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Panoramic dental radiography: an aid in detecting individuals prone to stroke
A H Friedlander1, I K Friedlander
1Dental Service, VA Medical Center, Sepulveda, CA 91343, USA.
Insights
Dentists can identify stroke risk factors on panoramic radiographs. Partially calcified atherosclerotic lesions in the carotid artery may appear as distinct opacities on dental X-rays, aiding early detection in at-risk individuals.
Area of Science:
- Dentistry
- Radiology
- Vascular Medicine
Background:
- Stroke, or cerebrovascular accident (CVA), is a leading cause of death and disability.
- Atherosclerotic lesions at the carotid artery bifurcation are a primary cause of stroke.
- These lesions can be partially calcified and visible on dental radiographs.
Observation:
- Calcified atheromas may manifest as nodular masses or two vertical lines on panoramic radiographs.
- These opacities are located in the neck's soft tissues, near the C3 vertebra.
- The opacities are distinct from the hyoid bone.
Findings:
- Panoramic dental radiographs can reveal signs of carotid artery atherosclerosis.
- Radiopaque findings suggestive of atheroma are identifiable in individuals over 55.
- Risk factors for atherosclerosis and stroke include hypertension, diabetes, smoking, and obesity.
Implications:
- Dentists play a role in identifying potential stroke risk factors.
- Routine review of panoramic radiographs in older patients with risk factors is recommended.
- Early detection of atherosclerosis via dental imaging may prompt preventative medical intervention.
Abstract:
Stroke (cerebrovascular accident, CVA) is the third leading cause of death and an important cause of hospital admission and long-term disability in England and Wales. Atherosclerotic lesions at the bifurcation of the common carotid artery are the most common cause of stroke. On occasion, these lesions are partially calcified and visible on a conventional panoramic dental radiograph. The atheroma may appear either as a nodular radiopaque mass or as two radiopaque vertical lines within the soft tissues of the neck at the level of the lower margin of the third cervical vertebra (C3). These opacities are separate and distinct from the hyoid bone and variably appear above or below it. Dentists should scrupulously review the panoramic radiographs of all individuals over the age 55 with medical histories (hypertension, diabetes mellitus, hypercholesterolaemia, coronary artery disease) and behaviours (smoking, alcohol abuse, dietary indiscretion, overweight, sedentary life-style) known to be associated with atherosclerosis and stroke.