Tuesday, January 7, 1997
HEALTH:
Study finds that routine dental x-rays can help detect blocked
arteriesBy Kathryn Combs
Daily Bruin Contributor
While the routine dental visit may seem unpleasant to some, a
recent study by the Veterans Affairs Medical Center and the UCLA
School of Dentistry has shown that these visits may save a person’s
life.
The study, published in the December issue of the Journal of the
American Dental Association, has found that x-rays routinely used
on patients seeking treatment such as orthodontics or implants are
able to detect small calcified plaques located in the carotid
arteries of the neck and head.
An individual with these blockages is more likely to suffer from
stroke and other heart-related problems, regardless of whether they
already exhibit symptoms of disease, said Dr. Arthur Friedlander,
an associate professor of oral and maxillofacial surgery at the
UCLA School of Dentistry.
Strokes are caused when the brain is starved of oxygen, which is
supplied by blood vessels and arteries. A stroke occurs when there
is either an abundance or reduction in the blood supply to the
brain. As a consequence, the brain tissue becomes compressed,
leading to permanent damage and loss of function.
Friedlander, who is one of the primary researchers, first
noticed these plaques in 1980. By examining the dental x-rays of
1,063 male veterans ranging in age from 25 to 85, he found that
none of these individuals had symptoms of disease. However, 3
percent of patients older than 55 had formed calcified plaques in
branches of the carotid arteries.
Researchers then determined that the formation of such blockages
may indicate disease located in other parts of the body.
"We have more that 150,000 people that die from stroke and an
additional 400,000 that suffer from non-fatal strokes," said
Friedlander, who is also Chief of Dental Services at the Sepulveda
VA Hospital.
Among factors leading to stroke and other heart-related problems
are cigarette smoking, obesity and high blood pressure.
Friedlander stresses the importance of the study’s findings in
predicting who is susceptible to stroke and says that there are
measures that can be taken to prevent the formation and growth of
already existing plaques, through use of dental x-rays.
"The fact is that stroke is the number three killer in the U.S.
and heart disease is the first; this has got to be a major
contribution of dentistry to America’s public health," said
Friedlander.
While many agree that this is a significant discovery, they
stress that it is not the only way to determine the extent of
disease in the carotid arteries.
"This is not a very efficient way of determining disease of the
carotid arteries," said Dr. J. Dennis Baker, professor of surgery
with the UCLA School of Medicine. "However it’s additional
information that can help in the overall management of the
patient."
A person whose arteries are more that 60 percent blocked is an
immediate candidate for the surgical removal of these plaques
because of the higher risk of stroke associated with formation of
the blockages.
Friedlander says that blocked blood vessels of the heart also
lead to nearly 1.5 million heart attacks in the United States
annually.
Dr. Wesley Moore, a professor of surgery/vascular disease at
UCLA, said that this research is significant in terms of
referral.
"The importance of this is to make dentists aware that there is
additional information that can be obtained at the time of the
x-ray," Moore said. "If they happened to be examining someone in
whom the dental x-ray shows calcification, they should inform the
patient and refer them to a vascular disease specialist." he
said.
This is the first time that routine dental x-rays, also called
lateral cephalometric x-rays, have been used to help diagnose
arterial blockages.
"Dentists that use these x-rays … must look beyond the
confines of the teeth to the neck," said Friedlander.
"I have not seen another dental discovery which has the
potential impact on the systemic health of Americans at any other
point in time," Friedlander said.
JUSTIN WARREN/Daily Bruin
Dr. Arthur Friedlander, an associate professor of oral and
maxillofacial surgery at the UCLA School of Dentistry, has found
that routine dental x-rays can detect precursors to stroke.Photo
Courtesy of Dr. Arthur Friedlander
Blockages in the areas indicated by the arrows can increase risk
for stroke and heart problems later in life.