental appliances cannot be removed with mechanical or chemical means and can only be removed cosmetically by covering the tooth with a bonded veneer or crown. 
     Accordingly, compositions for removing stains or increasing whiteness generally fall into two categories. The first category contains gels, pastes, or liquids, mouth abrasive rubs, chews, rinses and toothpastes that are mechanically agitated at the surface of the stained tooth in order to abrasively erode the stained pellicle. The second category includes gels, pastes, or liquids that use a chemical process while in contact with the surface of the tooth for a specified period of time to accomplish the tooth-whitening effect. The chemical process is typically oxidative or enzymatic. 
     Among the many chemical strategies that are available for removing or destroying tooth stains, the most effective compositions contain an oxidizing agent, such as hydrogen peroxide, carbinide or peroxols. These active compounds are used to attack the staining molecules in the tooth to render them colorless, water-soluble, or both. 
     Chemical tooth whitening treatments generally fall into two categories: (1) tooth treatments applied and supervised by a dental professional; and (2) home tooth whitening kits with materials that are applied by a non-professional user. 
     Professional tooth bleaching normally takes place in the dentist&#39;s office and usually involves one to several visits to the dentist&#39;s office. However, these treatments can take place at any location. Professional whitening treatments may also involve laser light exposures, heat lamps, high intensity light or ultraviolet light activated systems that are applied by the dentist. Mixed A and B basecoat solution systems may also be professionally applied. 
     One of the more popular approaches to whitening the teeth of a patient applied outside of the office involves the construction of a custom dental bleaching tray for the patient from an impression made of the patient&#39;s teeth by the dental professional. An oxidizing gel is used with the appliance that is worn intermittently by the patient over a period of about 2 weeks to about 6 months, depending upon the severity of tooth staining. Other gel systems are applied to tooth surfaces from a period of hours to days. These preparations can be reapplied by the individual patient as staining reappears on the teeth over time as directed by the dentist. 
     There are also many commercial kits for use by non-professionals that are available on the retail market to persons interested in whitening their teeth. These commercial products typically provide a kit that includes a generic appliance that fits over the teeth of the user and a container of bleaching gel. One major problem encountered with the generic appliance is that there is a poor fit with the teeth leaving gaps between the teeth and the appliance as compared with an appliance fitted by a dentist. The poorer fit results in the need for more gel to insure that the tooth surfaces are appropriately covered. Other approaches include the use of tapes or strips and brush on pastes that are applied to the front surfaces of the teeth. 
     The application to the teeth of whitening compositions known in the art may have a number of known adverse side effects. Bleaching compositions can cause tooth sensitivities, for example. The soft tissues of the patient, such as the lips, tongue and gingival tissues should be isolated from the oxidizing agent to avoid exposure and irritation and damage. The penetration of whitening agents through the enamel and dentin to the pulpal chamber risks damage to the pulpal tissue with some compositions. 
     Prolonged exposure of the teeth to some whitening compositions can result in demineralization and solubilization of calcium in the enamel layers of the teeth. Ingestion of oxidant gels that leach from the dental appliance can be hazardous to the patient if not administered with care. Free radicals may have an affiliation with some oral cancers. In addition, irregular or inconsistent bleaching can occur that leaves lines or spots on the teeth or differences in shade between different teeth. 
     Tooth “brightness” can be measured in a number of different scales. One scale that is commonly accepted is the VITA Shade Guide. A total of 16 tooth shades constitute the entire range of colors between very light (B1) to very dark (C4) in the VITA Guide. It has been shown that the satisfaction of the patient with a tooth whitening procedure increases with the number of tooth shade changes that are achieved. A minimum change of about 4 to 5 VITA shades is usually desirable, but the extent of color change is subjective on the part of the patient. Other reference scales may have a fewer or greater number of increments than the VITA guide. 
     Dental professionals may also have guides or machines that evaluate film of the teeth of the patient or monitor the color of the teeth directly. For example, another scheme provides an array of color samples on a stick for comparison with teeth. This system uses a uniform color scale such as the CIELAB psychometric color system. 
     There is a need for monitoring of tooth color an indicator of the success of a long term treatment scheme so that over treatments with home professional or non-professional kits can be avoided. In addition, changes from the optimum shades can be indentified, indicating the need for a new course of whitening treatments. 
     The present invention satisfies these needs, as well as others, by providing an apparatus and method for quickly and accurately obtaining color comparisons and endpoint evaluations. 
     BRIEF SUMMARY OF THE INVENTION 
     The present invention pertains to an apparatus which can be used to monitor the progress of tooth whitening procedures and to remind the patient or user to brush their teeth. Although a toothbrush is used as an illustration, other items such as a wand, tongue scraper, oral irrigator, gum stimulator and the like can be used to house a whitening guide according to the invention. 
     In one embodiment, a toothbrush is provided with a whiteness scale that is disposed in a transparent handle of the brush. The user can monitor the success of whitening treatments by comparing the scale to their teeth. Whitening treatments are preferably performed by a dentist. However, a home treatment performed by the user with the use of a whitening kit that contains the toothbrush with whiteness indicia, information and treatment materials is also contemplated. 
     In another embodiment, a panel insert with a whiteness scale is placed in a slot in the handle, body or head of the toothbrush is provided. The scale can be selected to show the beginning point of the treatments and successive improvements to a shade goal. The opposite side of the insert from the scale may also include instructions for use, warnings, information regarding the dentist, the name of the patient, time and date of the next appointment with the dentist, images and other information directed to the user. 
     The slots containing the inserts are preferably sealed so that liquid and bacteria do not collect in the slots. More than one slot and insert can be present in the toothbrush to convey information to the user. In another embodiment, the panel insert can be removed by the user and replaced within the slots in the brush. The inserts that can be removed are preferably made of durable material such as plastic, porcelain or coated metal. The panel inserts may be visible through a transparent brush or through windows in the body or handle of the brush. 
     In a further embodiment, whiteness indicia in the form of colored pieces are inlaid in the surface of the head or body of the brush. The color inlays can also be placed in a detachable head such as an electric toothbrush head. The inlays are compared with the teeth in the mirror to monitor progress. 
     An aspect of the invention is to provide a toothbrush with whiteness indicia to evaluate and monitor the status of the teeth or the progress of treatments. 
     Another aspect of the invention is to provide a whiteness guide that is readily accessible, easy to use and promotes good dental hygiene. 
     Further aspects of the invention will be brought out in the following portions of the specification, wherein the detailed description is for the purpose of fully disclosing preferred embodiments of the invention without placing limitations thereon. 
    
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING(S) 
       The invention will be more fully understood by reference to the following drawings which are for illustrative purposes only: 
         FIG. 1  is a top view of a toothbrush with whiteness indicia permanently fixed in the handle according to one embodiment of the invention. 
         FIG. 2  is a side view of the embodiment shown in  FIG. 1 . 
         FIG. 3A  is a side view of a toothbrush with a transverse slot containing an insert with whiteness indicia according to a second embodiment of the invention. 
         FIG. 3B  and  FIG. 3C  are top views of the toothbrush embodiment of  FIG. 3A  with the insert outside of and within the handle respectively. 
         FIG. 4A  and  FIG. 4B  are side views of another toothbrush embodiment with an insert disposed along the central axis of the brush and with the insert removed from the brush respectively. 
         FIG. 4C  and  FIG. 4E  are top views of the toothbrush of  FIG. 4A  with the insert removed and in place in a slot along the central axis of the brush. 
         FIG. 5A  is a bottom view of a toothbrush with whiteness indicia disposed in a slot in the head of the toothbrush in another embodiment of the present invention. 
         FIG. 5B  and  FIG. 5C  are side and top views of the toothbrush embodiment of  FIG. 5A  with the whiteness indicia inserts outside of the slot within the head of the brush. 
         FIG. 6A  and  FIG. 6B  are back side views of an alternative embodiment of the invention with a handle insert in the inserted and removed conditions respectively. 
         FIG. 7A  is an exploded bottom view of an alternative embodiment of a toothbrush with a detachable brush head with inlaid whiteness indicia and handle with an informational insert. 
         FIG. 7B  is a bottom view of an alternative detachable head shown in  FIG. 7A . 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     By way of example and not of limitation, the apparatus of the present invention generally comprises a toothbrush with a scale with a range of tooth colors that can be compared with the teeth of the user by bringing the scale in proximity with the teeth and viewed while the user is looking in the mirror. The user can then exercise appropriate judgment regarding continued use of whitening agents and whether additional treatment by a professional is warranted. Additionally, some diseases may have symptoms that have an effect on the color of the tooth or on oral health. A dental professional can screen patients for problems when the color change guide alerts the patient and has brought them back to the dentist for an examination due to the change in tooth shade. 
     Although a toothbrush is used as an illustration, other items such as a wand, tongue scraper, oral irrigator or dental floss holder or toothpaste cap or tube can be used to house a whitening guide according to the invention. 
     Turning now to  FIG. 1  through  FIG. 7A , several embodiments of the invention  10  are generally shown to illustrate the invention. In the embodiment shown in  FIG. 1  and  FIG. 2 , a toothbrush  10  is depicted with whiteness indicia permanently affixed in the handle. The toothbrush  10 , has a toothbrush head  12  with a neck  14  and body  16  that includes a handle. The handle or body  16  of the brush is preferably transparent to permit the view of the color scale  18  that has a range of increments, for example, ranging from 1 to 10 or from 10 to 1 as seen in  FIG. 1 . 
     In the embodiment shown in  FIG. 1 , the scale  18  is a thin panel with a top surface  20  and a bottom surface  22 . The scale of colors or whiteness indicia has individual elements that are tooth shaped in this embodiment. In another embodiment, the tooth shaped indicia are three dimensional. However, the whiteness indicia of panel  18  can be any desired size and shape. The background surface  20  of panel  18  can also be transparent or opaque. 
     In one preferred embodiment, the bottom surface  22  of the panel contains information directed to the specific user of the brush. Such information may include instructions for use, warnings, the date of the next appointment or the name and address of the dentist. Advertising could also be placed on the bottom side  22  of the scale panel  18 . 
     The plane of the scale panel  18  is facing perpendicular to the bristles of the brush in  FIG. 1  and  FIG. 2 . However, the plane of the panel  18  can be placed at any suitable angle with respect to the brush head  12  to permit easy viewing of the scale  18  aligned with the teeth. 
     One preferred scale for panel  18  is a 3D Master shade system that is based on the CIELAB psychometric color system. In this system there are three constituents that together constitute a “shade”. They are an L-Value (lightness level), a-Chroma (color saturation) and b-Hue (amount of red or yellow). All of the shades included in the 3D Master shade system fall within the following values of these three constituents: 65&lt;L&lt;87, 0.3&lt;a&lt;9 and 5.5&lt;b&lt;30. Although this scale is preferred, many different scales could be used as whiteness indicia. 
     Turning now to  FIG. 3A  through  FIG. 3C , an alternative embodiment  30  is shown. In this embodiment, the transparent toothbrush body  32  has a transverse slot  34  that is configured to receive a panel  36  that has a color scale  38  as shown in  FIG. 3B  and  FIG. 3C . The slot  34  can be located at any point within the body  32  of the toothbrush  30 . Although one slot  34  and one panel  36  are shown in  FIG. 3A  through  FIG. 3C , more than one slot and more than one panel can be put in the handle of the brush  30 . 
     Different panels  36  with different scales  38  or other indicia of brightness can be placed in the slot  34  over time. The panel  36  can have a color scale  38  on one side or both sides of the panel. 
     In another embodiment, the body  32  is opaque and has windows over the panels  36  so that the surface of the panel can be viewed through the window when the panel is installed in place. An opposing window can also be present so that both sides of the panel  36  can be viewed from the exterior. 
     The panel  36  is preferably secured in slot  34  with a sealant so that water or toothpaste or other fluids will not be retained in the slot as a location for the growth of bacteria or as a collection point for other organic or inorganic materials. The sealant disposed in slot  34 , as seen in  FIG. 3C , can provide a temporary reversible seal such as with silicone or it can be a permanent seal such as fast curing epoxy. 
     The panel  36  shown in  FIG. 3B , has a color or whiteness scale  38  on one side of the panel so that the indicia can be compared with the teeth. The indicia can include the starting color and one or more incremental goal shades to a final shade at the opposite end to allow monitoring of progress with each treatment. 
     The side of panel  36  that is opposite the side with the scale can also have a scale to effectively increase the length of the scale. In another embodiment, appointment dates, dentist office information, instructions, advertisements, graphics or other printed information may be placed surface of the panel. If more than one slot and panel are used, a variety of information can be provided by the dentist to the patient or general information if the brush is part of a home whitening kit. 
     A second alternative embodiment  40  is shown in  FIG. 4A  through  FIG. 4D . In this embodiment, a toothbrush  40 , is provided with a body  42  with a brush head  44  and a transparent handle  46 . In the embodiment shown, there is a longitudinal slot  48  in the handle  46  of body  44  of the toothbrush  40  that mates with an insert member  50 . Member  50  has a grip  52  and a panel  54  that slides in the slot  48 . The panel  54  of sliding insert member  50  is generally planar and has a scale  52  on one or both sides of the panel  54 . 
     The back side of the insert member  50  can have the name, address and telephone number of the dentist or other marketing information as well as the date and time of the next appointment of the patient as a reminder. The insert panel  54  could also have the name of the patient or a color so that the brush can be easily identified as that of the patient. 
     A variety of different scales  56  can be used and interchanged with different members  50 . In one embodiment, the panel  54  of insert member  50  is cylindrical and the indicia  56  scale consists of rings of different shades of white. The slot  48  in handle  46  is tubular to receive the ringed cylinder of panel  54  of insert member  50  in this embodiment. 
     In one embodiment, the insert member  50  is secured to the handle  46  with a fastening scheme such as interlocking threads, slip and click or a bayonet mount to make the slot  48  and insert  50  water tight and bacteria free. Grip  52  may also have a seal. 
     The insert member  50  with panel  54  are preferably made of durable materials such as plastic, porcelain, coated metal etc. that can withstand multiple removals and insertions into the slot  48  as well as cleanings and information applications. The insert member  50  may also be transferred to a new brush and may have a useful life that is longer than the brush. 
     A third embodiment  60  is shown in  FIG. 5A ,  FIG. 5B  and  FIG. 5C . The toothbrush in this illustration a toothbrush body  62  with a brush head  64  and a brush handle  66 . The brush handle  66  can be a transparent solid handle that includes a laminated strip that has information such as the name and address of the dentist, instructions for use, or other material. In another embodiment, the brush handle  66  has an insert such as insert member  50  shown in  FIG. 4B  or panel  36  shown in  FIG. 3B  that contains information such as appointment information, name and address of the dentist, instructions for use or other desired information directed to the user. 
     The brush head  64  has a slot  68 , as shown in  FIG. 5B  and  FIG. 5C , that has an opening at the top or the side of the brush head  64 . The slot  68  is configured to receive a panel  70  with a whiteness scale  72 . In one embodiment, the panel  70  is permanently fixed within the head  64 . The panel can include several different whiteness indicators  72  to allow the user to evaluate the progress of treatments or to recognize a change in color of the teeth over time from a selected ideal shade. 
     The panels  36 ,  50  and  70  shown in each of the embodiments described above are preferably color stable over time, formed of durable material and are resistant to bacteria. The panels or chips may also be laminated. The chips or panels are preferably opaque with whiteness indicia on the surface to give a true color when the indicator is placed next to the teeth. In one embodiment, the replaceable guide panels have a seal to keep out liquids and to stop the formation of bacterial colonies. The chips may also be permanently placed by the dentist in the brush or wand so that the guide will not be lost or used improperly by the patient. 
     In one embodiment, the panels  30 ,  50  or  70  are made from sintered porcelains such as feldspathic porcelain, leucite reinforced feldspathic porcelain, alumina-based porcelain, magnesia-based porcelain or zirconia-based porcelain. In another embodiment, the panels are made from glass-ceramics, including mica-based glass-ceramics, hydroxyapatite-based glass-ceramics or lithia-based glass-ceramics. The panels may also be constructed from thermoplastic polymers such as Polymethyl methacrylate (PMMA), Polypropylene (PP), Polystyrene (PS), High impact polystyrene (HIPS), Acrylonitrile butadiene styrene (ABS), Polyethylene terephthalate (PET), Polyester (PES), Polyamide (PA), Poly(vinyl chloride) (PVC), Polyurethane (PU), Polycarbonate (PC), Polyvinylidene chloride (PVDC), Polyethylene (PE), Polycarbonate/Acrylonitrile Butadiene Styrene (PC/ABS), Polyetheretherketone (PEEK) (Polyetherketone), Polyetherimide (PEI), Polysulfone (PES), or Styrene-acrylonitrile (SAN). In a further embodiment, the panels are formed from thermoset polymers such as Polyimide (PI), Phenolics (PF) or (phenol formaldehydes), Urea-formaldehyde, (UF), Melamine formaldehyde (MF). In another embodiment, the panels are manufactured from dental polymers including Bisphenol A-glycidyl methacrylate (BISMA), Urethane dimethacrylate (UDMA), Triethylene glycol dimethacrylate (TEGDMA), or Ethoxylated bisphenol-A dimethacrylate (BisEMA). 
     Although the forgoing materials are preferred, the list is not exhaustive of the materials that may be suitable for use for panel inserts or coatings for panel inserts. These materials may also be suitable for use with the tooth brush body as well. 
     In each of the embodiments shown herein, the brush or guide may have one or more lights  74  to enhance the color differences between the tooth and the scale as shown in  FIG. 5B  and  FIG. 5C . The light  74  may also be of a selected wavelength for illumination of the teeth for comparison. The light  74  of the brush is directed to the surface of the teeth while the whiteness guide is brought in proximity to the teeth for comparison. In another embodiment, the graded elements of the guide are illuminated with a light shown from either the back or the front surfaces of the guide to produce a consistent color for comparison with the teeth regardless of the amount of ambient light that is available. The light or lights are preferably inexpensive and low voltage such as a light emitting diode. Battery and actuator are preferably mounted to or enclosed in the handle. 
     Turning now to  FIG. 6A  and  FIG. 6B , a fourth embodiment of the invention is shown to further illustrate the invention. In this embodiment, a toothbrush  80  is provided that has a body  82  with a brush head  84  and handle  86 . The back of the brush head  84  has one or more inlaid disks  88  that are colored and are of a selected shade for comparison with the teeth of a patient. The color of the inlaid disks  88  may be selected as the colors existing at the beginning of the treatment and the desired shade at the end of the course of treatments. The disks  88  can be compared with the teeth of the patient at various times to determine the progress of the treatments. Although two circular inlaid disks  88  are shown as an illustration, it will be understood that more that two disks can be used and that the shape and position of the indicia on the head can vary. 
     The end of handle  86  is hollow and open and has one or more windows  90  that allow one to view what is in the interior of the hollow portion of the handle  86 . Two windows  90  placed on opposite sides of the toothbrush handle  86  are preferred. The windows  90  may be open or have a transparent covering for the opening to seal the interior. 
     An insert  94  that has end cap  96  and panel  98  is provided that is sized to fit in the open end  92  of the handle  86  of the toothbrush body  82 . Upon insertion of the insert  94 , the sides of panel  98  are visible through the windows  90  of the handle. The panel  98  can have dentist, appointment information and the like or additional whiteness indicia and the shades of disks  88  represent the starting and ending shades, in one embodiment. 
     The insert  94  has a system for securing and fastening the insert with the handle  86 . In the embodiment shown, the end cap  96  has a notch  100  with a central raised knob that fits within a corresponding hole in tab  102  at the end of the handle  86 . The system for securing the insert  94  to the handle  86  may include threads or a bayonet mount or similar systems. 
     A fifth embodiment of the invention is shown in  FIG. 7A  and  FIG. 7B . In this embodiment, the brush  110  has a handle  112  with a detachable brush head  114 . The distal opening  116  of brush head  114  engages the coupling pin  118  of the handle  112  reversibly securing the two pieces together. Other means for coupling the brush head  114  element with the body of the brush  112  element can also be used. 
     The brush head  114  has one or more inlaid color shade disks  120  as indicia of whiteness for comparison with the teeth of the user. An alternative embodiment of the detachable brush head  114  is shown in  FIG. 7B  to illustrate the different types of inlaid color chips  120  that can be used. In another embodiment, the whiteness indicia consist of colored rings around the neck of the brush head  114 . The brush head  114  also has standard bristles  128  or some other useful device such as a gum stimulator. 
     In another embodiment, the brush body or brush head  114  is made of material that is the same shade of white that the patient has determined to be cosmetically desirable and has set as the treatment goal. In this embodiment, the toothbrush is compared with the teeth so that the progress of the dental whitening treatments can be evaluated toward the goal color of the brush. 
     The handle  112  is preferably transparent at the end opposite of the coupling pin  118  and has a socket that can receive an insert  122 . The insert has a panel  126  and an end cap  124  in the embodiment shown in  FIG. 7A . The panel  126  of insert  122  can have appointment information, name of the dentist or patient, instructions, warnings, supplemental whiteness indicia or some other information that is relevant to the user. The insert  122  could also be a series of rings of different whiteness shades to show progression. The insert  122  may be replaced by the dentist at the next visit, or given to the patient for replacement of the prior insert or may be installed permanently in the body of the handle. 
     In another embodiment, the handle  112  comprises a standard electric toothbrush configured to couple with the brush head  114 . The end  116  of brush head  114  may include a socket that fits the pin  118  or may engage the pin with friction. The indicia  120  would be compared with the teeth between brushings. 
     In another embodiment, the brush and guide are part of a kit provided by the dentist to the patient that may include: a brush with the guide, dental floss, and an instruction booklet. The guide chip is selected by the dentist for the specific patient and permanently placed in the slot in the brush or wand. 
     In a further embodiment, the brush may have a first insert at the brush head and a second insert at the handle or neck of the brush. The brush could have two different color scales or a single scale in one slot and an insert with the patient identification, dentist identification, appointment date and time or some marketing material. 
     In yet another embodiment, the color indicia is applied to the brush body in the form of rings. The rings are of the different characteristic whiteness shades and described herein. 
     It is preferred that the selection of the shade indicia be a decision by dentist and the patient after an examination by the dentist. However, the panels or disk shades could be pre-selected for typical ranges and the brushes made part of a home treatment kit with whitening products and oral health products such as dental floss. A dental examination is preferred to ensure the suitability of the teeth of the patient for whitening treatments, define achievable whitening goals and to chart a course of treatment. Existing health conditions of the patient that may result in discoloration of the teeth can also be identified by the dentist the manifestation of those conditions on the teeth can be monitored by the patient with the monitoring of the shades of the teeth. A dramatic change in tooth color can be an indicator of an intensifying medical condition and alert the patient to consult a health care provider. 
     After the initial evaluation, the dentist will typically select a panel insert with a range of progressively lighter shades from a beginning shade to a goal. The panel insert may also include the date of the next appointment or other information that is affixed to the side of the panel opposite the color guide and disposed in the corresponding slot in the brush body. The opening of the slot containing the insert may be sealed with a sealant or the end cap glued into place. Alternatively, the panel insert may be reversibly secured and withdrawn from the slot in the brush body for use by the patient. The insert can have new information applied and transferred to another toothbrush body at the next appointment. 
     The indicia may also be colored disks that are selected and placed into the brush head or body and secured with adhesive. Alternatively, brushes with inlays of different shades can be pre-assembled. New toothbrushes or brushes with detachable heads with color shades for that particular time frame can be given to the patient at the end of the examination or treatment session. 
     In use, the patient or user of the guide can evaluate the success of a dental whitening procedure or monitor the progress of home applied whitening schemes. The user can compare the existing shade of the teeth with the goal or standard and can make an informed decision about going back to the dentist for additional treatments or if a particular treatment was unsuccessful and further evaluation is needed by the dentist. The patient can also determine when it is time to have additional whitening as the tooth surfaces change colors over time and use. Dramatic changes in tooth color that indicate an associated health problem can also be identified potentially leading to early diagnosis and treatment. 
     Accordingly, the invention can be embodied in various ways which include, but are not limited to, the following: 
     1. A tooth shade indicator apparatus, comprising: a brush body with a brush head with bristles; and a tooth shade indicator coupled to said brush body; wherein a user&#39;s tooth color can be visually compared with said tooth shade indicator. 
     2. An apparatus as recited in claim  1 , wherein said tooth shade indicator includes at least one color from a VITA, IVOCLAR, or other cosmetic dental color scale. 
     3. An apparatus as recited in claim  1 , wherein said tooth shade indicator comprises disks of different shades inlaid in the brush body and brush head. 
     4. An apparatus as recited in claim  1 , further comprising an insert configured to slide within a slot within said brush head, wherein said tooth shade indicator is mounted to said insert. 
     5. An apparatus as recited in claim  1 , further comprising an insert configured to slide within a slot within said brush body, wherein said tooth shade indicator is mounted to said insert. 
     6. An apparatus as recited in claim  5 , further comprising a second insert configured to slide within a slot within said brush head of said brush body, wherein said tooth shade indicator is mounted to said second insert and treatment information is printed on said first insert. 
     7. An apparatus as recited in claim  1 , further comprising a light source coupled to said brush body configured to illuminate teeth of a user when comparing said tooth shade indicator with the teeth of a user. 
     8. An apparatus as recited in claim  1 , further comprising a light source coupled to said brush body configured to illuminate said shade indicator. 
     9. An apparatus as recited in claim  1 , further comprising: an insert configured to slide within a slot within said brush body, said insert having an end cap and a panel with a top surface and a bottom surface; wherein information is applied to said top and bottom surfaces; and wherein the tooth shade indicator comprises disks of different shades inlaid in the brush head. 
     10. A tooth shade indicator apparatus, comprising: an indicator body; a detachable head configured to reversibly couple with said indicator body; and a tooth shade indicator coupled to said detachable head; wherein a user&#39;s tooth color can be visually compared with said tooth shade indicator. 
     11. An apparatus as recited in claim  10 , wherein said tooth shade indicator comprises disks of different shades inlaid in the detachable head. 
     12. An apparatus as recited in claim  10 , wherein said tooth shade indicator comprises rings of different shades inlaid in the detachable head. 
     13. An apparatus as recited in claim  10 , further comprising an insert configured to slide within a slot within said brush body, said insert comprising a handle and a panel with top and bottom surfaces; and wherein information is applied to said top and bottom surfaces of said panel. 
     14. An apparatus as recited in claim  13 , further comprising a tooth shade indicator applied to a top surface of said panel and information applied to said bottom surface of said panel; and wherein said tooth shade indicator comprises the color of the detachable head. 
     15. An apparatus as recited in claim  10 , said indicator body further comprising an electric toothbrush motor configured to rapidly alternate directions of rotation of a brush on said detachable head. 
     16. A tooth shade indicator apparatus, comprising: an indicator body with an indicator head that has the color of a cosmetically desirable tooth shade of white; an insert sized to fit within a socket in said indicator body, said insert having an outer surface; and a tooth shade indicator coupled to said outer surface of said insert; wherein a user&#39;s tooth color can be visually compared with said indicator head color to evaluate treatment progress and said tooth shade indicator to determine a tooth shade. 
     17. An apparatus as recited in claim  16 , further comprising information regarding a dental treatment applied to the outer surface of said insert in addition to the tooth shade indicator. 
     18. An apparatus as recited in claim  16 , further comprising a light source coupled to said indicator body configured to illuminate teeth of a user when comparing said shade indicator with the teeth of a user. 
     19. An apparatus as recited in claim  16 , wherein said indicator body further comprises a fastener configured to secure said insert within said socket and a plurality of windows; wherein said outer surface of said insert is visible from the exterior of the indicator body when secured within said socket. 
     20. An apparatus as recited in claim  16 , further comprising: a second insert sized to fit within a second socket in said indicator body or said indicator head, said second insert having an outer surface with information regarding a dental treatment applied to the outer surface of said second insert. 
     21. A tooth shade indicator apparatus, comprising: a toothbrush head with bristles; and a tooth shade indicator associated with said toothbrush head. 
     22. An apparatus as recited in claim  21 , wherein said tooth shade indicator includes at least one color from a VITA, IVOCLAR, or other cosmetic dental color scale. 
     23. An apparatus as recited in claim  22 , wherein said tooth shade indicator comprises the color at least a portion of said toothbrush head. 
     24. An apparatus as recited in claim  22 , wherein said tooth shade indicator is inlaid in said toothbrush head. 
     25. An apparatus as recited in claim  22 , wherein said tooth shade indicator comprises disks of different shades inlaid in said toothbrush head. 
     26. An apparatus as recited in claim  22 , further comprising an insert configured to slide within a slot within said toothbrush head, wherein said tooth shade indicator is coupled to said insert. 
     27. An apparatus as recited in claim  26 , further comprising a second insert configured to slide within said slot within said slot in said toothbrush head, wherein said tooth shade indicator is coupled to said second insert and treatment information is printed on said first insert. 
     28. A tooth shade indicator apparatus, comprising: a toothbrush body; and a tooth shade indicator associated with said toothbrush body. 
     29. An apparatus as recited in claim  28 , wherein said tooth shade indicator includes at least one color from a VITA, IVOCLAR, or other cosmetic dental color scale. 
     30. An apparatus as recited in claim  29 , wherein said tooth shade indicator comprises the color at least a portion of said toothbrush body. 
     31. An apparatus as recited in claim  29 , wherein said tooth shade indicator is inlaid in said toothbrush body. 
     32. An apparatus as recited in claim  29 , wherein said tooth shade indicator comprises disks of different shades inlaid in said toothbrush body. 
     33. An apparatus as recited in claim  29 , further comprising an insert configured to slide within said slot within said toothbrush body, wherein said tooth shade indicator is coupled to said insert. 
     34. An apparatus as recited in claim  33 , further comprising a second insert configured to slide within a slot within said toothbrush body, wherein said tooth shade indicator is coupled to said second insert and treatment information is printed on said first insert. 
     35. An apparatus as recited in claim  28 , further comprising a light source coupled to said brush body configured to illuminate teeth of a user when comparing said shade indicator with the teeth of a user. 
     36. An apparatus as recited in claim  28 , further comprising a light source coupled to said brush body configured to illuminate said shade indicator. 
     37. An apparatus as recited in claim  28 , further comprising: an insert configured to slide within a slot within said brush body, said insert having an end cap and a panel with a top surface and a bottom surface; wherein information is applied to said top and bottom surfaces; and wherein the tooth shade indicator comprises disks of different shades inlaid in the brush head. 
     It will further appreciated that any of the aforementioned embodiments or inventive concepts can be can be packaged with other instruments and devices, can be shaped into any desired shape or style, and can be part of an overall treatment or marketing system. 
     For example, the invention can be a component of a bleaching system, which would not only allow the invention to be used for treatment evaluation but to potentially increase sales of bleach, advertise services, or encourage patients to see the dentist more often for evaluation or treatment. 
     Furthermore, the invention could be configured so that it slides into or otherwise couples to a floss box, bleach material dispenser, stand or other device. 
     Embodiments of the invention may include a slot or other receptacle into which one or more tooth shade indicators can be inserted by sliding or otherwise. Written stickers, labels, materials with a writable surface, lights, identification tags, id tags, marketing information, or even novelty products such as those bearing Disney, Star Wars, Barbie, etc. optionally can be inserted as well. All of these items can optionally be removable by the patient or optionally locked into the device by a dental professional or other person. Even nail polish, lipstick or other color samples optionally could be inserted. 
     Embodiments of the invention may include manual versions, electric versions, or hybrids. The entire toothbrush, any part thereof, or a tooth shade indicator associated with any part of the toothbrush optionally can be a desired color, multiple colors in a graduated shading pattern indicating stages of whitening or color change, or include the existing color of a patient&#39;s tooth or teeth for comparison. Colors are preferably selected from VITA, IVOCLAR, or other cosmetic dental color scales used in the profession. 
     Furthermore, is will be appreciated that the use of the invention as a whitening evaluation gauge, advertising media, or the like, could encourage more frequent dental visits and potentially allow for early detection of dental disease such as periodontal disease, caries, etc., protect a person from dental disease becoming worse, or even save a person&#39;s life by early detection of oral cancer or other systemic diseases manifested in the oral cavity. 
     Although the description above contains many details, these should not be construed as limiting the scope of the invention but as merely providing illustrations of some of the presently preferred embodiments of this invention. Therefore, it will be appreciated that the scope of the present invention fully encompasses other embodiments which may become obvious to those skilled in the art, and that the scope of the present invention is accordingly to be limited by nothing other than the appended claims, in which reference to an element in the singular is not intended to mean “one and only one” unless explicitly so stated, but rather “one or more.” All structural, chemical, and functional equivalents to the elements of the above-described preferred embodiment that are known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be encompassed by the present claims. Moreover, it is not necessary for a device or method to address each and every problem sought to be solved by the present invention, for it to be encompassed by the present claims. Furthermore, no element, component, or method step in the present disclosure is intended to be dedicated to the public regardless of whether the element, component, or method step is explicitly recited in the claims. No claim element herein is to be construed under the provisions of 35 U.S.C. 112, sixth paragraph, unless the element is expressly recited using the phrase “means for.”