PANORAMIC DENTAL RADIOGRAPHY - AN AID IN DETECTING INDIVIDUALS PRONE TO STROKE

Stroke (cerebrovascular accident, CVA) is the third leading cause of d eath and an important cause of hospital admission and long-term disabi lity in England and Wales. Atherosclerotic lesions at the bifurcation of the common carotid artery are the most common cause of stroke. On o ccasion, these lesions are partially calcified and visible on a conven tional panoramic dental radiograph. The atheroma may appear either as a nodular radiopaque mass or as two radiopaque vertical lines within t he soft tissues of the neck at the level of the lower margin of the th ird cervical vertebra (C3). These opacities are separate and distinct from the hyoid bone and variably appear above or below it. Dentists sh ould scrupulously review the panoramic radiographs of all individuals over the age 55 with medical histories (hypertension, diabetes mellitu s, hypercholesterolaemia, coronary artery disease) and behaviours (smo king, alcohol abuse, dietary indiscretion, overweight, sedentary life- style) known to be associated with atherosclerosis and stroke.