Dental X-Ray Uncovers Clogged Artery

November 28, 2000

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.

"The patient described in our case report had no signs or symptoms or carotid artery (arteries on each side of the neck that carry blood from the heart to the brain) blockage," said lead-author Dr. Dov M. Almog, associate professor, University of Rochester Eastman Department of Dentistry. " 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 relatively common and usually occurs without warning," Dr. Almog said. 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 United States. One-half of them result from atherosclerotic plaques, which is a build up of cholesterol plaque and other fatty deposits in the arteries and 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 said, "and many more patients may fall into a similar category." The patient later underwent a bilateral carotid endarterectomy, which is a 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 percent blockage.

Because many significant carotid plaques contain calcium, 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 percent accurate," said Dr. Almog. "The usefulness of this type of observation obviously will depend on the prevalence and amount of calcium, which varies from patient to patient."

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