Recognizing calcifications of the carotid artery on panoramic radiographs to prevent strokes

Panoramic radiographs are made routinely in dentistry and are regarded as a standard component of an initial dental examination. Often, these radiographs show opacities in the carotid artery territory (CAT), which frequently arise as a result of calcification in the internal (ICA) or external carotid artery (ECA). This study details the examination of patients with suspected calcifications in the carotid artery (CA), using a sonographic examination based on the panoramic radio graphs to confirm or rule out a possible stenosis in the cervical bloodvessels. Thirty-three patients were examined sonographically. Based on the ultrasound investigation in 4 patients, hemodynamic stenoses were detected. Eighteen patients had an atheroma in the ICA, but no hemodynamic stenosis, and 5 patients showed no sign of calcification. Three patients were not examined sonographically at the University Hospital in Basel and were therefore excluded from the evaluation. Three patients did not attend the sonographic examination. The diagnosis of panoramic radiographs should not be restricted to teeth and jaws; especially in patients over 50 years old and in those with health risk factors, greater attention should be paid to the lateral areas. Using the radiographs they already have, dentists can also contribute.