Removing tarter with nails

RE: Removing tarter with nails

Christina Smith — Fri, 13 Sep 2019 23:01:39 GMT

Radio 4 . Not proven. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814083/ human hookworm v asthma.

An open mind is an intelligent mind - not proven or peer reviewed either

RE: Removing tarter with nails

Beats — Fri, 13 Sep 2019 21:38:44 GMT

[quote user="GrooveJet"]

[quote user="Christina Smith"]some studies suggesting negative correlation with endoparasites[/quote]

That's an interesting snippet... can you remember where you read about this?

[/quote]

did you read this at http://www.tylervigen.com/spurious-correlations ?

Did you know that babies who receive antibiotics in their first year of life are more likely to have health problems Must make sure I don't let the doctor give my sick baby an antibiotic then

Seriously though, I believe there are too many confounding factors in the endoparasites-asthma correlation study (well the one I read anyway about 10 years ago...) to suggest any causation before you start filling your kids with worms.

If there was a correlation between cats living longer and regular effective modern dental treatments, then that wouldn't explain why I see cats living much longer these days than in my younger days (neither would it say that improved dental health does not improve health and longevity). Come to think of it, the average cat seems to weigh more these days, so perhaps obesity is the cause of increased longevity?

RE: Removing tarter with nails

Anthony Todd — Fri, 13 Sep 2019 18:57:11 GMT

PS, now they'd advise a blood test......

RE: Removing tarter with nails

Anthony Todd — Fri, 13 Sep 2019 18:55:53 GMT

[quote user="GrooveJet"]in about 60 seconds from now[/quote]

Sheet, that's long gap! BITD we'd have done a vacc, worming and chip in that time!

PS: and advised that there was no plaque on the 15yo cat it was just a soup of pathogenic backteria [spelling on purpose, sounds more sinister] and the cat might die before it got home....

RE: Removing tarter with nails

Miriam Lodewyks — Fri, 13 Sep 2019 18:36:39 GMT

[quote user="Evelyn Barbour-Hill"]Plaque is a highly structured complete ecosystem consisting of many bacterial species which, despite the large size of the range involved, are pretty well always the same known range of species*, living very healthily within a biofilm which means, not soup, but an organised matrix of complex polycarbohydrates (not unlike Polycell wallpaper paste); within which, bacteria behave rather differently compared to when they are in the planktonic environment which is more familiar to us. There will be some other odd proteins floating about, and a whole catalogue of various cytokines and other "chemical messengers". There are not many host cells there (and any that are will on the whole be healthy and active, not dying (except maybe some degenerating erythrocytes)).[/quote]

Right.

Thanks for the correction.

I shall quote this passage of clinical wisdom to my next client when the topic of plaque rears it's ugly little head... that's in about 60 seconds from now.

I'll let you know their reaction!

RE: Removing tarter with nails

Evelyn Barbour-Hill — Fri, 13 Sep 2019 16:11:53 GMT

[quote user="Iain Richards"]

[quote user="Evelyn Barbour-Hill"]But actual bacteria migrating into the blood (bacteraemia, not septicaemia) from micro-ulcers on the gingival wall of the gingival sulcus are responsible for various chronic progressive damage to organs, notably kidneys. [/quote]

I thought this now wasn't the case. Any references? You word is good enough there, but I like to know a bit more on these things.

[/quote]

Sorry, I am quite unable to quote references on anything off the top of my head. But it's in modern human periodontology literature. Moreover, if Professor Ian Chapple (of Birmingham Dental School) describes it in a seminar, I'll take it as true. Get yourself one of the Cell To Cell DVDs from Quintessence. What has probably been discounted ( or rather, considerably modified and now thought "not quite so simple as that")is the idea that chronic inflammation somewhere leads by itself to damage to parenchymatous organs – that's not the same thing. Of course this all refers to humans, but it seems reasonable to suppose that the same is true in cats and dogs; especially with regard to the kidneys of cats, that seem to constantly be beneath the sword of Damocles.

[quote user="GrooveJet"]

[quote user="Evelyn Barbour-Hill"]No, please, please! Plaque is not pus!! In no way! Not remotely![/quote]

Evelyn. Calm yourself down my good man!

I use this ANALOGY to explain my reasoning to the uneducated public that need a little nudge towards my way of thinking...

[/quote]

Ah. I know you are so I won't tell you what I said to the last person who called me "my good man" nor who it was.

Anyway, I see what you are doing for the public, and that's OK, but personally I try to avoid analogies of this kind – I do remember a disciplinary case where one aspect of the complaint was that the veterinary surgeon had told the owner that the cat had a stomach ulcer when it did not. The fact was that the veterinary surgeon had been trying to explain his tentative diagnosis (I can't remember now what that was), the treatment plan and the depressingly slow progress by saying something like "it's like a stomach ulcer in a person".

I think that most members of the public are capable of grasping in a general sort of way, if you give thenm the chance, the nature of plaque and its development and the consequent pathogenesis.

[quote user="GrooveJet"]Also: how is plaque "not remotely" similar to pus??? they're both soups of biological origin containing vast amounts of bacteria. I'd call that SIMILAR at worst... no?[/quote]

No.

Pus is a completely unstructured aqueous soup consisting mainly of neutrophils (a few live, some dying, some dead), loose planktonic bacteria (a few live, some dying, some dead) which according to cirumstances may be of a single species or several but which certainly represent simply those species that chanced to get in in the first place, various other cellular debris, bits of fibrin and other junk, liquified to variable extent by serum.

Plaque is a highly structured complete ecosystem consisting of many bacterial species which, despite the large size of the range involved, are pretty well always the same known range of species*, living very healthily within a biofilm which means, not soup, but an organised matrix of complex polycarbohydrates (not unlike Polycell wallpaper paste); within which, bacteria behave rather differently compared to when they are in the planktonic environment which is more familiar to us. There will be some other odd proteins floating about, and a whole catalogue of various cytokines and other "chemical messengers". There are not many host cells there (and any that are will on the whole be healthy and active, not dying (except maybe some degenerating erythrocytes)).

*But the range (known rather neatly as the "oral microbiome") is different in different host species. The people at Waltham have done some work on the canine oral microbiome and shown it is not the same as the human.

RE: Removing tarter with nails

Miriam Lodewyks — Fri, 13 Sep 2019 15:28:24 GMT

[quote user="Christina Smith"]some studies suggesting negative correlation with endoparasites[/quote]

That's an interesting snippet... can you remember where you read about this?

RE: Removing tarter with nails

Miriam Lodewyks — Fri, 13 Sep 2019 15:26:10 GMT

[quote user="David Mills"]This theory, whilst neat, has been serially debunked.[/quote]

Really? It was discussed at length and in detail at a human dentistry CPD I attended fairly recently.

Any references you could point me towards?

RE: Removing tarter with nails

Miriam Lodewyks — Fri, 13 Sep 2019 15:23:02 GMT

[quote user="Evelyn Barbour-Hill"]No, please, please! Plaque is not pus!! In no way! Not remotely![/quote]

Evelyn. Calm yourself down my good man!

I use this ANALOGY to explain my reasoning to the uneducated public that need a little nudge towards my way of thinking...

Also: how is plaque "not remotely" similar to pus??? they're both soups of biological origin containing vast amounts of bacteria. I'd call that SIMILAR at worst... no?

[quote user="Evelyn Barbour-Hill"]Not the chronic inflammation [/quote]

I'm confused now because this is exactly the opposite of what I was told at a human dentistry congress fairly recently.

RE: Removing tarter with nails

Anthony Todd — Fri, 13 Sep 2019 15:18:31 GMT

As a connected aside do all wear gloves now when examining the mouth, and/or the rest, thus preventing the thumb-nail-flick?

RE: Removing tarter with nails

Iain Richards — Fri, 13 Sep 2019 14:16:06 GMT

I thought this now wasn't the case. Any references? You word is good enough there, but I like to know a bit more on these things.

Slef confessed tartar-exiteer who has read this thread with interest, thanks

RE: Removing tarter with nails

Anthony Todd — Fri, 13 Sep 2019 11:11:48 GMT

[quote user="Lucy Fleming"]Over and above the fact that it achieves nothing to improve the pet's oral health...i[/quote]

I can't believe I read this!

The "damaged" [seeing there's actually no pus, or pathology I've been told] returns to normal even if the tartar build up starts again, if initially invisably.

The smell stops, the pet seems happier, so the owner reports when [sometimes ]they return for another matter or even a proper dental.

RE: Removing tarter with nails

Lucy Fleming — Thu, 12 Sep 2019 12:02:50 GMT

Over and above the fact that it achieves nothing to improve the pet's oral health...it's quite gross? Who wants a pet's oral bioflora jammed under your thumbnail?

RE: Removing tarter with nails

Evelyn Barbour-Hill — Wed, 11 Sep 2019 22:18:44 GMT

[quote user="GrooveJet"]one little trick I find helpful in swaying people is to explain that plaque = pus, [/quote]

No, please, please! Plaque is not pus!! In no way! Not remotely!

But actual bacteria migrating into the blood (bacteraemia, not septicaemia) from micro-ulcers on the gingival wall of the gingival sulcus are responsible for various chronic progressive damage to organs, notably kidneys. Not the chronic inflammation (you are correct, Mr. Mills) but the bacteria themselves wriggling around, via a chain of events. Kidneys of course especially vulnerable cos once a nephron is jiggered, it's jiggered.

RE: Removing tarter with nails

Stephen Courtney — Wed, 11 Sep 2019 21:15:26 GMT

[quote user="GrooveJet"]

On a slightly different tangent: my grandfather was a surgeon. He was firmly of the opinion that one of the biggest contributing factors to the increased life-expectancy of people in the past century is better oral hygiene. Chronic low-level inflammation caused by gingivitis and periodontitis undoubtedly causes long, slow, on-going damage to multiple organs... often ignorantly called "aging".

[/quote]

One of my favourite museums is the Royal College of Surgeons' Hunterian Museum. It contains a vast collection of bits of deceased 17th Century peasantry collected by Mr hunter, who presumably had a similar sense of entitlement to our current government. Or just different times, different ethics...

Anyhoo, people in those days seemed to die from one of three things.

TB, syphilis, and dental disease. Often all three at once.

So I totally agree with Groovejet's Grandfather

RE: Removing tarter with nails

Christina Smith — Wed, 11 Sep 2019 20:24:44 GMT

IMO large chunks of tartar build up on carnassial indicate aversion to chewing. Probably swallowing food whole or overuse on opposite side. Often an underlying painful enamel erosion. Of course not published evidence buts lots of anecdote ! On the tangent thought I wonder if dental cases have less proneness to asthma given some studies suggesting negative correlation with endoparasites.

RE: Removing tarter with nails

David Mills — Wed, 11 Sep 2019 19:57:02 GMT

[quote user="GrooveJet"]

[/quote]

This theory, whilst neat, has been serially debunked. We replace all our cells (apart from nerves and dentine and other bits) every few years as part of regeneration, its a continual process. The body is very good at localising inflammation.

RE: Removing tarter with nails

Miriam Lodewyks — Wed, 11 Sep 2019 18:36:10 GMT

Right. I'll get down off my dais now....

RE: Removing tarter with nails

Miriam Lodewyks — Wed, 11 Sep 2019 18:34:34 GMT

RE: Removing tarter with nails

Miriam Lodewyks — Wed, 11 Sep 2019 18:02:35 GMT

Anthony, I get where you're coming from. I do. I used to feel exactly the same way.

BUT. Then I did some seriously good CPD and realised that the crowns are on the whole a really poor reflection of the pathology lurking below the gums, and since I've been xraying teeth that's been borne out. Once you truly understand what Rob Davies explains above, you realise that (tempting as it is), flicking the tartar may reduce or change the bacterial biofilm for a short period of time, but does NOTHING for the resorptive lesions and periodontal issues you can't see.

Flick it off by all means, but still try convince the clients that a full oral health assessment is necessary.

PS: one little trick I find helpful in swaying people is to explain that plaque = pus, and that when that stuff gets below the gumline it's leaching into the bloodstream constantly, causing low-level septicaemia. That usually gets their attention.

RE: Removing tarter with nails

Anthony Todd — Wed, 11 Sep 2019 17:07:46 GMT

Crikey, all those years seeing gums dripping a thick yellow fluidy stuff which was under the 5+mm of tartar just flicked off and the teeth from gum to crown suprisingly white and shiny, even a nice tooth/gum margin most times.

Must have been dreaming or still have had that bad leak in the Stephens............

RE: Removing tarter with nails

Evelyn Barbour-Hill — Wed, 11 Sep 2019 16:59:08 GMT

[quote user="Anthony Todd"]underlying purulent destroyed gum with usually apparently good teeth beneath[/quote]

NOT purulent. As for "apparently good teeth", periodontal disease is a disease of the periodontium, not of the tooth, certainly not of the crown of the tooth which is all you can see.

[quote user="Anthony Todd"]The gums then revert to normal, certainly for a time, with no signs of any pathology.[/quote]

I think not.

[quote user="Anthony Todd"]This is surely better than doing nothing but advising a full dental procedure with GA and etc. and not flicking the tartar off at the time?[/quote]

I leave you with this thought. What about the diseased gingiva of all the other teeth which didn't happen to have convenient great chunks of calculus that you could so satisfyingly flick off?

RE: Removing tarter with nails

Anthony Todd — Wed, 11 Sep 2019 16:01:47 GMT

Why I come back is as I, and others, have noticed on many occasions when the door-step tartar is flicked off it exposes the underlying purulent destroyed gum with usually apparently good teeth beneath.

The gums then revert to normal, certainly for a time, with no signs of any pathology.

This is surely better than doing nothing but advising a full dental procedure with GA and etc. and not flicking the tartar off at the time?

The dentists on here don't seem even to concide this first step?

RE: Removing tarter with nails

Rob Davis — Wed, 11 Sep 2019 15:32:38 GMT

[quote user="Anthony Todd"]

I don't want to turbo but, as others have admitted to the "tartar flick", and you say I'm "obsessed, ignore it ", tell us all what your approach is to the 5mm+ doorstep tartar on a "mature" cat in for something unrelated to the mouth.

Do you just leave the tartar without the obvious humane flick and advise further or what?

[/quote]

I have tried really hard to stay out of this but.....

Calculus (tartar) is generally not considered to be pathogenic in itself. Occasionally there will be trauma to adjacent soft tissues from severe build up. Plaque is the root of (almost) all evil in the mouth. The main problem with calculus is that it harbours plaque and protects it from our efforts to disrupt and remove it. Simply flicking of the calculus will leave a rough surface on the tooth on which plaque will quickly recolonise. If we are talking about periodontal disease (comprising gingivitis and periodontitis) then this is entirely caused by subgingival plaque and the patient's immune response to it. Flicking off the calculus does not address this pathogenic region at all.

The other really common dental pathology seen in cats is tooth resorption, and it is conceivable that in some situations calculus build up could actually reduce discomfort by covering exposed dentine tubules or even pulp and reducing exposure to the oral environment. Removing this calculus without addressing the other issues is at best useless and at worst causing increased discomfort.

So no, I wouldn't "just leave the tartar". I would advised that we perform a proper dental examination (which is simply not possible in any of our patients without anaesthesia) and then decide on what treatment would be appropriate based on the diagnosis made (and yes that would include radiography).

RE: Removing tarter with nails

Anthony Todd — Wed, 11 Sep 2019 14:55:59 GMT

So you're a non-tartar flicker during say, a booster visit, or do you, as most did, do the flick and advise further??