NZ713185B2 - Compositions for treatment of xerostomia and for tooth treatment - Google Patents

Abstract

The disclosure provides an oral care composition for whitening teeth comprising: a) emu oil; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents. Also provided is the oral care composition formulated as a bilayer tablet comprising: (i) a rapidly disintegrating layer; and (ii) a slowly eroding layer. vided is the oral care composition formulated as a bilayer tablet comprising: (i) a rapidly disintegrating layer; and (ii) a slowly eroding layer.

Description

COMPOSITIONS FOR TREATMENT OF XERDSTOHIA AND FOR TOOTH TfifihflflEflT Throughout this ation, n publications are referenced in parentheses. Full citations for these publications may be found immediately preceding the claims. The sures of these publications in their entireties are hereby incorporated by reference into this application.

Background Xerostomia is the subjective sensation of dry mouth and may be associated with diminished or deficient salivary secretion. Saliva and salivary flow help prevent the lation of microorganisms in the mouth (Nederfors et a1. 1997). Saliva is also necessary for effective remineralization of teeth (Narhi et al. 1999). Salivary flow initiates digestion of foods and help dissolve and remove food particles from the mouth. Saliva also lubricates the mucosa of the mouth, facilitating , eating, and swallowing' and preventing mechanical injury to the surfaces of the mouth. Xerostomia is a commonly‘ occurring disorder and results in higher’ risk for oral complications.

Diverse symptoms and consequences have been associated with xerostomia. Symptoms e halitosis, soreness, oral burning, difficulty swallowing, and altered taste sensation. omia also causes dental disorders including oral mucous ne ulcers, dental caries and ontosis, oral infections and respiratory tract infections.

Known causes of xerostomia include various diseases causing organic change of salivary glands; ogical changes of salivary glands caused by systemic diseases; damaged salivary glands owing to radiotherapy; HIV infection (AIDS); secretory hypofunction owing to aging; and effects of administration of various drugs. Mental fatigue or stress may also be factors.

W0 60285 s drugs also result in xeroetomia as a side effect. Examples of drugs that may cause xeroetomia include: diuretics such as trichloromethiazide and furosemide, hypotensors such as reserpine and clonidine hydrochloride. anticholinergic agents such as atropine sulfate, and antihistamines such as chlorphenylamine maleate. Other examples thereof include various expectorant/cough suppressants, anti‘Parkinson drugs, tropic drugs, antidepressants, tranquilizers, muscle relaxants, opiates and other narcotics.

Radiotherapy has become increasingly important for treating malignant tumors in oral surgery and yngology fields, and almost inevitably causes damage to salivary glands by ionizing radiation.

This damage can result in especially severe xerostomia. Medications are believed to be responsible for a icant proportion of cases of xerostomia, particularly in the elderly (Nedefors et a1. 1997)‘ The list of drugs that are believed to affect saliva levels includes more than 400 agents (Narhi et a1. 1999).

Xerostomia is more common among older people and among women (Hochberg et a1. 1998; ors et a1. 1997). In one study xerostomia was repoted in 21.3% of the men and in 2?.3% of women (Nederfors et al. 1996). In another study of elderly typee2 ic individuals, the prevalence of dry mouth was found to be 25% (Borges EC et al. 2013).

The prevalence of xerostomia in varied populations ranges from 0.9% to 46% (Orellana, M.F. et al. 2006).

There are various therapies for the treatment of xerostomia, although many result in unfavorable side effects and limited efficacy (Cassolato, S.F. et a1. 2003; Gupta, A. et a1. 2006; Silvestre—Donat, F.J. et a1. 2004). For example, malic and citric acid have been used as salivary ants. However. they had a demineralizing effect on tooth enamel (Anneroth, G. et al. 1980; Davies, A.N. 2000).

Summary The present application provides an oral care composition comprising: a) emu oil; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing e) one or more whitening agents.

The present application provides an oral care composition for ing teeth comprising one or more whitening agents, wherein the composition is formulated as a bilayer tablet comprising: (i) a rapidly disintegrating layer; and (ii) a slowly eroding layer, wherein the one or more whitening agents are each oxidizing agents and are each present only in the rapidly egrating layer.

The present application provides an oral care composition comprising: a) one or more omega fatty acids; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate ralizing agents; e) one or more whitening agents.

In a particular aspect, the t invention provides an oral care composition comprising: a) 5-10% by weight emu oil; b) one or more emulsifying agents; c) one or more se enzymes; and d) one or more soluble calcium phosphate remineralizing agents wherein the composition is formulated as a tablet, gel or [FOLLOWED BY PAGE 3a] In another particular , the present invention provides an oral care composition sing: a) 5-10% by weight emu oil; b) 1-5% by weight of an emulsifying agent; c) 40 mg to 60 mg of a protease enzyme; and d) 5-25% by weight of a soluble calcium ate remineralizing agent; wherein the composition is formulated as a tablet, gel or emulsion.

In a yet further particular aspect, the present invention provides an oral care composition comprising: a) 5-10% by weight emu oil; b) 1-5% by weight of an emulsifying agent; c) 1-10% by weight of a protease enzyme; and d) 5-25% by weight of a soluble m phosphate remineralizing agent wherein the composition is formulated as a tablet, gel or emulsion.

In a yet further particular aspect, the present invention provides an oral care composition comprising: a) 5-10% emu oil; b) 1-5% by weight lecithin; c) 40 mg to 60 mg of bromelain; and d) 5-25% by weight ous calcium phosphate wherein the composition is formulated as a tablet, gel or In a yet further particular aspect, the present invention provides an oral care composition comprising: a) 5-10% by weight emu oil; b) 1-5% by weight lecithin; c) 1-10% by weight of bromelain; and d) 5-25% by weight amorphous m phosphate, wherein the composition is formulated as a tablet, gel or emulsion.

[FOLLOWED BY PAGE 4] W0 60285 Brio! Doscrigtion of the Piggros Figure 1. Bilayer Tablet comprising a rapidly disintegrating layer and a slowly eroding layer.

Figure 2. Bilayer Tablet comprising a rapidly disintegrating core and a alowly eroding outer layer. 2014/026238 Detailed Daaarighion The present application provides an oral care composition comprising: a) emu oil; and one or more of the following: b) one or more emulsifying agents: c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one embodiment, the composition comprising: a) emu oil; and two or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one embodiment. the composition comprising: a) emu oil; and three or more of the following: b) one or more emulsifying ; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one ment. the composition sing: a) emu oil; b) one or more emulsifying ; c) one or more protease enzymes; d) one or more soluble m phosphate remineralizing agents; 6) one or more whitening agents.

W0 60285 In one embodiment, an oral care composition consisting essentially a) emu oil; and one or more of the following: b) one or more fying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents: e) one or more whitening agents.

In one embodiment, the ition consisting essentially of: a) emu oil; and two or more of the following: b) one or more emulsifying agents; c) one or more se enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one embooiment, the composition consisting essentially of: a) emu oil; anfl three or more of the following: b) one or more emulsifying ; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one embodiment, the composition ting essentially of: a) emu oil; b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

W0 2014/160285 2014/026238 In one embodiment, the composition wherein one or more of the protease enzymes are ed from the group consisting of papain, trypsin, chymotrypsin, eptidase, ypeptidase, pepsin, and cathepsin.

In one embodiment, the se enzyme is stem bromelain. The stem bromelain provides an anti-inflammatory effect.

In one embodiment, 50 mg of stem bromelain is present in the composition.

In one embodiment, the composition wherein the one or more whitening agents are selected from the group ting of carbamide peroxide and hydrogen peroxide.

In one embodiment, the composition wherein the one or more soluble calcium phosphate remineralizing agents are selected from the group consisting of dibasic calcium phosphate, monocalcium phosphate, tricalcium phosphate, and tetracalcium phosphate.

In one embodiment. the ition wherein the soluble calcium ohosohate remineralizing agent is amorphous caioium phosphate.

In one embodiment, the ition.wherein the one or more emulsifying agents are phospholipids.

In one embodiment, the composition wherein the phospholipids are lecithin.

In one embodiment, the composition wherein the lecithin is dairy-free and/or egg—free. A dairy—free or egg—free lecithin provides a composition with a longer shelf life in comparison to lecithin sourced from egg or milk.

W0 2014/160285 In one ment, the composition wherein the lecithin is soy in. In one embodiment, the composition wherein the in is sourced from soybeans.

In one embodiment, the composition wherein the composition further comprises an isomalt.

In one embodiment, the composition wherein the isomalt is selected from the group consisting of QTM 720 and galenIQm 721.

In one embodiment, the composition wherein the composition further comprises a disintegrating agent.

In one embodiment, the composition wherein the disintegrating agent is crospovidone.

In one embodiment, the composition wherein the composition further comprises ium stearate.

In one embodiment, the composition wherein the composition further comprises glycerin.

In one embodiment, the composition wherein the composition further comprises fluoride.

In one embodiment, the ition wherein the remineralizing agent is white in color.

In one embodiment, the composition is formulated as a tablet, a bilayer tablet, a multilayer tablet, Chewing gum, a aste, a lozenge, a powder, a gel, a viscous gel, an ointment, a cream, a liquid, a mouthwash, or a candy.

In one embodiment, the composition is formulated as a round flat tablet or a round concave tablet.

W0 2014/160285 In one ment, the composition is formulated as a bilayer tablet.

In one embodiment. the composition whereinthe bilayer tablet comprises a rapidly disintegrating layer and a slowly eroding layer.

In one embodiment, the composition whereinthe one or more whitening agents are present only in the rapidly disintegrating layer.

In one embodiment, the composition wherein the emu oil and the one or more proteases are present only in the slowly g layer.

In one embodiment, the composition wherein the one or more whitening agents are present only in the rapidly disintegrating layer; and the emu oil and the one or more proteases are t only in the slowly g layer.

In one embodiment, the composition wherein the rapidly disintegrating layer comprises carbamide peroxide in an amount between 0.1 to 10.0% by weight.

In one embodiment, the composition n the rapidly disintegrating layer comprises carbamide peroxide in an amount of 1.0% by weight.

In one embodiment, the composition wherein the slowly g layer comprises emu oil in an amount between 0.1 to 15% by weight.

In one embodiment, the composition wherein the slowly eroding layer ses emu oil in an amount of 10% by weight.

In one embodiment, the composition wherein the slowly eroding layer comprises papain in an amount n 0.1 to 20% by weight.

In one embodiment, the composition wherein the slowly eroding layer comprises papain in an amount of 10% by weight.

W0 60285 The present application provides a method of ng a subject suffering from omia which ses administering to the subject. in an amount effective to treat the xerostomia, a ition of the present application.

In one embodiment, the method wherein the composition further whitens teeth in the subject‘s mouth.

In one embodiment, the method wherein the composition further remineralizes teeth in the subject’s mouth.

In one embodiment, the method wherein the composition further whitens and ralizes teeth in the subject's mouth.

In one ment, the method wherein the composition further reduces dental sensitivity of the subject.

In one embodiment, the method wherein the composition further treats dental caries of the subject.

In one embodiment, the method wherein the subject is a human.

In one embodiment, the method wherein the subject is a non—human animal.

In one embodiment, the method wherein the subject has an mune disease, diabetes, Sjogren‘s syndrome. or has recently undergone radiation therapy or chemotherapy.

In one embodiment, the method wherein the subject is rently taking one or more medications that causes xerostomia.

The present application provides an oral care composition for whitening teeth comprising one or more whitening agents, wherein the composition is formulated as a bilayer tablet comprising: (i) a rapidly disintegrating layer; and W0 2014/160285 (ii) a slowly eroding layer, wherein the one or more whitening agents are each oxidizing agents and are each t only in the rapidly disintegrating layer.

In one embodiment, an oral care composition for whitening teeth consisting essentially of one or more whitening agents, wherein the composition is formulated as a bilayer tablet comprising: (i) a rapidly disintegrating layer; and (ii) a slowly eroding layer, wherein the one or more whitening agents are each oxidizing agents and are each present only in the rapidly disintegrating layer, In one embodiment of the bilayer composition, the composition wherein the one or more whitening agents are selected from the group consisting of carbamide peroxide and hydrogen peroxide.

In one embodiment of the bilayer composition, the composition wherein the whitening agent is carbamide peroxide and is t in an amount n 0.1 to 10.0% by weight of the disintegrating layer.

In one ment of the bilayer composition, the composition wherein the whitening agent is iée peroxide and is t in an amount of 1.0% by weight of the disintegrating layert In one embodiment of the bilayer composition, the composition further sing one or more of the following: a) emu oil; b) one or more emulsifying agents; c) one or more se enzymes; d) one or more soluble calcium phosphate ralizing agents.

In one embodiment of the bilayer composition, the composition further comprising two or more of the following: a) emu oil; b) one or more emulsifying agents; c) one or more protease enzymes: d) one or more soluble calcium phosphate remineralizing agents.

In one embodiment of the bilayer composition, the composition further comprising three or more of the following: a) emu oil; b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing agents.

In one embofliment of the bilayer composition, the composition further comprising each of the following: a) emu Oil; b) one or more emulsifying agents; c) one or more protease enzymes; d) one or more soluble calcium ate remineralizing agents.

In one embodiment of the bilayer composition, the composition further comprising each of the following: a) emu Oil: and one or more of the following: b) one or more emulsifying ; c) one or more protease enzymes; d) one or more soluble calcium phosphate remineralizing In one embodiment of the r composition, the composition wherein 3O the emu oil, the one or more emulsifying agents, and the one or more se enzymes are present only in the slowly eroding layer.

In one embodiment of the bilayer composition, the composition wherein the one or more e calcium ate remineralizing agents are present only in the rapidly disintegrating layer.

W0 2014/160285 The present application. provides a method of ng a subject suffering from xerostomia which ses administering to the subject, in an amount effective to treat the xerostomia, a bilayer ition of the present application.

In one embodiment, the method wherein the r composition r whitens teeth in the subject's mouth.

In one embodiment, an oral care composition comprising: a) a whitening agent; and one or more of the following: b) one or more emulsifying agents; o) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents.

In one ment, an oral care composition comprising: a) emu oil; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents.

In one ment, an oral care composition consisting essentially a) a whitening agent; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents.

In one embodiment, an oral care composition consisting essentially of: a) emu oil: W0 2014/160285 and one or more of the following: b) one or more fying agents; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents.

The present application provides a package comprising: i) a first oral care composition comprising: a) a whitening agent; and one or more of the following: b) one or more emulsifying agents; c) one or more se enzymes; and d) one or more e calcium phosphate remineralizing agents; ii) a second oral care composition comprising a) emu oil; and one or more of the following: b) one or more emulsifying agents; c) one or more groteaee enzymes; and d) one or more soluble calcium phosphate remineralizing agents; and iii) instruction for use of the first oral care ition and second oral care composition to treat a subject ted with mucositis or xerostomia.

The present application provides a package consisting essentially of: i) a first oral care composition comprising: a) a whitening agent; and one or more of the ing: b) one or more emulsifying agents; c) one or more protease enzymes; and W0 2014/160285 d) one or more soluble calcium phosphate remineralizing agents; ii) a second oral care ition comprising: a) emu oil; and one or more of the following: b) one or more emulsifying agents: c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents; and iii) instruction for use of the first oral care composition and second oral care composition to treat a subject ted with mucositis or xerostomia.

The t application provides a therapeutic package for dispensing to, or for use in dispensing to, a subject afflicted with mucositis or xerostomia, which comprises: i) a first oral care composition comprising: a) a whitening agent; and one or more of the following: b) one or more emulsifying egents; c) one or more protease enzymes; and d) one or more e calcium phosphate ralizing agents; ii) a second oral care composition comprising: a) emu oil; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents; and W0 2014/160285 iii) labeling ing the use of said package in the treatment of said subject.

The present application provides a therapeutic package for dispensing to, or for use in dispensing to, a subject afflicted with mucositis or xerostomia, which ts ially of: i) a first oral care composition comprising: a) a whitening agent: and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes: and d) one or more soluble calcium phosphate ralizing agents; ii) a second oral care composition comprising: a) emu oil; and one or more of the following: b) one or more emulsifying ; 0) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents; and iii) labeling directing the use of said package in the treatment of said subject.

The present ation provides a method of treating a subject afflicted with mucositis or xerostomia comprising administering a first oral care composition followed by one or more of a second oral 3O care composition.

The present ation provides a method treating a subject afflicted with mucositis or xerostomia consisting essentially of administering a first oral care composition followed by one or more of a second oral care composition.

W0 2014/160285 2014/026238 The present application provides a method treating a subject afflicted with mucositis or xerostomia comprising administering a single first oral care composition followed by five of a second oral care composition.

The present application provides a method treating a subject ted with mucositis or xerostomia consisting essentially of administering a single first oral care composition followed by five of a second oral care composition.

In one embodiment, the first oral care composition ses: a) a whitening agent; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; and 6) one or more soluble calcium ate remineralizing ; and the second oral care composition comprises: a) emu oil; one one or more of the following: b) one or more emulsifying agents; c) one or more se enzymes; and a) one or more soluble calcium phosphate remineralizing agents.

In one embodiment, the first oral care composition consists essentially of: a) a whitening agent; and one or more of the ing: b) one or more emulsifying agents; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents; and the second oral care composition consists essentially of: W0 2014/160285 2014/026238 a) emu oil; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents.

In one embodiment the first oral care composition and the one or more of a second oral care compositions are administering over 24 hours.

In one embodiment, the e is a sealed package.

In one embodiment, the sealed package is a r pack.

In one embodiment, the blister pack contains one of the first oral care composition and five of the second oral care ition.

In one embodiment, the first oral care composition r comprises isomalt.

In one embodiment: the Lirstx: oral care comoosition further comprises sucrolose.

In one embodiment, the second oral care composition further comprises potassium nitrate.

In one embodiment, the first oral care composition is a tablet. In one embodiment, the tablet is an 800 mg tablet. In one embodiment, the tablet is a 1000 mg tablet.

In one embodiment, the second oral care composition is a tablet. In one embodiment, the tablet is an 800 mg tablet. In one embodiment, the tablet is a 1000 mg tablet.

In one embodiment, the whitening agent is carbamide peroxide. In one embodiment. the amount of carbamide peroxide in the tablet is 1 mg - W0 2014/160285 mg. In one ment, the amount of carbamide peroxide in the tablet is 1 mg ~ 4 mg. In one embodiment, the amount of carbamide peroxide in the tablet is 2 mg ~ 3 mg. In one embodiment, the amount of oarbamide peroxide in the tablet is 1 mg. In one embodiment, the amount of carbamide peroxide in the tablet is 2 mg. In one embodiment, the amount of carbamide peroxide in the tablet is 2.5 mg.

In one embodiment, the emulsifying agent is soy lecithin. In one embodiment, the concentration of the soy lecithin is between 1 to 5% by weight. In one embodiment, the concentration of the soy lecithin is n 2 to 5% by weight.

In one embodiment, the soluble calcium phosphate remineralizing agent is tricalcium phosphate. In one embodiment, the concentration of the tricalcium phosphate is between 1 to 10% by weight. In one embodiment, the concentration of the tricalcium phosphate is between 3 to 10% by weight. In one embodiment, the concentration of the tricalcium phosphate is 10% by weight.

In one embodiment, the tration of the emu oil is between 5 to 19% by weight. In one embodiment. the concentration of the emu oil ie between 5 to 7% by . In one embodiment, the concentration of the emu oil is 6% by weight.

In one embodiment, the protease enzyme is stem bromelain. In one ment. the amount of stem bromelain in the tablet is 25 mg — 75 mg. In one ment, the amount of stem bromelain in the tablet is 40 mg ~ 60 mg. In one ment, the amount of stem bromelain in the tablet is 50 mg.

The present application provides an oral care composition comprising: a) one or more omega fatty acids; and one or more of the following: b) one or more emulsifying agents; c) one or more protease enzymes; W0 2014/160285 2014/026238 d) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one embodiment, the composition comprising: a) one or more omega fatty acids; ana two or more of the following: b) one or more emulsifying agents; 0) one or more se s: d) one or more soluble calcium ate remineralizing agents: e) one or more whitening agents.

In one embodiment. the composition comprising: a) one or more omega fatty acids; and three or more of the following: b) one or more emulsifying agents; 0) one or more protease s; d) one or more soluble calcium ate remineralizing agents; e} one or more whitening agents.

In one embodiment; the composition oomorising each of the following: a) one or more omega fatty acids; b) one or more emulsifying agents; c) one or more protease enzymes: 6) one or more soluble calcium phosphate remineralizing agents; e) one or more whitening agents.

In one embodiment, the composition wherein the one or more omega fatty acids comprise omega—3 fatty acids or omega—6 fatty acids.

In one embodiment, the composition wherein the omega-3 fatty acid is alpha—linoleic acid and the omega—6 fatty acid is gamma-linoleic acid.

W0 2014/160285 In one embodiment, a ition for treating xerostomia. In one embodiment, a composition for treating dry mouth. In one embodiment, a composition for treating mucositis.

In some embodiments of the present methods, the tis is mucositis of the oral cavity and pharynx. In some ments of the present methods, the xerostomia is xerostomia of the oral cavity and pharynx.

In one embodiment, a composition for whitening teeth.

In one embodiment, a composition for remineralizing teeth.

In one embodiment, a composition for whitening and remineralizing teeth.

In one embodiment, the composition has a cariostatic effect on the subject‘s teeth. In one embodiment, the compoeition has an anti— cariogenic effect on the subject's teeth.

In one embodiment, the concentration of emu oil in the composition is between 0.1 to 60% by weight.

In one embodiment, the concentration of peroxiée in the composition is n 0.1 to 50% by . Concentration of peroxide in excess of 40% by weight would be for professional use.

In one embodiment, the concentration of soluble calcium phosphate in the composition is between 0.1 to 50% by weight.

In one embodiment, the concentration of the protease enzyme in the composition is between 0.1 to 40% by .

In one embodiment, the concentration of the phospholipids in the composition is between 0.1 to 20% by weight.

W0 2014/160285 In one ment, the concentration of emu oil in the slowly eroding layer is between 0.1 to 15% by weight. In one embodiment, the concentration of emu oil in the slowly eroding layer is n 1.0 to 10% by weight. In one embodiment, the concentration of emu oil in the slowly eroding layer is n 5 to 10% by weight. In one embodiment, the concentration of emu oil in the slowly eroding layer is 10% by weight.

In some embodiments, the whitening agent is an oxidizing agent.

Different ing agent can be used in the composition. Examples of oxidizing agent include, but are not limited to, peroxides. In some embodiments. the whitening agent is selected from the group comprising of one or more of ide peroxide and hydrogen peroxide.

In one embodiment, the concentration of the peroxide in the disintegrating layer is between 0.1 to 20% by weight. In one embodiment, the concentration of the peroxide in the disintegrating layer is between 1.0 to 20% by weight. In one embodiment, the concentration of the peroxide in the disintegrating layer is between 1.0 to 10% by weight. In one embodiment, the concentration of the de in the disintegrating layer is between 1.0 to 5% by weight.

In one embodiment, the tration of the peroxide in the disintegrating layer is 1.0% by .

Different protease enzymes can be used in the composition. Examples of proteases include, but are not limited to, the group comprising of one or more of paoain, trypsin, chymotrypsin, aminopeptidase, ypeptidase, pepsin, and cathepsin.

In one embodiment, papain is used. In one embodiment, the protease enzyme is obtained from a papaya extract.

In one embodiment, the concentration of the protease enzyme in the slow eroding layer is between 0.1% to 20% by weight. In one embodiment, the concentration of the se enzyme in the slow eroding layer is W0 2014/160285 between 1% to 20% by weight. In one embodiment, the concentration of the protease enzyme in the slow eroding layer is between 1% to 10% by weight. In one embodiment, the concentration of the protease enzyme in the slow eroding layer is between 5% to 15% by weight. In one embodiment, the concentration of the se enzyme in the slow g layer is 5% by weight. In one embodiment. the concentration of the se enzyme in the slow eroding layer is 10 % by weight.

In one embodiment, the soluble calcium phosphate remineralizing agent is selected.from the group comprising of one or more of dibasic calcium phosphate, monocalcium phosphate, dicalcium phosphate anhydrous, tricalcium phosphate, and tetracalcium phosphate. In one embodiment, cium phosphate, dicalcium phosphate anhydrous, tetracalcium phosphate or dibasic calcium phosphate anhydrous are used. In one embodiment, tricalcium phosphate is used.

In one embodiment, the concentration of the soluble calcium phosphate remineralizing agent in the disintegrating layer is between 0.1% to 50% by weight. In one embodiment, the tration of the soluble calcium phosphate remineralizing agent in the disintegrating layer is between 1% to 25% by weight. In one embodiment, the concentration of the soluble calcium phosphate remineralizing agent in the disintegrating layer is between 5% to 25% by weight. In one embodiment, the concentration of the e calcium phosphate remineralizing agent in the disintegrating layer is between 9.5% to 20% by weight.

In one ment, the concentration of the soluble calcium phosphate ralizing agent in the disintegrating layer is 9.5% by weight.

In one ment, the concentration of the soluble calcium phosphate remineralizing agent in the disintegrating layer is 20% by weight.

In one embodiment, the tration of the soluble calcium phosphate remineralizing agent in the slowly eroding layer is between 0.1% to 50% by . In one embodiment, the tration of the soluble calcium phosphate remineralizing agent in the slowly eroding layer is between 1% to 35% by weight. In one embodiment, the tration of the soluble calcium: phosphate remineralizing agent in the slowly W0 2014/160285 eroding layer is between 10% to 35% by weight. In one embodiment, the concentration of the soluble calcium ate remineralizing agent in the slowly g layer is 10% by weight. In one embodiment, the concentration of the soluble calcium phosphate remineralizing agent in the slowly g layer is 35% by weight.

In one embodiment, the concentration of the olipide in the slow eroding layer is between 0.1% to 20% by weight. In one embodiment, the concentration of the phospholipids in the slow eroding layer is n 1% to 10% by weight. In one embodiment, the concentration of the phospholipids in the slow eroding layer is between 1% to 2% by weight. In one embodiment, the concentration of the phospholipids in the slow eroding layer is 2% by' weight. In one embodiment, the concentration of the phospholipids in the slow eroding layer is 1% by weight.

In order for calcium phosphate to act as a remineralizing agent, it is preferable that the calcium phosphate be in soluble form. If a significant n of the calcium phosphate were to precipitate out of solution, it would function as an abrasive agent and not as a remineralizer. The addition of glycerin to the comeosition acts to keep the calcium phosphate from forming a itate.

In one embodiment, the composition further comprises glycerin. In one embodiment, the concentration of glycerin is between 10 to 60% by weight.

In one embodiment, the composition further ses fluoride, for example sodium fluoride. In one embodiment, the concentration of sodium fluoride is between 0.01 to 5% by .

In one embodiment, the remineralizing agent is white in color. Thus, the uptake of remineralizing material may contribute to the whitening effect.

W0 2014/160285 In one embodiment, the composition contains potassium nitrate. which can act as a desensitizing agent.

The composition can be ed in a carrier. In different embodiments, the carrier is selected from the group consisting of a tablet, a bilayer tablet, a multilayer tablet, a chewing gum, a candy, a toothpaste, a lozenge, a , a gel, a s gel, an ointment, a cream, a liquid, a mouthwash, and a candy.

In one embodiment, the liquid carrier or ash carrier r comprises sodium bicarbonate.

In some embodiments, the bilayer tablet ses a disintegrating layer and a slowly g layer. The differing relative rates of release of active material content from the disintegrating layer and a slowly eroding layer of the tablet may be achieved in various ways.

The differing rates of release may be achieved by a first layer which is a disintegrating layer which releases the bulk of its active al content within a relatively short time, for example, including, but not limited to, within 1 min, 10 min, 30 min, or 1 hour, and a second layer which is a slowly eroding layer which releases the bulk 05 its active material Content during a relatively 103g period after stration or after a period of delay after administration.

The disintegrating layer may have a composition similar to that of known rapidly disintegrating tablets. Slowly eroding layers may have a composition similar to that of known slowly eroding tablets and comprise active material content together with a release retarding material.

In some embodiments, the composition is a single layer tablet comprising a disintegrating fraction and a slowly eroding fraction.

The disintegrating fraction may be intermingled uniformly or randomly W0 2014/160285 with the slowly eroding fraction. In some embodiments, the whitening agent is found only in the disintegrating fraction.

In some embodiments, the composition is a bilayer layer tablet comprising a slowly eroding tablet core and a disintegrating outer layer. In some embodiments, the ing agent is found only in the disintegrating outer layer.

The advantages of the compositions disclosed herein include le synergistic effects between the actions of the protease and the ing agent, and ease of use especially in a home or veterinary setting. The compositions described in this patent disclosure are believed to provide improved effects both on extrinsic dental stains and on previously “untouchable" sic dental stains. The removal of chromogen from enamel is believed to be aided by the presence in the composition of a protease enzyme able to react with protein Chromogens and the le layer. creating enhanced mechanisms for penetration of an oxygen free radical bleaching agent (e.g., hydrogen peroxide molecules from carbamide peroxide solution or hydrogen peroxide solution). It is believed that one of the effects of ing proteases with whitening agents in accordance with this patent disclosure is deeper penetration of the whitening agents into enamel, in addition to the beneficial effect of the reaction of proteases with protein chromogensl The composition provides an advantageous ease of use in that it allows for treatment of xerostomia and a whitening agent, a protease enzyme, and a ralizing agent to be d to teeth using only a single composition rather than having to apply the different components in separate compositions. This is ularly advantageous for home and veterinary use, and when the composition is supplied in certain carriers, such as for example chewing gum, toothpaste, e, mouthwash, and candy.

The composition has the further advantage that when available application time is limited, the whitening agent, protease enzyme, W0 2014/160285 and ralizing agent can be simultaneously applied to the teeth for the full duration of the application time. In contrast, for the same total available treatment time, if the whitening agent, protease enzyme. and remineralizing agent were applied in te itions, the time of application of each component would have to be reduced in order to keep total treatment time constant.

In one embodiment of the composition, silica is added to the composition to increase the viscosity of the composition. In other ments, the composition contains methylcellulose (10—20% by weight) or xantahan gum (10—20% by weight).

In some ments, a sweetener or flavorant can be added to the composition. In one embodiment, the concentration is between about 0.2—10% by . In one embodiment the sweetener is saccharin or sspartame. In one embodiment the flavorant is peppermint or clove.

In some embodiments, the sweetener is maltitol, isomaltitol, manitol, lactitol, aoesulfame potassium, cyclamate, taumatin or other known sweeteners.

The pH of the ition can be adjusted. In one embodiment, the pH is between about pH 6 to 7.5. In one embodiment, baking soda is used as a pH lizer.

Advantageous s for whitening and remineralizing teeth are also disclosed. The methods comprise applying to teeth any of the compositions described herein for whitening and remineralizing teeth_ In a further embodiment of any of the methods of whitening and remineralizing a subject's teeth described herein, a gel polymer is used at the base of the teeth to contain the whitening and remineralizing compositions to the teeth and to help avoid their contact with the gum. In different embodiments, the gel ses polyethyl methylacrylate or polymethyl methylacrylate with W0 2014/160285 plastizers. A dental tray or dam can also be used for isolation of the dentition.

The total time for application of whitening and remineralization compositions can typically vary from 20~30 s to 2-3 hours. In a home application setting, compositions can be applied to the teeth overnight. In home application kits, the treatment time may vary between 1-2 weeks to up to several weeks depending upon the stain. In one embodiment, the whitening and remineralizing composition includes a light activated photo—initiator as an tor of time exposure.

The compositions, kits and methods described herein can be used both on l teeth and on some types of artificial teeth.

Using the compositions, kits and methods described herein, loss of calcium that may occur during dental bleaching can be restored by remineralization so that a more efficacious whitening composition can be used safely with enhanced effect. ageous methods for treating dental sensitivity and for treating dental caries are also described herein and comprise applying any of the compositions described herein to the subject's teeth. ing can cause dental sensitivity. This sensitivity can he treated using the described compositions, kits and methods for tooth whitening and remineralization‘ In addition, the bed compositions, kits, and methods can be used to treat dental sensitivity that occurs in the absence of bleaching. ralization may se ivity by decreasing the permeability of dentin. In addition, the described compositions, kits and methods for tooth whitening and remineralization can be used in other applications where remineralization would be beneficial, for example in the treatment of dental .

After the whitening and remineralizing procedures described herein have been carried out, additional compositions for restorative or cosmetic purposes may be applied to the teeth.

W0 60285 As used herein, “treating" means preventing, slowing, halting, or reversing the progression. of a condition, e or ion.

Treating may also mean improving one or more ms of a condition, disease or infection.

The compositions used in the method sed in this patent specification may be administered in various forms, including those detailed herein. The treatment with the compositions may be a component of a combination therapy or an adjunct therapy, i.e. the t or patient in need of the composition is treated or given another drug or composition for the condition, disease or infection in conjunction with one or more of the instant compositions. This ation therapy can be sequential therapy where the patient is treated first with one composition or drug and then the other or the two are given simultaneously. These can be administered ndently by the same route or by two or more different routes of administration depending on the dosage forms employed.

As used herein. a "pharmaceutically acceptable r" is a pharmaceutically acceptable solvent, suspending agent or vehicle, for delivering the instant comcsitions to the animal or human. The carrier may he liquid or solid and is selected with the planned manner of administration in mind. Liposomes are also a pharmaceuticaliy acceptable carrier.

The dosage of the compositions stered in treatment will vary depending upon factors such as the pharmacodynamic characteristics of the compositions and its mode and route of administration: the age, sex, metabolic rate, absorptive efficiency, health and weight of the recipient; the nature and extent of the symptoms; the kind of concurrent treatment being administered; the frequency of treatment with; and the desired therapeutic effect.

A dosage unit of the composition used in the method of the present invention may comprise a single composition or mixtures thereof with additional agents. The compounds can be administered in oral dosage W0 2014/160285 forms as s, capsules, pills, powders, granules, elixirs, tinctures, suspensions, syrups, and ons.

The compositions used in the method of the present invention can be administered in admixture with suitable pharmaceutical diluents, extenders, excipients, or carriers (collectively referred to herein as a pharmaceutically acceptable carrier) suitably selected with respect to the intended form of administration and as consistent with conventional pharmaceutical ces.

The compositions can be administered alone or mixed with a pharmaceutically acceptable carrier. This carrier can be a solid or liquid, and the type of carrier is generally chosen based on the type of administration being used.

Techniques and itions for making dosage forms useful in the present invention are bed in the following references: 7 Modern Pharmaceutics, Chapters 9 and 10 (Banker & Rhodes, Editors, 1979) Pharmaceutical Dosage Forms: Tablets (Lieberman et a1., 1981); Ansel, Introduction to ceutical Dosage Forms 2nd Edition (1976); Remington’s Pharmaceutical Sciences! 17th ed. {Mack ?ublishing Company, Easton, Pa., 1985): Advances in ceutical Sciences {David ton, irevor Jones, Eds,g 1992;; Advances in Pharmaceutical Sciences Vol. 7. (David ton, Trevor Jones, James McGinity, Eds., 1995); Aqueous Polymeric gs for Pharmaceutical Dosage Forms (Drugs and the Pharmaceutical Sciences, Series 36 (James McGinity, Edi, 1989); Pharmaceutical Particulate rs: Therapeutic Applications: Drugs and the Pharmaceutical Sciences, vol 61 (Alain Rolland, Ed., 1993); Drug Delivery to the Gastrointestinal Tract (Ellis Horwood Books in the Biological Sciences. Series in Pharmaceutical Technology; J. G. Hardy, S. S. Davis, Clive G. Wilson.

Eds.); Modem Pharmaceutics Drugs and the Pharmaceutical Sciences, vol 40 (Gilbert S. Banker, Christopher T. Rhodes, Eds.). All of the aforementioned publications are incorporated by reference herein.

W0 2014/160285 Tablets may contain suitable binders, lubricants, egrating agents, coloring agents, flavoring agents, floweinducing agents, and melting agents. For ce, for oral administration in the dosage unit form of a tablet or capsule, the active drug component can be combined with an oral, non—toxic, pharmaceutically able, inert carrier such as lactose, gelatin, agar, , sucrose, glucose, methyl cellulose, magnesium stearate, dicalcium phosphate, calcium e, mannitol, sorbitol and the like. Suitable binders include starch, gelatin, natural sugars such as glucose or beta—lactose, corn sweeteners, natural and synthetic gums such as acacia, tragacanth, or sodium alginate, carboxymethylcellulose, polyethylene glycol, waxes, and the like. Lubricants used in these dosage forms include sodium oleate, sodium stearate, magnesium stearate, sodium benzoate, sodium acetate, sodium chloride, and the like. Disintegrators include, without limitation, starch, methyl cellulose, agar, bentonite, xanthan gum, and the like.

In the present application, all numbers or percentages sed herein are approximate values, regardless whether the word "about" or "approximate" is used in connection therewith. They may vary by 1 percent, 2 percent, a pezcent, or up to 20 t, er a numerical range with a lower limit and an upper limit is disclosed, any number telling within the range is specifically disclosed.

Each embodiment disclosed herein is plated as being able to each of the other disclosed embodiments. Thus, all combinations of the various elements described herein are within the scope of the invention.

This patent specification will be better understood by reference to the Experimental Details which follow, but those d in the art will y appreciate that the specific experiments detailed are only illustrative of the invention as described more fully in the claims which follow thereafter.

W0 2014/160285 2014/026238 gigozimnntal Details Materials and Method- When le, compendial (e.g, USP) grades or phannaceutical grades of the chemicals were obtained, Carbamide peroxide is an oxidizing agent generally used for its oxygen—releasing effect in the local treatment and hygienic prevention of minor infections and inflammation or irritation of the gums and mouth, ing canker sores (aphthous ulcers), gingivitis, periodontitis, stomatitis, and Vincent's infection. The drug also is used in the treatment of minor inflammation caused by dentures, mouth nces (orthodontics), or dental procedures. The material obtained here is a white, crystalline powder with a relatively large particle size.

Omega fatty acids include omega-3 fatty acid, omega—6 fatty acid and omega-9 fatty acids. Omega-3 fatty acids are a family of unsaturated fatty acids that have in common a final carbon—carbon double bond in the nv3 on, that is, the third bond, counting from the methyl end. Omega—6 fatty acids are a family of unsaturated fatty acids that have in common a final carbon-carbon double bond in the n—S position. that is, the sixth bond, counting from the methyl end, Omega~9 fatty acids are a family of unsaturated fatty acids that have in common a final carbon-carbon double bond in the n—9 position, that is, the ninth bond, counting from the methyl end.

Omega—3 fatty acids include but are not limited to Hexadecatrienoic acid (HTA), alpha—Linolenic acid (ALA), Stearidonic acid (SDA).

Eicosatrienoic acid (ETE), Eicosatetraenoic acid (ETA), Eicosapentaenoic acid (EPA), Heneicosapentaenoic acid (EPA), Docosapentaenoic acid (DPA), Clupanodonic acid, Docosahexaenoic acid (DHA), Tetracosapentaenoic acid or Tetracosahexaenoic acid.

Omegac6 fatty acids include but are not d to Gamma-linolenic acid (GLA), Calendic acid, Eicosadienoic acid, -gamma-linolenic acid (DGLA), Arachidonic acid (AA), Docosadienoic acid, Adrenic acid, Docosapentaenoic acid, Tetracosatetraenoic acid, or Tetracosapentaenoic acid.

W0 2014/160285 Omega—9 fatty acids include but are not limited to oleic acid, elaidic acid, c acid, mead acid, erucic acid, nervonic acid.

Essential fatty acids cannot be synthesized.by the human body and must be obtained from a dietary source. Because humans lack the required enzyme to introduce carbon~carbon double bonds at carbon atoms beyond the ninth carbon atom in unsaturated fatty acids (the ninth carbon atom from the omega end of the chain). Gamma—linoleic acid (an m—6 fatty acid) and alpha—linolenic acid (an m-3 fatty acid) are essential fatty acids that must be obtained by humans from a dietary source to ensure good wellness. miting examples of suitable oil materials include oleic canola Oil (Brassica campeetris, B. napus, B. rapa : characterized by having an oleic content greater than 70%, e.g., hi oleic canola oil, very high oleic canola oil, or partially hydrogenated canola oil), marula kernel oil (Sclerocarya birrea), palm oil (Elaeis Guineensis Oil), palm olein, palm stearin, palm superolein, pecan oil, pumpkin seed oil, oleic safflower oil (Carthamus Tinctorius; characterized by having an oleic content of greater than about 33% ané omega-6 fatty acid content of less than about 50%, e.g., hi oleic safflower oil), sesame oil (Sesamum indicum, S. oreintale}, seybean oil {Glycine max, e.g., hi oleic soybean, low linolenic soybean oil, partially enated), oleic sunflower oil (Helianthus annus; terized by having an oleic t of greater than about 40%, e.g., mid oleic wer or high oleic sunflower oil), and mixtures thereof. oleic canola oil, palm oil, sesame oil, hi oleic safflower oil, hi oleic soybean oil, mid oleic sunflower oil, and high oleic sunflower oil are common plant—bred derived oils and may be also be derived from non—genetically modified organisms (non—GMO).

The above oils are commercially—available from a number of vendors.

Emu oil is oil ed from the fat of the emu, a bird indigenous to Australia. Unadulterated emu oil can vary widely in color and W0 60285 viscosity, but is generally a yellow liquid composed of imately 70% unsaturated fatty acids. The largest component is oleic acid, a mono—unsaturated omega~9 fatty acid. Emu oil also contains y % linoleic acid (omega~6 fatty acid) and 1-2% linolenic acid (omega— 3 fatty acid). Emu oil is marketed and promoted as a dietary supplement with a wide variety of claimed health benefits. Commercial emu oil supplements are not standardized and vary widely in their potency.

The Emu Oil used herein is marketed as ProuEmu Oil from Progressive Emu Inc., PO Box 590088, Birmingham, AL 35259 and is a formulated product which es some vitamin E.

Emu oil is oil rendered from the fat of the emu, a bird indigenous to Australia. Unadulterated emu oil can vary widely in color and viscosity, but is generally a yellow liquid composed of approximately 70% unsaturated fatty acids. The t ent is oleic acid, a mono~unsaturated omegaAQ fatty acid. Emu oil also contains roughly % linoleic acid (an omega-6 fatty acid) and 1—2% linolenic acid (an omega—3 fatty acid). Emu oil is marketed and promoted as a dietary supplement with a wide variety of claimed health benefits. Commercial emu oil supplements are not standardized and vary widely in their potency. The Emu Oil used herein is marketed as Pro-Emu Gil from Progressive Emu Inc., PO Box 590088. Birmingham. AL 35259 and is a formulated product which includes some Vitamin ’1c.

Lecithins vary greatly in their al form, from viscous semi- s to powders, depending upon the free fatty acid content. They may also vary in color from brown to light yellow. depending upon whether they are bleached or unbleached or on the degree of purity. when they are exposed to air, rapid oxidation occurs, also resulting in a dark yellow or brown color. The Lecithin utilized herein is a brown to light yellow wax—like material that may be difficult to bute throughout a solid powder by traditional blending. It should be noted that in is incompatible with ses owing hydrolysis and it is also incompatible with oxidizing agents. Thus, the Lecithin should be separated from the carbamide peroxide.

W0 2014/160285 In addition to other pharmaceutical excipients, erated isomalt was chosen as "filler" for the tablet formulations. Specifically, galenIQm 720 (low solubility) and galenIQm 721 (high solubility) are agglomerated spherical isomalts for direct compression applications.

In l, these exipients are of non~animal origin, they have very low hygroscopicity, grades with diffierent solubilities are available, they have excellent chemical stability; and are highly ant against degradation by enzymes and acids, they are generally regarded as a xic, non-allergic and non-irritant material, and they have a pleasant sugar—like, natural sweet taste profile. The higher solubility grade would be appropriate for a rapidly disintegrating layer, whereas the low solubility grade would be appropriate for a slowly eroding layer.

Papain is a white or grayish—white, slightly hygroscopic powder. Its potency varies according to process of preparation with the usual grade digesting ~35 times its weight of lean meat. Papain is atible with strong oxidizers and vated by oxidation. The papain used herein is designated as USP.

W0 2014/160285 W101.

The initial study (Table l) focused on incorporation of the emu oil and lecithin into a solid dosage form (slow eroding ). Emu oil has a fairly high melting point and the material employed here appears as a free flowing semi-solid at room temperature.

Table 1. Initial tion Eat I. slaw g tabla: layer containing oil. museum: and te-nimznlizinq agent.

Item Component % by Weight In Weight per Actual Wt. tablet (mg) per batch 1 Isomlt <galen1Q 720) 202.4 7.1994 Anhydrous Dibasic Calcium ll 5 28.68 1.0202 Phosphate (Anhydrous Emcompress, JRS Phama) 3 --Emu Oil(Pro—Emu Oil, Progressive 5‘68 14.21 0.5054 u Lecithin NF (Spectrum) 4,764 0.1695 TOTAL 100.0 (approx.) 250.0 8.895 The following outcomes were obtained from this initial trial: - The powder mass accommodateci the oil well; a very clean and dust free e was obtained.

- Distribution of the lecithin was non~uniform, and subsequent processing efforts involve melting the in and/or mixing it with the Emu Oil to produce a liquid form before combining it with powder.

- The mixture compacted easily on a Carver Press to form strong tablets. The oil appeared to reduce die wall friction sufficiently to obviate the need for the addition of a lubricant. - when placed in water, the tablet erodes slowly — complete erosion occurred in approximately 5 minutes. During this time, the liquid becomes cloudy, presumably due to emulsification of the oil. The ium phosphate appears as insoluble particles.

W0 2014/160285 - The tablet has a l taste; the Isomalt does not provide noticable sweetness nor does it provide the endothermic cooling associated with a filler like sorbitol. ure for preparation of composition described in Table l: l) Accurately weigh the Emu Oil (Item 3) into a disposable polyethylene weighing dish. 2) Accurately weigh the Isomalt (Item 1) into a disposable lO polyethylene weighing dish. 3) Take a portion of the Isomalt weighed in step 2 and transfer it into the dish containing the Emu Oil. Use a spatula to mix the powder with the oil. After mixing. transfer this mass to a glass mortar.

Repeat this procedure using additional portions of Isomalt until all the Emu Oil has been absorbed onto powder. Transfer any remaining Isomalt into the glass mortar. 4) Accurately weigh the Anhydrous Dibasic m Phosphate (item 2) into a able polyethylene weighing dish, and transfer this powder into the glass mortar containing the Isomalt and Emu Oil mixture. 5) Triturate the mixture in the mortar with a pestle to obtain a m blend. 6) Accurately weigh the Lecithin (Item 4) and transfer it to the mixture in the mortar. 7) Triturate the mixture in the mortar with a pestle to obtain a uniform blend. 8) Compress powder s into tablets using a Carver press.

Example 2.

A second. similar formulation was processed. Given the taste 3O assessment described above, aspartame was included as a sweetener (Table 2). In terms of processing, in this case, the lecithin was added to Emu oil and the mixture was warmed in a microwave oven to obtain a liquid mixture. This mixture was then added to the blend of t and ous ium phosphate.

Table 2. uoditiod formulation for a slow eroding tablet layer containing oil, surfactant and ralizing agent.

Component % by Weight per Actual Wt .

Weight per batch (g) In Blend Isomalt (galele 720) 810 8.3000 Anhydrous Dibasie Calcium Phosphate 1&0 1.0000 (Anhydrous Emcompress, JRS Pharma) Emu Oil (Pro~8mu Oil, Progressive 6‘00 0-6000 Emu ) 1.00 2.50 0.1000 252.5 10.144 g of the lecithin/Emu oil e was done by placing a beaker in the microwave oven and heating for 30 second intervals. After each interval, the mixture was stirred. Fragments of the in continued to be present and a total of approximately 5 intervals was required; it appeared that the lecithin eventually melted and/or dissolved in the oil. It should be noted that in subsequent processing, heating for longer time intervals led to nt decomposition of the lecithin.

Tablets were produced from this blend and they had r physical attrihutee to those obtained previously. The addition oi the asyartame produced a slight improvement in taste, but additional sweetener could be required.

Procedure for preparation of composition described in Table 2: l) Accurately weigh the Lecithin (Item 4) into a 50 mL glass beaker. 2) Tare the beaker containing the Lecithin and accurately weigh the Emu Oil (item 3) into the beaker ning the Lecithin. 3) Accurately weigh the Anhydrous c m Phosphate (Item 2) into a disposable polyethylene weighing dish. 4) Transfer the Anhydrous Dibasic Calcium Phosphate (Item 2) into a glass mortar. Triturate until a fine powder is obtained.

) Accurately weigh the Isomalt (Item 1) into a disposable polyethylene weighing dish. Transfer the Isomalt to the mortar W0 2014/160285 containing Anhydrous Dibasic Calcium Phosphate. Triturate to obtain a uniform blend and then transfer the blend to a weighing dish. 6) Place the beaker containing the lecithin and Emu Oil into the microwave oven and heat until the Lecithin melts. Use a spatula to mix the Lecithin with the oil. 7) Take a portion of the oowder mixture obtained from 5 and transfer it into the beaker containing the Lecithin and Emu Oil mixture. Use a spatula to mix the powder with the oil. After mixing, transfer mass to a glass mortar. Repeat this ure using additional portions of powder mixture until all the Lecithin and Emu oil has been absorbed onto powder. Transier any remaining powder into the glass mortar.

B) Triturate the mixture in the mortar with a pestle to obtain a uniform blend. 9) Accurately weigh the Aspartame (Item 5) and transfer it to the e in the mortar. Triturate to form a uniform mixture.

) Compress powder samples into tablets using a Carver Press.

Example 3.

Presented in Table 3 is a bilayer tablet formulation. An initial formulation was developed for the y disintegrating layer, built around the concept of using 3 directly compressible dicalcium phosphate carrier and also including crospovidone, a led “super" egrant. Dicelcium phosphate seemed to be a good choice becauee it is inorganic and therefore not incompatible with the strong oxidizer carbamide de. Also, the rapid disintegration would release a substantial quantity of a re-mineralizing agent. Due to its atibility with strong oxidizers, papain was ed in the slow eroding layer, and the isomalt was replaced with sorbitol.

W0 60285 Table 3. Initial Bil-yer Tablet Formulation.

Dilintegr‘ting urn: Item Component ‘8 by Weight per Actual Wt. per Weight tablet (mg) batch (g) In Blend Carbamide Peroxide (Spectrum) Anhydrous Dibasic Calcium ate . . 9.503 (Anhydrous Emcompress, JRS Pharma) Crospovidone D. 3528 D. 1040 . 0666 Weight batch (g) In Blend Sorbitol 78.0 390.0 7.7701 Anhydrous Dibasic Calcium Phosphate lO . 0 SO . 00 l. 0565 (Anhydrous Emcompress, JRS Pharma) Emu Oil (Pro-Emu Oil, Progressive 6.00 30.00 0.6488 Emu) Lecithin NF (Spectrum) 1.00 5‘00 0.1399 The ing outcomes were ed from this trial: S - The sorbitol, which has a larger garticle size than the isomalt, did not accommodate the oil as well. The overall character of the blend for the slow eroding layer was more "oily".

- Each dual blend compacted easily to fiorm strong tablets, as did the combination of materials for the bilayer tablet.

- When placed in water, the disintegrating layer does indeed disintegrate rapidly releasing insoluble ium phosphate particles.

- The second layer erodes slowly.

- The sorbitol did not produce an improvement in taste.

W0 2014/160285 Procedure for preparation of composition bed in Table 3: Disintegrating Laxer l) tely weigh the Anhydrous Dibasic Calcium Phosphate (Item 2) into a disposable polyethylene weighing dish. 2) Accurately weigh the Carbamide de (Item 1) and transfer the powder into a glass mortar. 3) Geometrically add the Anhydrous Dibasic Calcium Phosphate into a glass mortar with trituration after each on to produce a uniform blend. 4) Accurately weigh the Crospovidone (Item 3) and add it to the powder blend in the glass . Triturate to form a uniform blend. ) tely weigh the Magnesium Stearate (Item 4) and add it to the powder blend in the glass mortal. Triturate lightly to form a uniform blend. 6) Transfer the blend into a bulk container and hold for tableting.

Slow Eroding Lager 7) Accurately weigh the Lecithin (Item 9) into a 50 mL glass beaker. 8) Tare the beaker containing the in and tely weigh the Emu Oil (Item 8) into the beaker containing the Lecithin. 9) Accurately weigh the ous Dibasic Calcium Phosphate (Item 6) into a disposable polyethylene weighing dish.

) Transfer the Anhydrous Dibasic Calcium ate (item 6) into a glass mortar. Triturate until a fine powder is obtained, 11) Accurately weigh the Sorbitol (Item 5) into a disposable polyethylene weighing dish, Transfer the Sorbitol to the mortar containing the Anhydrous Dibasic Calcium Phosphate. Triturate to obtain a uniform blend and then transfer the blend to a weighing dish. 12) Place the beaker containing the Lecithin and Emu Oil into the microwave oven and heat until the Lecithin melts, Use a spatula to mix the Lecithin with the oil. 13) Take a portion of the powder mixture obtained from step 1 and transfer' it into the beaker containing the Lecithin and Emu Oil mixture. Use a spatula to mix the powder with the oil. After mixing, transfer this mass to a glass mortar. Repeat this procedure using W0 2014/160285 2014/026238 additional portions of powder mixture until all the Lecithin and Emu Oil has been absorbed onto powder. Transfer any remaining powder into the glass mortar. 14) Triturate the mixture in the mortar with a pestle to obtain a m blend. ) tely weigh the Papain (Item 7) and add it into a glass mortar. Triturate until a uniform mixture is obtained. 16) Transfer the blend into a bulk container and hold for tableting.

Bilayer Tablet Production 17) Weigh approximately 500 mg of the powder for the slow eroding layer and transfer it into the die, Compress the powder into the first layer using a Carver Press. 18) Weigh approximately 250 mg of the powder for the disintegrating layer and transfer it into the die containing the first layer. Compress the powder onto the first layer using the Carver press. 19) Eject tablet from die.

Example 4.

Modifications made in the next iteration (Table 4) include a replacement of the sorbitol with isomalt, anfi the use of vely large, capsule-shaped tablet tooling. A tablet size of 1.2 g was targeted, with 400 mg and 800 mg for the éisintegratimg and eroding layers, respectively.

Table 4. Carbanido Peroxide (4 mg) and Papain (40 mg) hilayer tablet formulation.

Dialntegratinq Layer Item ent % by Weight per Actual Wt. per Weight In tablet batch (g) Blend —_—m_ ----AnhydrousDibasic Calcium Phosphate 94.5 378.00 9,479 slow :rading Layer W0 2014/160285 Item Component Weight per Actual Wt. per batch (g) Anhydrous Dibasic Calcium ate 10.0 rous Emcomprese JRS Pharma) Papain USP30 (Anhui) Emu Oil (Pro-Emu Oil Progressive Lecithin NF (Spectrum) TOTAL Subsequent to cture of these bilayer tablets, two things became evident. When handling this tablet. it appeared that the edges of this layer were easily abraded. Second, when placed in simulated intestinal fluid, a large quantity of insoluble ium phosphate was released, which might be "gritty“ and not be desirable. ure for preparation of composition described in Table 4: Disintegrating Layer 1) Accurately weigh the Anhydrous Dibasic Calcium Phosphate (Item 2) into a disposable polyethylene weighing dish. 2) Accurately weigh the Carbamide Peroxide (Item 1) and transfer the gowder into a glass mortar. 3) Geometrically add the Anhydrous Dibasic Calcium Phosphate into a glass mortar with trituration after each on to produce a uniform blend. 4) Accurately weigh the Crospovidone (Item 3) and add it to the powder blend in the glass mortar. Triturate to form a m blend. 5) Accurately weigh the Magnesium Stearate (Item 4) and add it to the powder blend in the glass . Triturate lightly to form a uniform blend. 6) Transfer the blend into a bulk container and hold for tableting.

Slow Eroding Layer 7) Accurately weigh the Lecithin (Item 9) into a 50 mL glass beaker.

W0 2014/160285 8) Tare the beaker containing the lecithin and accurately weigh the Emu Oil (Item 8) into the beaker containing the Lecithin. 9) Accurately weigh the Anhydrous Dibasic Calcium Phosphate (Item 6) into a disposable polyethylene weighing dish. 10) Transfer the Anhydrous Dibasic Calcium Phosphate (item 6) into a glass mortar. Triturate until a fine powder is obtained. 11) Accurately weigh the Isomalt (Item 5) into a disposable polyethylene ng dish. Transfer the Isomalt to the mortar ning the Anhydrous Dibasic Calcium Phosphate. Triturate to obtain a m blend and then transfer the blend to a weighing dish. 12) Place the beaker containing the Lecithin and Emu Oil into the ave oven and heat until the Lecithin melts. Use a a to mix the Lecithin with the oil. 13) Take a n of the powaer mixture obtained from step 11 and transfer it into the beaker containing the Lecithin and Emu Oil mixture. Use a spatula to mix the powder with the oil. After mixing, transfer this mass to a glass mortar. Repeat this procedure using additional portions of powder mixture until all the Lecithin and Emu Oil has been absorbed onto powder. er any remaining powder into the glass mortar. la) Tritsrete the mixture in the mortar with a pestle to obtain a m blend.

) Accurately weigh the Pepain (Item 7} and afid it into a glass mortar. Triturate until a uniform mixture is obtained. 16) Transfer the blend into a bulk container and hold for tableting.

Bilayer Tablet Production 17) Weigh approximately 650 mg of the powder for the slow eroding layer and transfer it into the die, Compress the powder into the first layer using a Carver Press. 18) Weigh approximately 350 mg of the powder for the disintegrating layer and transfer it into the die containing the first layer. Compress the powder onto the first layer using the Carver press. 19) Eject tablet from die.

W0 2014/160285 Example 5.

A reduction in the quantity of phosphate salt was made and a soluble filler was added. Thus, in the next iteration (Table 5) the concentration of dicalcium phosphate was reduced and isomalt was included as the soluble filler in the disintegrating layer. The bilayer tablet produced from the formulation in Table 5 showed no signs of incompatibility in the dosage form. There is. considerable flexibility in the tablet in terms of both composition, , and the weight of the respective .

Table 5. ed Caz-band. Peroxide (4 mg) and pepsin (00 mg) 1:11:er tablet formulation. ni-incmrnting Layer Item Component 32; by Weight per Actual Wt. per Weight tablet (mg) hatch (g) In Blend Carbamide Peroxide (Spectrum) 1.0 4.00 Anhydrous Dibasic Calcium ate -0.969 (Anhydrous Emcompress. JRS Pharma) t (galenIQ 720) Crospovidone . _ 100.0 400.0 Slow lgrading Layer .Item Comgsonent 6 t(galenIQ 720) 73.0 624.0 —--—Anhydrous Dibasic Calcium Phosphate 10.0 80.0 1.406 Papain USP3O (Anhui) 5.0 40.0 0.5454 T Emu oil (Pro—Emu 011, Progressive I.-6.00 43.0 0.6929 ———n- Procedure for preparation of composition described in Table 5: W0 2014/160285 Disintegrating Layer 1) Accurately weigh the Anhydrous Dibasic Calcium Phosphate (Item 2) into a disposable polyethylene weighing dish. 2) Accurately weigh the Carbamide Peroxide (Item 1) and er the powder into a glass mortar. 3) Add the ous Dibasic Calcium Phosphate into the glass mortar and triturate to produce a uniform blend. 4) Accurately weigh the Isomalt (Item 3) and add it to the powder blend in the glass . Triturate to form a uniform blend. 5) Accurately weigh the Crospovidone (Item 4) and the Magnesium Stearate (Item 5) and add them to the powder blend in the glass mortar.

Triturate lightly to form a uniform blend. 6) Transfer the blend into a bulk container and hold for tableting.

Slow Eroding Layer 7) Accurately weigh the Lecithin (Item 10) into a 50 mL glass beaker. 8) Tare the beaker ning the lecithin and accurately weigh the Emu Oil (Item 9) into the beaker containing the Lecithin. 9) Accurately weigh the Anhydrous Dibasic Calcium Phosphate (Item 6) into a disposable polyethylene weighing dish.

} Transfer the Anhydrous fiibasic Calcium Phosphate (Item 7) into a glass mortar. Triturate until a fine powder is ed. 11) Accurately weigh the isomalt (Item 6) into a disposable polyethylene weighing dish. Transfer the Isomalt to the mortar containing the Anhydrous Dibasic Calcium Phosphate. Triturate to obtain a uniform blend and then transfer the blend to a weighing dish. 12) Place the beaker containing the Lecithin and Emu Oil into the microwave oven and heat until the Lecithin melts. Use a spatula to mix the Lecithin with the oil. 13) Take a portion of the powder mixture ed from step ll and transfer it into the beaker containing the in and Emu Oil mixture. Use a spatula to mix the powder with the oil. After , transfer this mass to a glass mortar. Repeat this procedure using onal portions of powder mixture until all the in and Emu Oil has been absorbed onto powder. Transfer any remaining powder into the glass mortar.

W0 2014/160285 14) Triturate the mixture in the mortar with a pestle to obtain a uniform blend.

) Accurately weigh the Papain (Item 8) and add it into a glass . Triturate until a uniform mixture is obtained. 16) Transfer the blend into a bulk container and hold for tableting. r Tablet Production 17) Weigh approximately 800 mg of the powder for the slow eroding layer and transfer it into the die, Compress the powder into the first layer using a Carver Press. 18) Weigh approximately 400 mg of the powder for the disintegrating layer and transfer it into the die containing the first layer. Compress the powder onto the first layer using the Carver press. 19) Eject tablet from die.

Example 6.

Presented in Figure 7 is another formulation. Several changes were made including: 1) the weight of the rapidly disintegrating layer was reduced and that of the slowly eroding layer increased — there is no need for much mass to accommodate the carbamide peroxide, and the larger the mass of the elowly eroding layer the more oil can be included; 2} Emu oil level was increased to 10% and lecithin level was increased from 1 % to 2%.

The Emu oil and lecithin were combined in a beaker and heated on a hot plate with. stirring. The temperature required to “melt" the lecithin and orate it into the oil was quite high. While it is possible to obtain what s to be a one phase solution of the two components, excessive heating may change the character of the oil and/or degrade the lecithin.

Table 6. modified ide Peroxide (2 mg) and pepsin (100 mg) t tablet formulation including tricalcium phosphate. tegrating Layer Item Component is by Weight Weight per Actual Wt. per In Blend tablet (mg) batch (g) W0 2014/160285 Tricalcium Phosphate, Powder NF I 20.0 1 146.00 1 144505 0.3860 .0229 % by weight Weight per Actual wt. per In Blend tablet (mg) batch (g) Isomalt(galenl0 720) 8.5481 Tricalcium ate, Powder NF Papain USP3O (Anhui) Emu Oil (Pro—Emu Oil, Progressive Emu) in NF (Spectrum) The warm oily solution was added to the tricalcium phosphate with the expectation that it could be distributed uniformly throughout this powder. The combination of the fine powder and the decrease in temperature resulted in the formation of wax—like aggregates which were very hard to completely disperse. After compression, there were yellow spots on the tablet e that indicated that the distribution of the in was not uniform. The e of the oil, lecithin, and powders may need to be heated to obtain the d uniformity. In terms of larger scale production this can be accomplished in a jacketed high shear mixer. It appeared that more oil could be accommodated and the consistency of the slow eroding layer appears to be fine, Procedure for preparation of composition described in Table 6: Disintegrating Layer 1) Accurately weigh the Tricalcium Phosphate (Item 2) into a disposable polyethylene ng dish. 2) Accurately weigh the Carbamide Peroxide (Item 1) and transfer the powder into a glass mortar. 3) Add the Tricalcium Phosphate into the glass mortar and triturate to produce a uniform blend.

W0 2014/160285 4) Accurately weigh the Isomalt (Item 3) and add it to the powder blend in the glass mortar. Triturate to form a uniform blend.

) Accurately weigh, the vidone (Item 4) and the Magnesium Stearate (Item 5) and add them to the gowder blend in the glass mortar.

Triturate lightly to form a uniform blend. 6) Transfer the blend into a bulk container and hold for tableting.

Slow Eroding Layer 7) Accurately weigh the Lecithin (Item 10) into a 50 mL glass . 8) Tare the beaker containing the lecithin and accurately weigh the Emu Oil (Item 9) into the beaker containing the in. 9) Accurately weigh the Tricalcium Phosphate (Item 7) into a disposable polyethylene weighing dish.

) Accurately weigh the Isomalt (Item 6) into a disposable polyethylene weighing dish. 11) Place the beaker containing the Lecithin and Emu Oil on a hot plate and heat until the Lecithin mixes with the oil. 12) Add the tricalcium phosphate from step 9 into the beaker containing the in and Emu Oil mixture. Use a spatula to mix the powder with the oil. After mixing. transfer the mass to a glass mortar. Repeat grocedure using additional portions of the Isomalt powder from step and continue until all the Lecithin and Emu Oil has been absorbed onto the powder. er any remaining t powder into the glass mortar. 13) Triturate the mixture in the mortar with a pestle to obtain a uniform blend. l4) Accurately weigh the Papain (Item 8) and add it into a glass mortar. Triturate until a m mixture is ed.

) Transfer the blend into a bulk container and hold for tableting.

Bilayer Tablet Production 16) Weigh approximately 1000 mg of the powder for the slow eroding layer and transfer it into the die. Compress the powder into the first layer using a Carver Press.

W0 2014/160285 17) Weigh approximately 200 mg of. the powder for the disintegrating layer and transfer it into the cilia containing the first layer. Compress the powder onto the first layer using the Carver press. 18) Eject tablet from die. ml.7.

An attempt at increasing the oil level to 15% by weight is represented by the tablet described in Table 7. This batch was preparefi at the 100 g size with the ation that it could be compressed on an instrumented single station press to evaluate flow. However, when a screening study was done on the Carver press, the rapidly disintegrating layer did not adhere to the slowly g layer. The applied pressure essentially squeezed the oil out of the carrier producing a highly lubricated interface between the layers.

Table 7. Modified Cathamido Peroxide (2 mg) and papain (100 mg) r tablet formulation including 1596 emu oil.

Dinintagratinv Layer Item ent 0, by Weight per Actual Wt. per Weight tablet (mg) batch (g) In Blend Carbamide Peroxifie {Syectrusak Tricalcium Phosphate, Powder NF 20.0 40.00 ngidcne 4.00 3.00 3.9924 Magnesium Stearate 2.00 4.00 % In Weight per Actual Wt. per Blend tablet (mg) batch (g) Isomalt (galenIQ 720) 380.0 Tricalcium Phosphate, Powder NF 350‘0 Papain 03930 ) 100.0 Emu Oil mu Oil, Progressive 15.00 150.0 15.1024 m, - - Lecithin NF (Spectrum) 20.00 Procedure for preparation of composition described in Table '7: W0 60285 egrating Layer 1) Accurately weigh the Tricalcium ate (Item 2) into a disposable polyethylene weighing dish. 2) Accurately weigh the Carbamide Peroxide (Item 1) and transfer the powder into a glass mortar. 3) Add the cium Phosphate into the glass mortar and ate to produce a uniform blend. 4) Accurately weigh the Isomalt (Item 3) and add it to the powder blend in the glass mortar. Triturate to form a uniform blend.

S) Accurately weigh the vidone (Item 4) and the Magnesium te (Item 5) and add them to the powder blend in the glass mortar.

Triturate lightly to form a uniform blend. 6) Transfer the blend into a bulk container and hold for tableting.

Slow Eroding Layer 7) Accurately weigh the Lecithin (Item 10) into a glass beaker. 8) Tare the beaker containing the lecithin and accurately weigh the Emu Oil (Item 9) into the beaker containing the Lecithin. 9) Accurately weigh the Tricalcium Phosphate (Item 7) into a disposable polyethylene weighing dish.

) Accurately weigh the Isomalt (Item 8) into a disposable polyethylene weighing dish. 11) Place the beaker ning the Lecithin and Emu Gil on a hot plate and heat until the Lecithin mixes with the oil. 12) Add the tricalcium phosphate from step 9 into the beaker containing the Lecithin and Emu Oil mixture. Use a spatula to mix the powder with the oil. After mixing, er the mass to a glass mortar. Repeat procedure using additional portions of the Isomalt powder from step and continue until all the Lecithin and Emu Oil has been absorbed onto the powder. Transfer any remaining Isomalt powder into the glass mortar. 13) Triturate the mixture in the mortar with a pestle to obtain a uniform blend. l4) Accurately weigh the Papain (Item 8) and add it into a glass mortar. Triturate until a uniform mixture is obtained.

) Transfer the blend into a bulk container and hold for tableting.

W0 2014/160285 Bilayer Tablet Production 16) Weigh approximately 1000 mg of the powder for the slow eroding layer ans transfer it into the die, Compress the powder into the first layer using a Carver Press. 17) Weigh approximately 200 mg of the powder for the disintegrating layer and transfer it into the die containing the first layer. Compress the powder onto the first layer using the Carver press. 18) Eject tablet from die.

Example 8.

The following compositions are prepared using the methods described hereinabove: A composition comprising emu oil and one or more emulsifying agents.

A composition comprising omega fatty acids and one or more emulsifying . A composition comprising omega fatty acids and one or more protease enzymes. A composition comprising omega fatty acids and one or more e m phosphate remineralizing agents. A composition comprising omega fatty acids and one or more whitening . A composition comprising omega fatty acids and two of the following: one or more emulsifying agents, one or more protease enzymes, one or more soluble calcium phosphate remineralizing agents, one or more whitening . A composition comprising omega fatty acids and three of the following: one or more emulsifying agents, one or more protease enzymes, one or more soluble calcium ate remineralizing agents, one or more whitening agents. A ition comprising omega fatty acids, one or more emulsifying agents, one or more protease enzymes, one or more soluble calcium phosphate remineralizing agents, and one or more whitening agents.

A composition comprising emu oil and one or more emulsifying agents.

A composition comprising emu oil and one or more protease enzymes. A composition comprising emu oil and one or more soluble m phosphate remineralizing agents. A composition comprising emu oil and one or more ing agents. A ition comprising emu oil and W0 2014/160285 two of the following: one or more emulsifying agents, one or more protease enzymes, one or more soluble calcium phosphate remineralizing agents, one or more whitening agents. A composition comprising emu oil and three of the following: one or more emulsifying agents, one or more protease enzymes, one or more soluble calcium phosphate remineralizing agents, one or more ing . A composition comprising emu oil, one or more emulsifying' , one or more protease enzymes, one or more soluble m phosphate remineralizing agents, and one or more whitening agents.

The above compositions are formulated as single layer s, bilayer tablets or as any one of the formulations described above.

Example 9.

The composition of the present application is administered to a subject or subjects suffering from xerostomia andlor hyposalivation.

The composition increases salivary flow in the subject(s). The composition also reduces the subjective sensation of dry mouth in the subject(s). The Composition of the t application is administered to a subject’s teeth. The ition whitens the subject's teeth.

The bilayer tablet composition of the present application comprising one or more whitening agents in the rapidly disintegrating layer and emu oil is administered to a subject or subjects suffering from xerostomia and/or hyposalivation. The bilayer tablet composition increases salivary flow in the subject(s). The composition composition also reduces the subjective sensation of dry mouth in the subject(s).

The bilayer tablet composition of the present application comprising one or more whitening agents in the rapidly disintegrating layer and emu oil is administered to a subject's teeth. The bilayer tablet s the subject's teeth.

The bilayer tablet ition of the present application comprising one or more whitening agents in the rapidly disintegrating layer is administered to a t's teeth. The bilayer tablet whitens the subject’s teeth.

W0 2014/160285 A single first oral care composition of the present application followed by five second oral care compositions of the present application are stered over 24 hours to a subject suffering from xerostomia of the oral cavity and pharynx. The composition increases salivary flow in the t(s). The composition also reduces the subjective sensation of dry mouth in the Subject(s) .

A single first oral care composition of the present application followed by five second oral care compositions 0E the present application are administerecl over 24 hours to a subject suffering from mucositis of the oral cavity and pharynx. The itions treat the subject: ing from muoositis of the oral cavity and pharynx.

W0 60285 Discussion The composition sed herein relate to a stable, multi—component, solid dosage form for use in dental therapy that delivers an efifective S combination of emu oil, a whitening/cleansing agent, a protease enzyme, a re«mineralizing agent, and an emulsifying agent in the oral cavity. The combination of ingredients have been formulated. and sed into a bilayer tablet. No immediate signs of incompatibility in the dosage form itself were evident. There is considerable flexibility in the tablet in terms of both composition, weight, and the weight of the layers, i.e. the slowly g later and the disintegrating layer. However, the concentration of emu oil that can be accommodated in this dosage form is 15% or less (based on the slow eroding layer). Incorporation of the lecithin was accomplished by dissolving the surfactant in the Emu oil. This approach required high temperature. However, alternative processing approaches are available.

The r tablet is described in Figures 1 and 2. The tablet consists essentially of a rapidly disintegrating layer containing the whiteningicleansing agent (i.e., carhamide peroxide) and a non« disintegrating slow eroding “lozenge—like' layer that contains the other comyonents. The bilayer tablet creates a physical separation of the oxidizer from other product components in the dosage form. This feature is especially desirable considering that the peroxide may be antable with the other agents (i.e. pepsin). when placed in the oral cavity, the saliva causes rapid disintegration of the disintegrating layer, ng a liquid environment with an effective level of free hydrogen peroxide. Simultaneously, the second layer, which contains the other components, including emu oil and the papain, begins to slowly erode. The duration of the whitening/cleansing action of the peroxide is relatively short, so exposure of the other ent subject to oxidative degradation is d and e of these ingredients is sustained.

W0 2014/160285 Refer-neo- Anneroth G, Nordenram G, son S. (1980) Effect of saliva stimulants (Hybrin and malic acid) on cervical root surfaces in vitro. Scand J Dent Res. 88, 214—8.

Borges B.C. et al. (2010) Xerostomia and hyposalivation: a preliminary report of their prevalence and associated factors in Brazilian elderly ic patients. Oral Health Prev. Dent. 8, 2, 153-158.

Cassolato SF, ll RS. (2003) Xerostomia: clinical aspects and treatment. Gerodontology. 20, 64-77, Davies AN. (2000) A comparison of artificial saliva and chewing gum in the ment of xerostomia in patients with ed cancer.

Palliat Med. 14, 3.

Hochberg MC, Tielsch J, Munoz B, et al. (1998) Prevalence of symptoms of dry mouth and their relationship to saliva production in community dwelling elderly: the SEE project. J Rheumatol 25, 486—4891.

Nederfors, T. (1996) Xerostomia: prevalence and pharmacotherapy. with special reference to betaeadrenocector antagoniste. Swed Dent J Suppl. 116, 1—70.

Nederfors T, Isaksson R, Mornstad H, Dahlof C. (1997) Prevalence of perceived symptoms of dry mouth in an adult Swedish population~ relation to age, sex and pharmacotherapy. Community Dent Oral iol, 25, 211—216.

Narhi TO, Meurman JH, Ainamo A. (1999) Xerostomia and hyposalivation: causes, consequences and treatment in the elderly. Drugs & Aging 15, 103-116.

W0 2014/160285 Orellana MF, Lagravére MO, Baychuk DGJ, Major PW, Flores-Mir C. (2006) Prevalence of xerostomia in population—based samples: a systematic review. Journal 0f public health dentistry 66, 2, 152—158.

Scully C, Bagan JV. (2004) Adverse drug reactions in the orofacial . Crit Rev Oral Biol Mea. 15, .

Silvestre—Donat FJ, Miralles-Jorda L, Martinez~Mihi V. (2004) Protocol for the clinical management of dry mouth. Med Oral. 9, 273—9.

Claims (21)

What is claimed is:

1. An oral care composition comprising: a) 5-10% by weight emu oil; b) one or more emulsifying ; c) one or more protease enzymes; and d) one or more soluble calcium phosphate remineralizing agents wherein the composition is formulated as a tablet, gel or emulsion.

2. An oral care composition comprising: a) 5-10% by weight emu oil; b) 1-5% by weight of an emulsifying agent; c) 40 mg to 60 mg of a protease enzyme; and d) 5-25% by weight of a soluble m phosphate ralizing agent; wherein the composition is formulated as a tablet, gel or emulsion.

3. An oral care composition comprising: a) 5-10% by weight emu oil; b) 1-5% by weight of an emulsifying agent; c) 1-10% by weight of a protease enzyme; and d) 5-25% by weight of a soluble calcium phosphate remineralizing agent wherein the composition is formulated as a tablet, gel or emulsion.

4. An oral care composition comprising: a) 5-10% emu oil; b) 1-5% by weight in; c) 40 mg to 60 mg of bromelain; and d) 5-25% by weight amorphous calcium phosphate wherein the composition is formulated as a tablet, gel or emulsion.

5. An oral care ition comprising: a) 5-10% by weight emu oil; b) 1-5% by weight lecithin; c) 1-10% by weight of bromelain; and d) 5-25% by weight ous calcium phosphate, wherein the composition is formulated as a tablet, gel or emulsion.

6. The composition of any one of claims 1-5, wherein the composition further comprises canola oil, palm oil, sesame oil, safflower oil, soybean oil or sunflower oil.

7. The ition of any one of claims 1-6, wherein the composition further comprises an isomalt.

8. The composition of any one of claims 1-7, wherein the composition is formulated as a bilayer tablet or a multilayer tablet.

9. The composition of any one of claims 1-7, wherein the composition is a gel or a viscous gel.

10. The composition of any one of claims 4-9, wherein the lecithin is soy lecithin.

11. The composition of any one of claims 4-10, wherein the bromelain is stem bromelain.

12. The composition of any one of claims 1-3, wherein the one or more of the se enzymes are selected from the group consisting of papain, trypsin, chymotrypsin, aminopeptidase, carboxypeptidase, pepsin, and cathepsin.

13. The composition of any one of claims 1-3, wherein the one or more soluble m phosphate remineralizing agents are selected from the group consisting of dibasic m phosphate, monocalcium phosphate, tricalcium phosphate, and alcium phosphate.

14. The composition of any one of claims 1-3, wherein the one or more emulsifying agents are phospholipids.

15. The composition of claim 14, wherein the phospholipids are lecithin.

16. The composition of any one of claims 1-15 further comprising: e) one or more whitening agents.

17. The composition of claim 16, wherein the one or more whitening agents are selected from the group consisting of carbamide peroxide and hydrogen peroxide.

18. Use of the composition of any one of claims 1-17 for the preparation of a medicament for the ent of xerostomia.

19. Use of the composition of any one of claims 1-17 for the preparation of a medicament for the treatment of mucositis of the oral cavity and/or pharynx.

20. The use of any of claims 18-19, wherein the composition r whitens teeth, ralizes teeth, reduces dental sensitivity, or treats dental caries.

21. The oral care compositions of any one of claims 1 to 5 ntially as herein described with reference to any one of the Examples and/or