Panoramic radiographs: a screening tool for calcified carotid atheromatous plaque
Aruna Ramesh1, Tarunjeet Pabla
1Department of General Dentistry, Tufts University School of Dental Medicine, USA.
Insights
Panoramic radiographs can screen for cervical carotid artery calcifications, a major cause of stroke. Early detection during dental visits may reduce healthcare costs and improve patient outcomes.
Area of Science:
- Cardiovascular disease screening
- Oral and maxillofacial radiology
- Public health
Background:
- Stroke is a leading cause of death, with atherosclerosis in the cervical carotid artery being a primary contributor.
- Atherosclerotic plaque in the carotid arteries results in substantial annual healthcare expenditures.
- Panoramic radiographs are widely utilized in dental practices.
Observation:
- The carotid bifurcation, a common site for atherosclerotic plaque, is visible on panoramic radiographs.
- Panoramic radiography is a frequently used diagnostic tool in private dental settings.
Findings:
- Calcifications in the cervical carotid arteries can be identified using panoramic radiographs.
- This oral manifestation of systemic atherosclerosis is detectable via routine dental imaging.
Implications:
- Utilizing panoramic radiographs for carotid artery calcification screening can aid in early stroke risk identification.
- Integrating this screening into routine dental care may reduce morbidity and healthcare costs associated with atherosclerosis.
- This approach offers a cost-effective method for detecting a significant risk factor for stroke.
Abstract:
Stroke is the third leading cause of death in the United States, according to a 2005 National Center for Health Statistics report. Atherosclerotic plaque in the cervical carotid artery accounts for a major proportion of strokes and also leads to billions of dollars in direct and indirect costs annually. The carotid bifurcation area, which is a likely site for atherosclerotic plaque accumulation, is well within the field of view of a diagnostic panoramic radiograph. Panoramic radiographs are the most frequently used extraoral images in private dental practices. It is only logical to use this widely available diagnostic tool to screen for calcifications in the cervical carotid arteries. If this oral and maxillofacial manifestation of a systemic disorder is identified during routine dental care and the patient is referred for appropriate follow-up and management, it would help reduce morbidity and bring significant savings in overall health care costs associated with atherosclerosis.
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