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Dental
X-Rays Can Detect Stroke Risk
Excerpt
By Nancy A. Melville, HealthScoutNews
(HealthScoutNews) -- A routine trip
to the dentist could prove to be a lifesaver for women at risk
of stroke.
According to new research published in the Journal of the
American Dental Association, X-ray technology that's being
used by an increasing number of dentists allows for the detection
of neck arteries blocked by hardened fatty tissues, or atheromas.
Such blockages often occur without symptoms and, in worst cases,
can lead to stroke.
The X-ray technology in question allows for panoramic or "wide-angle
radiography." Currently, about 50 percent of American dentists
use this type of X-ray, according to the researchers.
For the study, the researchers reviewed the X-rays and medical
records of 52 female military veterans who averaged 70 years of
age. To participate in the study, the women had to have no symptoms
of neurological disease or illness.
During the review, the researchers found that 31 percent -- or
16 of the women -- had atheromas in the neck.
Because they were asymptomatic, it's unlikely the women would
have been diagnosed until they had developed more dangerous symptoms,
says Dr. Arthur H. Friedlander, associate chief of staff and director
of graduate medical education at the Veterans Affairs Greater
Los Angeles Healthcare System, and lead author of the study.
"It's fortuitous that we found these on these X-rays because
individuals [without symptoms] are usually not otherwise screened,"
he says.
There was no follow-up done on the women's conditions for the
study, Friedlander says, but he knew of at least one participant
who had undergone surgery to remove the blockage.
Lest patients begin asking their dentists for neck X-rays, however,
Friedlander emphasizes that the technique should only be used
when a patient already needs an X-ray for a justifiable dental
purpose.
That's because X-rays subject patients to radiation that should
only be used when necessary. Also, ultrasound screenings used
by doctors are necessary to determine the nature of the atheroma,
the extent of the blockage and the necessary treatment, he says.
"There are more sensitive imaging systems which can pick
up much earlier lesions than we're picking up with these X-rays,"
Friedlander says. "So, if a person was interested in finding
out whether they were at risk, they are best advised to go see
a doctor first.
"We don't want dentists to take these X-rays just to look
for these atheromas in the neck," he adds. "There needs
to be a dental rationale and a need. Once that's been met, then
since it's already there, the dentist needs to review the entirety
of the radiograph and not just the teeth."
Atheromas occur more often in post-menopausal women than men
as estrogen levels decline. When the blockage is less than 60
percent, the treatment normally consists of medications, such
as hypertension drugs, along with lifestyle changes to treat conditions
like obesity or diabetes.
More severe blockages can be treated with surgery, Friedlander
says.
Some symptoms of an atheroma include short-term loss of strength
in a hand, an arm, a leg or a foot, as well as short-term difficulty
in speaking, says Dr. Richard Latchaw, chief of the Department
of Neuroradiology at the University of Pittsburgh Medical Center.
"Those are very dangerous situations and if you have something
like that, go to your doctor and have a work-up soon, even if
it goes away, because that's a harbinger for an increased risk
of stroke," says Latchaw, who's also a spokesman for the
American Stroke Association.
Latchaw shares Friedlander's concern that the study might prompt
some dentists or patients to see dental X-rays as a first-line
means of detecting atheromas.
"I'm worried dentists may look at this and say, 'Hey, I've
got another use for my X-ray machine.' And we're saying, 'No,
don't do that,' " Latchaw says.
However, Friedlander says it behooves dentists to make a habit
of looking not just at the teeth in X-Rays, but also checking
for atheromas.
"If you [a dentist] happen to see the [atheroma] while looking
at dental X-rays, refer the patient to a general practitioner
and that doctor will hopefully just order an ultrasound to see
if there is significant narrowing. And if there is, that is a
patient who will go on to some kind of definitive therapy,"
Friedlander says.
What to Do: Visit the
American Stroke Association for more information on the symptoms
and treatment for stroke. And the American Heart Association has
a helpful site on
women and stroke.
Reference
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