Findings on a wide-angle or panoramic dental radiograph (x-ray) uncovered a patient’s critically clogged neck arteries, prompting potentially life-saving treatment, according to a case study in the November 2000 issue of the Journal of the American Dental Association (JADA).
“The patient described in our case report had no signs or symptoms of carotid artery (arteries on each side of the neck that carry blood from the heart to the brain) disease,” says lead author Dov Almog, DMD, professor, Eastman Department of Dentistry, University of Rochester, Rochester, N.Y. “She would not have been evaluated or screened for atherosclerotic disease (hardening of the arteries) without our finding calcified carotid plaques on a panoramic radiograph.”
The patient had bilateral high-grade narrowing of the artery associated with high-stroke risk. This type of stroke is common and usually occurs without warning, Dr. Almog says.
However, based on the incidental observation from the x-ray, the 67-year-old female patient received appropriate therapy for her condition.
Approximately 730,000 strokes occur each year in the U.S. One-half of them result from atherosclerotic plaques (build up of cholesterol plaque and other fatty deposits in the arteries) found in the carotid artery, according to the National Stroke Association. Over a lifetime, strokes touch four out of five American families.
“The findings on the panoramic radiograph led to appropriate and potentially life-saving treatment,” Dr. Almog says, “and many more patients may fall into a similar category.”
The patient later underwent a bilateral carotid endarterectomy (surgical removal of plaque blocking or reducing blood flow in a carotid artery). It is performed when the artery is moderately to significantly diseased or blocked — more than 50% blockage.
“Because many significant carotid plaques contain calcium,” he says, “any calcifications found on a panoramic x-ray in the carotid area could prompt further evaluation.
“No method of detection for any disease is 100% accurate,” Dr. Almog adds. “The usefulness of this type of observation obviously will depend on the prevalence and amount of calcium, which varies from patient to patient.”
For information, visit www.ada.org.
With contribution from Chris Smith
Managing Editor, E-dental.com