Dental X-rays of carotid artery not enough to estimate stroke risk
30 April 2007 A review of research on the detection of calcified tissue
in the carotid artery by dental x-rays has found that the technique does not
give enough evidence to estimate a patient’s stroke risk. The review was
published in the April issue of the Journal of the American Dental
Association (JADA). Panoramic radiography is a procedure used in dental
practice for detecting dental disease. According to authors of the review, a
trend toward using panoramic x-rays to identify stroke-prone patients has
become a much-debated health care issue over the past two decades. In
their literature review, the authors conducted an electronic search using 11
databases to evaluate evidence that links calcified carotid artery atheroma
(CCAA) detection on panoramic radiographs and the precipitation of
cerebrovascular accidents (CVA). The search identified 54 articles for the
review. Only one study satisfied the authors’ inclusion criteria and found
no significant difference in the incidence of cerebrovascular diseases
between subjects with CCAA and subjects without CCAA. Stroke is one of the
leading causes of death and disability among adults in the U.S. It occurs
when a blood vessel that brings oxygen and nutrients to the brain bursts or
becomes clogged by a blood clot or some other mass. This issue is
complicated because there are many risk factors that predispose a person to
generalized atherosclerosis and plaque formation that also can promote the
risk of cerebrovascular blockage and stroke, according to the article.
Incidental findings of CCAA on panoramic radiographs, the authors wrote,
should not be the only basis for estimating risk of stroke. Risk factors
such as age, smoking history, total cholesterol level, systolic blood
pressure and hypertension should receive close examination.
Panoramic radiography may demonstrate that CCAAs calcify over time, but
there is little evidence-based information that CCAAs are risk predictors
for the diagnosis of cerebrovascular disease, they concluded. “Further
research is warranted before any recommendations can be made for or clinical
guidelines developed regarding CCAAs detected on panoramic radiographs to
predict a cerebrovascular accident,” the authors wrote. For more
information about the ADA, visit the Association's website at
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