Two studies published in the Journal of the American Dental Association (JADA) suggest that dental x-rays are effective screening tools for strokes and osteoporosis.
One study, conducted by researchers at the Veterans Affairs Medical Center in Sepulvada, Calif., examined cepholometric x-rays of 1,063 healthy men between the ages 25 and 85 to determine if they revealed atherosclerotic lesions or blockage in the carotid artery that carries blood to the brain. The V.A. researchers discovered that 2 percent of the subjects had blockages that were visible at the third and fourth cervical vertebrae, an area that is visible to dentists who use a cephalometric x-ray machine. This equipment is commonly used by orthodontists and oral and maxillofacial surgeons to evaluate the jaws and face for deformities.
Arteriosclerosis is the most common cause of stroke. Approximately one-third of individuals suffering a stroke die within the year. The lead researcher, Dr. Arthur Friedlander, recommended that the findings be used by dentists to refer patients with blocked carotid arteries to a physician. Other researchers have recently reported that asymptomatic patients whose carotid artery is more than 60 percent blocked can reduce their risk of stroke by more than half if the plaque is surgically removed. Those with less extensive lesions may require medications to prevent further build up. Earlier studies have shown that a calcified carotid artery is a strong marker of underlying coronary artery disease.
In the other study published in the December JADA, researchers at the University of Washington School of Dentistry conducted an analysis of the panoramic and periapical x-rays of 111 women and found that dental x-rays are as effective as traditional diagnostic methods at distinguishing osteoporatic from non-osteoporatic subjects. The researchers compared diagnostic methods used to evaluate panoramic and periapical dental x-rays and then compared these methods with three standard bone density measurement techniques used to diagnose osteoporosis.
“We found that using the pixel intensity and fractal dimension diagnosis of dental x-rays was just as effective as traditional diagnostic methods in measuring bone density,” said Dr. Anne-Marie Bollen, assistant professor, Department of Orthodontics at the University of Washington School of Dentistry. Pixel intensity refers to the fineness of the x-ray image. Fine pixel intensity allows the dentist or physician to more readily discern bone density. Dr. Bollen stressed that dental x-rays offer advantages over other imaging techniques because dental x-rays are common and are less expensive than other diagnostic imaging methods.
The authors concluded that dental x-rays may serve as a valuable tool to assist dentists in screening their patients for signs of osteoporosis.
The authors note that more than 1 million bone fractures occur in the United States as a result of osteoporosis, a generalized decrease in bone mass that develops in the later decades of life. Early diagnosis of osteoporosis could identify people at risk for experiencing fractures and enable them to take preventive measures.
