Dental x-rays may reveal stroke risk in women

By Keith Mulvihill

NEW YORK, Aug 29 (Reuters Health) - People usually visit the dentist with the idea of improving their dental health. But for women older than 55, a trip to the dentist may also yield evidence about stroke risk, according to a new report.

Panoramic dental x-rays can reveal calcifications in the carotid arteries, which increase a person's risk of stroke, the researchers explain.

In the study, Drs. Arthur H. Friedlander and Lisa Altman of Veterans Affairs Greater Los Angeles Healthcare Systems evaluated standard panoramic dental x-rays of 52 postmenopausal women aged 55 to 90 with no prior history of heart attack or stroke. Sixteen (31%) of the women showed evidence of calcification in their carotid arteries.

Women older than 55 who receive panoramic dental x-rays should ask doctors to examine the x-rays for calcification in the carotid arteries that would be consistent with blockage of blood flow to the brain, Friedlander recommended in an interview with Reuters Health.

While the findings offer another avenue of detection for women at risk of stroke, the researchers point out that the medical records of the women with the blockages were "heavily laden" with many other red flags for heart disease and stroke. For instance, 94% of the women were diagnosed with high blood pressure, 50% were characterized as overweight or obese, 38% were heavy smokers, and nearly 70% of the women had high levels of blood fats including cholesterol.

While Friedlander published similar findings in 1981 and again in 1994 from studies of men's dental x-rays, this study, published in the August issue of the Journal of the American Dental Association, is the first to examine dental x-rays of women for blockages, he noted.

More than 60% of the deaths in the United States attributed to stroke occur in postmenopausal women, the report indicates.

As a woman's estrogen levels decrease after menopause, her blood levels of cholesterol increase, which makes her more vulnerable for build-up of arterial plaque, Friedlander explained.

These plaque deposits, which collect in the inner lining of the artery, contain fatty substances such as cholesterol, cellular waste products, calcium and other substances. Plaques may grow large enough to reduce blood flow through an artery. They can also become fragile and rupture. Plaques that rupture form blood clots that can block blood flow or break off and travel to another part of the body. If a clot blocks a blood vessel that feeds the brain, a stroke can result.

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