Patent Publication Number: US-2022226667-A1

Title: Intraoral phototherapy device

Description:
TECHNICAL FIELD 
     This present disclosure relates generally to phototherapy and more particular to intraoral phototherapy devices. 
     BACKGROUND 
     Phototherapy can be utilized for treating and providing pain relief for various conditions, including a condition called Oral Mucositis (OM). Phototherapy can be delivered in several ways, e.g., directly to the tissue via Low Level Laser Therapy (LLLT) or via a light emitting diode (LED) array that propagates light through the skin into the affected region. 
     Currently there are two known methods for administering phototherapy for the treatment of various phototherapy treatment conditions of the mouth including, but not limited to Oral Mucositis (OM), low level laser therapy and light emitting diode (LED) arrays. Oral Mucositis is one of the most common and highly significant toxicities of cancer therapy. 
     Barriers to the acceptance of low-level laser therapy include the cost of laser equipment and the labor intensiveness. Additionally, there are problems with interoperator variability and the need for specialized training. Also patients receiving this form of treatment are required to hold their mouths open for long periods of time which is uncomfortable and becomes extremely painful as the Mucositis progresses. 
     LED arrays utilize a plurality of LEDs to irradiate larger areas of tissue externally. The light from these arrays penetrates the skin to stimulate the mucosal membrane. LED arrays have the advantage of irradiating a large surface area, are simpler to implement than spot laser systems, and are more comfortable to the patient. The main disadvantages of using LED arrays for administering phototherapy treatment is that they lack dose control because they must transilluminate cheek tissue and have difficulty reaching all regions of the oral cavity, including the tonsillar and palatal regions which are highly susceptible to OM. Also variability in tissue thickness between different buccal regions and different patients makes it impossible to accurately monitor and control the dose of light administered to the mucosa. 
     SUMMARY 
     The present disclosure provides an intraoral phototherapy device including a bifurcated central projection for illuminating a roof of the oral cavity, a floor of the oral cavity, and one or more surfaces of the tongue. 
     The present disclosure also provides an intraoral phototherapy device having a breathing tube to improve patient breathing and to allow patient vocalization to improve illumination of tissues at the back of the mouth. 
     The present disclosure further provides an intraoral phototherapy device allowing separate control of light emission from different areas of the intraoral phototherapy device, such that different tissues receive different optical doses. 
     While several features are described herein with respect to embodiments of the invention; features described with respect to a given embodiment also may be employed in connection with other embodiments. The following description and the annexed drawings set forth certain illustrative embodiments of the invention. These embodiments are indicative, however, of but a few of the various ways in which the principles of the invention may be employed. Other objects, advantages, and novel features according to aspects of the invention will become apparent from the following detailed description when considered in conjunction with the drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The annexed drawings, which are not necessarily to scale, show various aspects of the invention in which similar reference numerals are used to indicate the same or similar parts in the various views. 
         FIG. 1  is a front perspective view of an embodiment of an intraoral phototherapy device. 
         FIG. 2  is a rear perspective view of the intraoral phototherapy device of  FIG. 1 . 
         FIG. 3  is a side view of the intraoral phototherapy device of  FIG. 1 . 
         FIG. 4  is a front view of the intraoral phototherapy device of  FIG. 1 . 
         FIG. 5  is a top view of the intraoral phototherapy device of  FIG. 1 . 
         FIG. 6  is a bottom view of the intraoral phototherapy device of  FIG. 1 . 
         FIG. 7  is a side cut away view of the intraoral phototherapy device of  FIG. 4 . 
         FIG. 8  is a top front perspective view of another embodiment of the intraoral phototherapy device. 
         FIG. 9  is a lower front perspective view of the intraoral phototherapy device of  FIG. 8 . 
         FIG. 10  is a rear perspective view of the intraoral phototherapy device of  FIG. 8 . 
         FIG. 11  is a side view of the intraoral phototherapy device of  FIG. 8 . 
         FIG. 12  is a front view of the intraoral phototherapy device of  FIG. 8 . 
         FIG. 13  is a top view of the intraoral phototherapy device of  FIG. 8 . 
         FIG. 14  is a bottom view of the intraoral phototherapy device of  FIG. 8 . 
         FIG. 15  is a side cut away view of the intraoral phototherapy device of  FIG. 12 . 
         FIG. 16  is a front view of a further embodiment of the intraoral phototherapy device. 
         FIG. 17  is a top view of the intraoral phototherapy device of  FIG. 16 . 
         FIG. 18  is a top perspective view of another embodiment of the intraoral phototherapy device. 
         FIG. 19  is a rear perspective view of the intraoral phototherapy device of  FIG. 18 . 
         FIG. 20  is a top perspective partially transparent view of a further embodiment of the intraoral phototherapy device including lenses. 
         FIG. 21  is a top perspective view of the intraoral phototherapy device of  FIG. 20 . 
         FIG. 22  is a top perspective view showing the substrate of the intraoral phototherapy device of  FIG. 20 . 
         FIG. 23  is a front perspective partially transparent view of the intraoral phototherapy device of  FIG. 20 . 
         FIG. 24  is a side cut away view of an embodiment of the intraoral phototherapy device located in the oral cavity. 
         FIG. 25  is a top cut away view of the intraoral phototherapy device of  FIG. 24  located in the oral cavity. 
         FIG. 26  is a front perspective partially transparent view of an embodiment of the intraoral phototherapy device located in the oral cavity. 
         FIG. 27  is a front perspective less transparent view of the embodiment of the intraoral phototherapy device of  FIG. 25  located in the oral cavity. 
         FIG. 28  is a side cut away view of an intraoral phototherapy device including a light guide. 
     
    
    
     The present invention is described below in detail with reference to the drawings. In the drawings, each element with a reference number is similar to other elements with the same reference number independent of any letter designation following the reference number. In the text, a reference number with a specific letter designation following the reference number refers to the specific element with the number and letter designation and a reference number without a specific letter designation refers to all elements with the same reference number independent of any letter designation following the reference number in the drawings. 
     DETAILED DESCRIPTION 
     According to an exemplary embodiment, an intraoral phototherapy device is provided that improves tissue illumination. Oral tissue illumination is particularly difficult in the oral cavity inside of the teeth. That is, it is particularly difficult to illuminate the roof of the mouth, floor of the mouth, sides of the tongue, and/or ventral surface of the tongue. The intraoral phototherapy device improves illumination of these tissues using a bifurcated central projection that receives a portion of the tongue. 
     According to another exemplary embodiment, an intraoral phototherapy device is provided that includes a breathing tube. While receiving phototherapy, it is often difficult to illuminate the back of the mouth due to obstructions caused by other tissues (e.g., the tongue). By including a breathing tube, the phototherapy device improves illumination of the back of the throat by allowing the patient to vocalize certain sounds (such as “00000” or “ahhhhh”) while receiving phototherapy. 
     According to a further exemplary embodiment, an intraoral phototherapy device is provided that enables individualized phototherapy based on patient need. The intraoral phototherapy device allows for separate control of light emission from areas of the intraoral phototherapy device, such that different tissues receive different optical doses. 
     In the embodiment depicted in  FIGS. 1-7 , an intraoral phototherapy device  10  is shown for illuminating targeted regions of an oral cavity of a patient. The intraoral phototherapy device  10  includes a main body portion  12  shaped (1) to conform to contours of the oral cavity when inserted therein and (2) to direct light to the targeted regions of the oral cavity. The main body portion includes a pair of laterally spaced side wings  14  and a bifurcated central projection  16 . The side wings  14  are sized and shaped to be received between teeth and cheeks of the patient on opposite sides of the oral cavity. The pair of laterally spaced side wings  14  includes an inner surface  20  facing towards a tongue and an outer surface  22  opposite the inner surface  20  and facing towards the cheeks when inserted into the oral cavity. The bifurcated central projection  16  has a first projection  30 , and a second projection  32  separated from the first projection  30 . The first projection  30  and the second projection  32  are sized and shaped to receive a portion of a tongue of the patient between the first projection  30  and the second projection  32 . 
     The received portion of the tongue (i.e., the portion of the tongue received between the first projection  30  and the second projection  32 ) may be at least 25% of an oral tongue of the patient. Use of the term “oral tongue” herein refers to a body of the tongue between the apex of the tongue and the foramen cecum of the tongue. In another embodiment, the received portion of the tongue includes at least 15%, at least 50% or at least 75% of the oral tongue. In a further embodiment, the received portion of the tongue includes at least one of (1) a portion of the frenulum or (1) at least one of the submandibular salivary ducts. 
     In the embodiment depicted in  FIGS. 1-15 , the first projection  30  is an upper projection and the second projection  32  is a lower projection. The upper projection  30  has an outer surface  34  facing towards a roof of the oral cavity and an inner surface  36  facing towards a top of the tongue when inserted into the oral cavity. The lower projection  32  has an inner surface  38  facing towards a bottom of the tongue and an outer surface  40  facing towards a floor of the oral cavity when inserted into the oral cavity. 
     In one embodiment, the intraoral phototherapy device  10  includes light emitters  50  positioned on the main body portion  12 . The light emitters  50  are configured to emit the light that is directed onto the targeted regions of the oral cavity. The light emitters  50  may be segmented into groups based on the tissues or regions of the oral cavity that the light emitters  50  illuminate when the intraoral phototherapy device  10  is inserted into the oral cavity. As is described in further detail below, the groups of light emitters  50  may be separately controlled to vary the optical dose received by different tissues of the oral cavity during phototherapy. The light emitters  50  may include at least one of buccal light emitters  52 , top tongue light emitters  54 , bottom tongue light emitters  56 , mouth roof light emitters  58 , or mouth floor light emitters  60 . The groups of light emitters  50  may be separated in name only. That is, the different groups of light emitters  50  may be controlled together with other light emitter groups. Similarly, different light emitter groups may be independently controlled. 
     The buccal light emitters  52  are positioned on the outer surface  22  of the side wings  14  and illuminate the buccal tissues. The top tongue light emitters  54  are positioned on the inner surface  36  of the upper projection  30  and illuminate a top surface (also referred to as dorsal surface) of the tongue. The bottom tongue light emitters  56  are positioned on the inner surface of the lower projection  32  and illuminate a bottom surface (also referred to as a ventral surface) of the tongue. The mouth roof light emitters  58  are positioned on the outer surface  34  of the upper projection  30  and illuminate a roof of the oral cavity. The mouth floor light emitters  60  are positioned on the outer surface  40  of the lower projection  32  and illuminate a floor of the oral cavity (underneath the tongue). Different embodiments of the intraoral phototherapy device  10  may include different groups of light emitters  50 . 
     In one embodiment, the light emitters  50  include the buccal light emitters  52 , the top tongue light emitters  54 , and the bottom tongue light emitters  56 . This allows the light emitters  50  to illuminate the buccal tissues, the top of the tongue, and the bottom of the tongue. In another embodiment, the light emitters  50  additionally include mouth roof light emitters  58  and mouth floor light emitters  60 . The inclusion of these additional light emitters  50  enable the intraoral phototherapy device  10  to also illuminate the roof of the oral cavity and the floor of the oral cavity. 
     The main body portion  12  may be made of a material that is at least partially transparent to light emitted by the light emitters  50 . For example, the main body portion  12  may be made at least partially made from a soft, flexible, optically clear silicone material 
     While the above described embodiments include light emitters  50  housed on the main body portion, the intraoral phototherapy device  10  may instead receive the light directed onto the targeted regions from a light source external to the main body portion  12 . The light source may direct light to the main body portion  12  and the main body portion act as a light guide to may both transmit and emit the light that illuminates the targeted regions of the oral cavity. For example, the light source may be attached to the main body portion  12  via a light guide. In this example, the light source may be a light box supported by an external structure (e.g., a table). In another example, the light source may be physically mounted to a tab  61  on an external surface of the main body portion  12 . In this example, the light source may be one or more light emitters  50  enclosed in a housing that includes a power source (such as a battery). 
     In one embodiment, the light source is a remote light source that is optically coupled to rearwardly protruding ends of the main body portion  12  via a fiber optic cable. In an embodiment, the remote light source includes one or more LEDs or a laser. 
     In some embodiments, one or more portions of the main body portion protrude rearwardly beyond the side wings  14  for optically coupling of a light source thereto. For example, the light source may be one or more LEDs directly optically coupled to rearwardly protruding ends (also referred to as a tab)  61  of the main body portion  12 . The light source may comprise multiple light sources and the output of the light sources may vary in optical power. For example, the LEDs may be mounted on a circuit board inside a housing attached to the tab  61  with the LEDs in substantially direct contact with the tab  61 . 
     In some embodiments, the main body portion  12  acts as a light guide for transmitting and directing light to targeted regions of the oral cavity by internal reflection and causing light to be emitted therefrom by providing disruptions or lenses along the length of the main body portion  12 . For example, the main body portion  14  may be made of an optically transparent soft flexible biocompatible polymeric material such as silicone. As an example, the main body portion  12  may be made of different formulations of polycarbonate, polymethyl methacrylate, polystyrene, nylon, acrylonitrile butadiene styrene, polyolefin, or other biocompatible thermoplastic elastomer formulations. 
     The light emitters  50  may include a plurality of light emitting diodes (LEDs). The light emitters  50  may additionally include one or more lasers. As will be understood by one of ordinary skill in the art, the light emitters  50  may include any suitable source of electromagnetic radiation. The light emitters  50  may emit light having a wavelength from 600 nm to 1000 nm. For example, the light emitters  50  may emit electromagnetic radiation having a wavelength approximately equal to at least one of 630 nm, 660 nm, 670 nm, 810 nm, or 880 nm. 
     The different groups of light emitters may include any number of light emitters. The different groups of light emitters may also include light emitters having different properties. For example, the position and number of light emitters  50  in a group may be chosen depending on the target regions being treated and based on properties of the user (e.g., size, weight, skin tone, etc.). 
     In one embodiment, the main body portion  12  additionally includes bite pads  62  located on the inner surfaces  20  of the side wings  14 . The bite pads  62  are protrusions projecting inward (i.e., towards the interior of the oral cavity) from the inner surface  20  and are positioned on the side wings  14  for engagement by teeth of the patient. The bite pads  62  are used to secure the side wings  14  in place when the main body portion  12  is inserted into the oral cavity of the patient. 
     The bite pads  62  may additionally be used to create a gap between the teeth for illuminating the lateral surfaces of the tongue. For example, in one embodiment the light emitters  52  include lateral tongue light emitters  64  positioned to emit light from at least one of the inner surface  20  of the side wings  14  or a distal surface  66  of the bite pads  62 , such that the light emitted by the tongue light emitters  64  projects inward (1) from the inner surface  20  and/or (2) from the distal surface  66 , and between the molar teeth to illuminate a lateral surface of the tongue when the main body portion  12  is inserted into the oral cavity. That is, when positioned in the oral cavity, the bite pads  62  create a gap between the teeth. By projecting light from at least one of the inner surface  20  or the distal surface  66 , the light from the lateral tongue light emitters  64  passes through the gap in the teeth and illuminates the lateral tongue tissues. For example, the bite pads  62  may be positioned towards a distal end of the side wings, such that the bit pads  62  engage with the molar teeth when the intraoral phototherapy device  10  is inserted into the oral cavity. 
     The bite pads  62  may be made from any suitable material for transmitting light and for engaging with the teeth. For example, the bite pads may be made from the same material as the main body portion  12 . 
     In one embodiment, the upper portion  30  additionally has a distal surface  70  located between the upper surface  34  of the upper portion  30  and the lower surface  36  of the upper portion  30 . In this embodiment, the light emitters  52  include a tonsil light emitter  72  located on or emitting light from the distal surface  70  of the upper portion  30 . The tonsil light emitter  72  are configured to emit light that is directed onto a tonsillar region of the oral cavity when inserted into the oral cavity. The tonsillar region may include the back of the mouth comprising at least one of the tonsils, uvula, or soft palate. 
     The tonsil light emitter  72  may be configured to emit more focused light from the main body portion  12  than from other groups of light emitters. For example, the tonsil light emitters  72  may have properties that cause the tonsil light emitters  72  to emit more directed light than light emitters of other groups. 
     In a particular embodiment, the inner surface  36  of the upper projection  30  has a curvature that conforms to contours of the dorsal surface of the tongue, such that light emitted from the inner surface  36  (e.g., the top tongue light emitters  54 ) illuminates the dorsal surface of the tongue and at least a portion of the lateral surfaces of the tongue. For example, light emitted from the inner surface  36  of the upper projection  30  may illuminate the dorsal surface of the tongue and a top portion of the lateral surfaces of the tongue. 
     Similarly, the inner surface  38  of the lower projection  32  may have a curvature that conforms to contours of the ventral surface of the tongue, such that light emitted from the inner surface  38  (e.g., the bottom tongue light emitters  54 ) illuminates the ventral surface of the tongue and at least a portion of the lateral surfaces of the tongue. For example, light emitted from the inner surface  38  of the lower projection  32  may illuminate the ventral surface of the tongue and a bottom portion of the lateral surfaces of the tongue. 
     Turning to the embodiments depicted in  FIGS. 16 and 17 , instead of an upper projection and a lower projection, the first projection  30  may be a left projection and the second projection  32  may be a right projection. The first projection  30  has an outer surface  34  facing towards gums of the oral cavity and an inner surface  36  facing towards a first lateral surface (i.e., one side) of the tongue. The second projection  32  has an outer surface  40  facing towards the gums of the oral cavity and an inner surface  38  facing towards a second lateral surface (i.e., another side) of the tongue. 
     Similar to the embodiment described above and depicted in  FIGS. 1-15 , the intraoral phototherapy device  10  may also include light emitters  50  positioned on the main body portion  12  when including a left and right projection  30 ,  32 . The light emitters  52  may include at least one of buccal light emitters  52 , lateral tongue light emitters  64 , mouth roof light emitters  58 , or mouth floor light emitters  60 . The buccal light emitters  52  are positioned on the outer surface  22  of the side wings  14 . The lateral tongue light emitters  64  are positioned on a central portion of the inner surface  36 ,  38  of at least one of the left projection  30  or the right projection  32 . The mouth roof light emitters  58  are positioned on the outer surface  34 ,  40  of at least one of the left projection  30  or the right projection  32 . The mouth floor light emitters  60  may be positioned on the outer surface  34 ,  40  of at least one of the left projection  30  or the right projection  32 . 
     For example, the mouth roof light emitters  58  may be positioned on at most a top half, a top third, or a top quarter of the outer surface  34 ,  40  of the left projection  30  and/or the right projection  32 . Similarly, the mouth floor light emitter  60  may be positioned on at most a bottom half, a bottom third, or a bottom quarter of the outer surface  34 ,  40  of the left projection  30  and/or the right projection  32 . In this way, both the mouth roof light emitters  58  and the mouth floor light emitters  60  may be housed on one or more of the left projection  30  or the right projection  32 . 
     In one embodiment, the light emitters  50  include the buccal light emitters  52 , the lateral tongue light emitters  64 , the mouth roof light emitters  58 , and the mouth floor light emitters  60 . At least one of the left portion  30  or the right portion  32  may additionally have a distal surface  70  located between the inner surface  36  and the outer surface  34 . In such an embodiment, the light emitters  50  include the tonsil light emitter  72  located on the distal surface  70 . 
     As described above, the targeted regions of the oral cavity may include at least one of the tongue, mandibular and maxillary buccal surfaces of the oral cavity, the floor and roof of the oral cavity, and tonsillar tissues. In one embodiment, the targeted regions of the oral cavity include the tongue, mandibular and maxillary buccal surfaces of the oral cavity, the floor and roof of the oral cavity, and tonsillar tissues. As described in further detail below, the intraoral phototherapy device  10  may apply phototherapy unevenly across the tissues by varying the optical dose received by different tissues. This variation in optical dose may be due to present medical issues in these tissues (e.g., lesions, sores, etc.). Alternatively, this variation may be due to a statistically higher likelihood of these tissues experiencing such issues. In this example, phototherapy may be used as a preventative treatment. 
     That is, the particular dose of optical power delivered to the target regions may vary between at least two of the target regions. For example, the target regions may include at least one of: a tonsillar region, buccal tissues of an oral cavity, a hard palate, a soft palate, or the tongue. The particular dose of optical power delivered to the different tissues may be varied based on known effective optical doses for treating different issues. For example, the particular dose for the tonsillar region may be different from the particular dose of optical power delivered to the hard palate. 
     The particular dose of optical power for each of the target regions may be between 10 milliwatts/cm 2  and 150 milliwatts/cm 2 . The particular dose of optical power received by each of the target regions may not vary between the target regions by more than 20%. 
     The intraoral phototherapy device may be used in a number of applications, several examples of which include oral mucositis, acute necrotizing ulcerative gingivitis (ANUG), periodontal diseases, trismus, decreasing recovery time from oral surgery, light delivery for orthodontics, and photodynamic light therapy, e.g., to activate a chemical mouthwash. 
     As shown in the depicted embodiments, the main body portion  12  may include vertical wings  92 . The vertical wings  92  include an upper wing  94  vertically spaced from a lower wing  96 . The vertical wings  92  are sized and shaped to be received between the teeth and lips of the patient. The vertical wings  92  include an inner surface  98  facing towards the tongue and an outer surface  100  opposite the inner surface  98 . The outer surface  100  faces towards the lips when inserted into the oral cavity. In this embodiment, the light emitters may include labial emitters  102  positioned on the outer surface  100  of the vertical wings  92 , such that the light emitted by the labial light emitters  102  illuminates the lip mucosa when the main body  12  is positioned within the oral cavity. 
     In the embodiments depicted in  FIGS. 8-17 , the intraoral phototherapy device  10  includes at least one inner channel  80  extending between an opening  82  on an interior of the main body portion  12  and an exterior of the main body portion  12 . The inner channel  80  provides an air path between the oral cavity and an environment outside of the oral cavity. The air path allows for improved patient breathing during treatment using the intraoral phototherapy device  10 . 
     In the embodiment depicted in  FIGS. 8-17 , the opening  82  of the inner channel  80  on the interior of the main body portion is located on at least one of the first projection  30  or the second projection  32 . In the embodiment depicted in  FIGS. 18 and 19 , the opening  82  of the inner channel  80  on the interior of the main body portion is located on the interior surface  20  of at least one of the side wings  14 . For example, in the depicted embodiment there are two inner channels  80  having an opening  82  for one of the channels  80  located on each of the side wings  14 . 
     The inner channel  80  may be configured to act as a breathing tube when the intraoral phototherapy device  10  is placed in the oral cavity. In embodiments including the inner channel  80 , a patient is able to exhale, opening the back of the throat to expose the soft tissues for phototherapy. For example, a patient may be asked to say “00000” during exhalation to more fully open the back of the throat during treatment. The inner channel  80  may be formed from a same or different material as the main body portion  12 . 
     In one embodiment, at least one of the first projection  30  or the second projection  32  include a surface irregularity  86  on an inner surface  36 ,  38 . The surface irregularity  86  is configured to aid in placement of the tongue between the inner surfaces  36 ,  38  of the first projection  30  and the second projection  32  by allowing a patient to feel the surface irregularity  86  while positioning their tongue in between the central projection  16 . The surface irregularity  86  may be positioned on the first projection  30  and/or the second projection  32  such that the surface irregularity  86  is only detectable by the tongue (i.e., can only be felt by the patient using their tongue) when the tongue is inserted between the inner surfaces  36 ,  38  of the first projection  30  and the second projection  32 . For example, the surface irregularity  86  may be at least one of a surface texturing, depression, protrusion, or surface contouring. The surface irregularity  86  may be any suitable structure that is detectable by a user using touch. The surface irregularity  86  may also be positioned such that it is only detectable when the patient&#39;s tongue is inserted in the central projection  16 , such that a length or sufficient portion of the tongue is illuminated by the light emitted from the main body portion  12 . 
     In another embodiment, the intraoral phototherapy device  10  includes at least one sensor for detecting tongue placement. If the tongue is not detected by the sensor, then the intraoral phototherapy device  10  may issue a notification (e.g., a sound, vibration, or light) indicating that the tongue is improperly placed. 
     In the embodiment depicted in  FIGS. 18 and 19 , the main body portion  12  includes a coating  90  covering the light emitters  50 . The coating  90  may include lenses positioned to alter a distribution of light exiting from the coating  90 . For example, the coating  90  may increase a diffusion of light exiting the coating  90  to improve a uniformity of tissue illumination by the light emitters  50 . Alternatively or additionally, the coating  90  may increase the directionality of light exiting some areas of the coating to preferentially illuminate particular locations (e.g., associated with particular tissues) when the main body portion  12  placed in the oral cavity. In an embodiment, the coating  90  includes disruptions or lens patterns to cause light to be emitted from the intraoral phototherapy device  10  in a controlled manner. For example, in the embodiment shown in  FIGS. 20-23 , the intraoral phototherapy device  10  includes lenses  108  that alter the distribution of light exiting the distal surface  70 . 
     In the embodiment shown in  FIGS. 20-23 , the main body portion  12  includes a substrate  110  and the coating  90 . The light emitters  50  are mounted to the substrate  110  and also receive electrical power from the substrate  110 . The coating  90  at least partially covers the substrate  110  and the light emitters  50 . As shown in  FIG. 22 , the intraoral phototherapy device  10  may additionally include circuitry  112  and the substrate  110  may include a plurality of separate circuit boards  116  including a pair of side wing circuit boards  118  (i.e., a first side wing circuit board  120  and a second side wing circuit board  122 ), a first central projection circuit board  124 , and a second central projection circuit board  126 . The substrate  90  may include a support structure  125  that supports the circuit boards  116 . The circuit boards  116  may be printed circuit boards (PCBs) such as flexible PCBs. The support structure  125  may support the circuit boards  116  before the coating  90  is applied. The coating  90  may be overmolded onto the circuit boards  116  being supported by the support structure. Each of the separate circuit boards  116 : interfaces with the circuitry  112 , receives electrical power from the circuitry  112 , and supplies the electrical power to the light emitters  50 . For example, the light emitters  50  may be attached to the circuit boards  116  and the circuit boards  116  may be formed to control the direction of light travel from the intraoral phototherapy device  10 . 
     In one embodiment, the circuitry  112  is configured to separately and independently supply electrical power to at least two of the circuit boards  116 , such that the electrical power received by the at least two circuit boards  116  is separately controlled by the circuitry  112 . For example, the circuitry  112  may receive a control signal from an electronic device specifying optical power to be supplied by at least one of the circuit boards  116 . The circuitry  112  may control the electrical power supplied to the circuit boards  116  based on the received control signal. As an example, if a patient has lesions on the roof of their mouth but no lesions on their cheeks, then an external device may be used to communicate to the circuitry  112  (via the control signal) that a higher dose of optical power is needed on the roof of the mouth compared to the cheeks (i.e., buccal tissues). In this example, the circuitry  112  may supply electrical power to the first central projection circuit board  124 , such that the mouth roof light emitters  58  supply a larger optical dose compared to the light emitters  50  of the side wing circuit boards  118 . 
     The circuitry  112  may vary the optical dose delivered by the different groups of light emitters  50  by varying the sum of electrical power supplied to the groups of light emitters  50 . For example, when supplying electrical power, the circuitry  112  may supply the same level of electrical power to the circuit boards  116 , but the circuitry  112  may vary the amount of time that electrical power is supplied to the various boards  116 . As an example, the circuitry  112  may use pulse width modulation (PWM) to control the total amount of time supplied to the different circuit boards  116 . 
     The circuitry  112  may have various implementations. For example, the circuitry  112  may include any suitable device, such as a processor (e.g., CPU), programmable circuit, integrated circuit, memory and I/O circuits, an application specific integrated circuit, microcontroller, complex programmable logic device, other programmable circuits, or the like. The circuitry  112  may also include a non-transitory computer readable medium, such as random-access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), or any other suitable medium. Instructions for performing the method described below may be stored in the non-transitory computer readable medium and executed by the circuitry  112 . The circuitry  112  may be communicatively coupled to the computer readable medium and a network interface through a system bus, mother board, or using any other suitable structure known in the art. The circuitry  112  may receive parameters for controlling the illumination source  14  via the network interface. Alternatively or additionally, the circuitry  112  may receive particular optical doses for different tissues from the network interface and the circuitry  112  may control the illumination source  14  so that the received optical doses are received by the respective tissues. 
       FIGS. 24-27  show an embodiment of the intraoral phototherapy device  10  positioned within the oral cavity  130 . As described above, received portion of the tongue may be at least 25% of an oral tongue  132  of the patient. Use of the term “oral tongue” herein refers to a body of the tongue between the apex of the tongue and the foramen cecum of the tongue. In another embodiment, the received portion of the tongue includes at least 15%, at least 50% or at least 75% of the oral tongue. In a further embodiment, the received portion of the tongue includes at least one of (1) a portion of the frenulum or (1) at least one of the submandibular salivary ducts. 
     As described above, the intraoral phototherapy device  10  may receive the light directed onto the targeted regions from a light source external to the main body portion  12 . In the embodiment shown in  FIG. 28 , the light emitters  50  are physically mounted to a tab  61  on an external surface of the main body portion  12 . The light emitted by the light emitters  50  is received by a light guide  140  that directs the light from the light emitters  50  to an emission surface  142  of the main body portion  12 . For example, the light guide  140  may be a portion of the main body portion  12  that acts as a light guide to both transmit and emit the light that illuminates the targeted regions of the oral cavity. While the depicted embodiment shows only a single light guide, multiple light guides may be used to project light onto the target tissues. The light guide(s)  140  may be over molded in Silicone with the flexible circuit boards described above. The light guide(s)  140  geometry may also be incorporated with the support structure  125  that holds onto the circuit boards  116 . 
     In any of the embodiments, a reflective coating  24  may be provided on the inwardly facing sides of the side wings to reflect light out through the outwardly facing sides of the side wings. 
     In any of the embodiments, the side wings may have a curvature that is contoured to mandibular and maxillary buccal surfaces of the oral cavity for emitting light thereto. 
     All ranges and ratio limits disclosed in the specification and claims may be combined in any manner. Unless specifically stated otherwise, references to “a,” “an,” and/or “the” may include one or more than one, and that reference to an item in the singular may also include the item in the plural. 
     Although the invention has been shown and described with respect to a certain embodiment or embodiments, equivalent alterations and modifications will occur to others skilled in the art upon the reading and understanding of this specification and the annexed drawings. In particular regard to the various functions performed by the above described elements (components, assemblies, devices, compositions, etc.), the terms (including a reference to a “means”) used to describe such elements are intended to correspond, unless otherwise indicated, to any element which performs the specified function of the described element (i.e., that is functionally equivalent), even though not structurally equivalent to the disclosed structure which performs the function in the herein illustrated exemplary embodiment or embodiments of the invention. In addition, while a particular feature of the invention may have been described above with respect to only one or more of several illustrated embodiments, such feature may be combined with one or more other features of the other embodiments, as may be desired and advantageous for any given or particular application.