Finding Carotid Plaque On A Standard Dental X-Ray May Predict Fatal Heart Attack Or Stroke, UB Study Finds

WASHINGTON, D.C. -- Everyone knows that clogged arteries increase the risk of a heart attack or stroke. Unfortunately, most people don't know they have clogged arteries until they actually have a heart attack or some other serious cardiovascular event. By that time, the damage may already be done.

Evidence is mounting, however, that information gleaned from a routine dental X-ray may serve as an accurate early-warning system of risk of dying from heart attack or stroke.

Researchers from the University at Buffalo School of Dental Medicine reported here today (April 4) at the International Association for Dental Research that calcifications in the carotid arteries, which show up on standard panoramic X-rays, can serve as significant predictors of death from cardiovascular disease. The study was conducted in a population with a high incidence of diabetes.

"Results of this study move us closer to the use of panoramic dental radiographs as a screening tool for all cardiovascular disease," said Laurie Carter, D.D.S., Ph.D., UB associate professor of oral diagnostic sciences and senior author on the study. "It is a very significant step in that direction. However, we need more of this type of research in a general population."

In a 1997 study published in the Journal of the American Dental Association, Carter showed that panoramic dental X-rays -- wide-angle frontal images taken to establish the baseline condition of teeth and surrounding bone -- also revealed any calcium deposits present in the carotid arteries. These are the large vessels on either side of the neck that carry blood from the heart to the brain and back. The study involved 2,700 new patients in UB's dental clinics.

Carter and colleagues conducted the current research among the Pima Indians of the Gila River Indian Community in Arizona. These Indians are distinctive because they have one of the world's highest incidence of Type 2 diabetes, known as adult-onset or non-insulin-dependent diabetes, and a low incidence of cigarette smoking.

This relative homogeneity renders the group particularly useful for studying risk factors for cardiovascular disease, Carter said. A wide variety of data, including regular dental X-rays, was collected from the group during an epidemiologic study conducted from 1983-1990. Death statistics also are available through 1998.

The UB researchers evaluated baseline panoramic dental X-rays for calcified plaque in the carotid arteries from 818 participants. They found calcification in 7.5 percent of the study group. Calcified plaque is found in only about 3 percent of the general population, Carter said.

Comparing calcification with cause of death, they found that people with plaque in the carotid arteries were twice as likely to die from heart attack or stroke than those with no plaque.

Also involved in the research were William Wordworth, UB dental student; Robert J. Genco, D.D.S., Ph.D., professor and chair of the UB Department of Oral Biology; William Knowler, M.D., David Pettitt, M.D. and Marc Shlossman, D.D.S. of the Public Health Service in Arizona; Robert Dunford, UB senior programmer, and John Duthie, UB dental student.

The study was support by grants from UB and the National Institutes of Health.