ABSTRACT It has been suggested that atherosclerotic plaques can be visualized in a panoramic radiograph but this tool is not reliable for systematic screening of patients due to its low sensitivity. This study investigated the potential role for dental practitioners in using an ultra- sound machine to detect carotid artery plaques. 100 subjects completed a survey concerning theirathero-sclerosis risk factors. Bilateral images and digital video clips of the carotid arteries of each person were obtained with a portable high-resolution ultrasound device equipped with an L38/10-5 MHz linear-array transducer. Images were subsequently interpreted. We found images suggestive of atherosclerotic plaque build-up in two Caucasian females: one 59 year-old with risk factors including: past smoker, high choles- terol, and family history of atherosclerosis and one 54 year-old with risk factors including: past smoker, overweight, and reported no physical activity. Both individuals were referred to their primary care providers for further assessments. 2% of the patient adult population may have carotid blockages detectable by ultrasound. The frequency can be as high as 5.5% in individuals older than 50. In the dental setting, ultrasound imaging can be used to capture bilateral pictures of the carotid arteries. With these images, at-risk patients may be screened for atherosclerotic plaques that could ultimately form a stroke-causing embolus. The dentist is particularly well suited for this role because he/she sees patients every six months while a physician can go years without seeing his/her patients.
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Vieira, A. and Babb, L. (2012) Detection of carotid artery plaques in the dental setting. Open Journal of Stomatology, 2, 136-139. doi: 10.4236/ojst.2012.22024.
 Friedlander, A.H., Manesh, F. and Wasterlain, C.G. (1994) Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. Oral Surgery Oral Medicine Oral Pathology, 77, 669-673.
 Carter, L.C., Tsimidis, K. and Fabiano, J. (1998) Carotid calcifications on panoramic radiography identify an asymptomatic male patient at risk for stroke. A case report. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics, 85, 119-122.
 Almog, D.M., Illig, K.A., Khin, M. and Green, R.M. (2000) Unrecognized carotid artery stenosis discovered by calcifications on a panoramic radiograph. Journal of American Dental Association, 131, 1593-1597.
 Ohba, T., Takata, Y., Ansai, T., Morimoto, Y., Tanaka, T., Kito, S., Awano, S., Akifusa, S. and Takehara, T. (2003) Evaluation of calcified carotid artery atheromas detected by panoramic radiograph among 80-year-olds. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics, 96, 647-650.
 Almog, D.M., Illig, K.A., Elad, S., Romano, P.R. and Carter, L.C. (2005) Supplementary role of panoramic radiographs in the medical surveillance of a patient at risk for stroke. Compendium of Continuing Educationin Dentistry, 26, 369-372.
 Bayram, B., Uckan, S., Acikgoz, A., Müderrisoglu, H. and Aydinalp, A. (2006) Digital panoramic radiography: A reliable method to diagnose carotid artery atheromas? Dentomaxillofacial Radiology, 35, 266-270.
 Kumagai, M., Yamagishi, T., Fukui, N. and Chiba, M. (2007) Long-term cigarette smoking increases the prevalence of carotid artery calcification seen on panoramic dental radiographs in male patients. Tohoku Journal of Experimental Medicine, 212, 21-25.
 Ramesh, A. and Pabla, T. (2007) Panoramic radiographs: A screening tool for calcified carotid atheromatous plaque. Journal of Massachusetts Dental Society, 56, 20-21.
 Griniatsos, J., Damaskos, S., Tsekouras, N., Klonaris, C., and Georgopoulos, S. (2009) Correlation of calcified carotid plaques detected by panoramic radiograph with risk factors for stroke development. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics, 108, 600-603. doi:10.1016/j.tripleo.2009.03.041
 Dolatabadi, M.A., Motamedi, M.H., Lassemi, E. and Janbaz, Y. (2010) Asymptomatic carotid artery calcifications discovered on panoramic radiograph. General Dentistry, 58, 97-99.
 Bayer, S., Hefgen, E.H., B?s, C., Kraus, D., Enkling, N. and Mues, S. (2011) Prevalence of findings compatible with carotid artery calcifications on dental panoramic radiographs. Clinical Oral Investigations, 15, 563-569.
 Kamikawa, R.S., Pereira, M.F., Fernandes, A. and Meurer, M.I. (2006) Study of the localization of radiopacities similar to calcified carotid atheroma by means of panoramic radiography. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics, 101, 374-378.
 Damaskos, S., Griniatsos, J., Tsekouras, N., Georgopoulos, S., Klonaris, C., Bastounis, E. and Tsiklakis, K. (2008) Reliability of panoramic radiograph for carotid atheroma detection: A study in patients who fulfill the criteria for carotid endarterectomy. Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics, 106, 736-742.
 Yoon, S.J., Yoon, W., Kim, O.S., Lee, J.S. and Kang, B.C. (2008) Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery. Dentomaxillofacial Radiology, 37, 104-108. doi:10.1259/dmfr/86909790
 Khosropanah, S.H., Shahidi, S.H., Bronoosh, P. and Rasekhi, A. (2009) Evaluation of carotid calcification detected using panoramic radiograph and carotid Doppler sonography in patients with and without coronary artery disease. British Dental Journal, 207, E8.
 Spence, J.D. (2006) Technology insight: Ultrasound measurement of carotid plaque—Patient management, genetic research, and therapy evaluation. Nature Clinical Practice Neurology, 2, 611-619.
 Hendricson, W.D. and Cohen, P.A. (2001) Oral health care in the 21st century: Implications for dental and medical education. Academy of Medicine, 76, 1181-1206.
 Lewis, D.A. and Brooks, S.L. (1999) Carotid artery calcification in a general dental population: A retrospective study of panoramic radiographs. General Dentistry, 47, 98-103.