Detection of calcified tissue in the carotid artery by dental x-rays is not enough evidence to estimate a patient’s stroke risk, according to a literature review published in the April issue of the Journal of the American Dental Association. Stroke is one of the leading causes of death and disability among adults in the United States. 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. According to the authors, a trend toward using panoramic x-rays to identify stroke-prone patients has become a much-debated healthcare issue. The authors conducted an electronic search using 11 databases to evaluate evidence that links calcified carotid artery atheroma (CCAA) detection on panoramic radiographs to 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 be-tween the subjects with and without CCAA. This issue is complicated by the many risk factors that predispose a person to generalized atherosclerosis and plaque formation that also can promote the risk of cerebrovascular blockage and stroke. 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.”
(Source: American Dental Association, April 20, 2007)
