Dental X-Rays Can Identify Stroke Risk, Researchers Say : Medicine: Films reveal calcification of the neck arteries, one cause of the ailment, two surgeons report. Preventive steps including medication and surgery can then be taken.
Panoramic X-rays taken during a normal dental exam can identify patients with stroke-causing calcification of the neck arteries, opening the door to aggressive, life-saving treatment, according to researchers from UCLA and the Sepulveda Veterans Affairs Medical Center.
Dr. Arthur Friedlander, an oral and maxillofacial surgeon, and Dr. Dennis Baker, a vascular surgeon, studied panoramic X-rays--360-degree views of the mouth and neck areas--from 295 VA patients who were older than 55 and had no symptoms of stroke. They found 10 with calcifications, they will report Wednesday in the Journal of the American Dental Association. These were patients, Friedlander said, whose calcification would have gone undetected until they developed symptoms or had a stroke.
One patient underwent successful surgery and the other nine, who had less severe blockage, are receiving aggressive treatment to reduce risk factors for stroke, such as high blood pressure and smoking.
Most of the nine patients had previously refused to give up smoking or to take blood pressure medication, Friedlander said Monday, but became more cooperative when confronted with physical evidence of their increased risk.
“It makes a dramatic impact when they see in black and white that they have a problem,” he said. “It’s no longer abstract.”
Friedlander is not arguing that people over 55 seek out the panoramic X-rays or be screened for stroke risk. Rather, he is urging dentists to check for calcification when they read the X-rays of a normal exam and to refer suspected cases to cardiologists.
An estimated 150,000 Americans die from strokes each year, and 85,000 of those deaths are the result of blood clots triggered by such calcification.
A National Institutes of Health study released in October reported that surgical intervention to remove the calcification, called a carotid endarterectomy, can sharply reduce the risk of stroke. But there are no organized programs to detect the blockages in patients without symptoms.
“With surgery being shown to be beneficial (in preventing strokes), there is clearly going to be an increased effort toward identifying the asymptomatic patient” with a blockage of the carotid arteries, said Dr. Wesley S. Moore, a UCLA vascular surgeon and member of the American Heart Assn.’s Council on Stroke. “This would certainly complement that effort.”
Dentists already screen their patients for a variety of conditions ranging from oral cancer and sinus abnormalities to disorders of the salivary glands and temporomandibular joints, added Stuart White, a professor of dentistry at UCLA. “This is one more potential problem that they need to be aware of.”
