Detection of Carotid Artery Blockage in the Dental Setting

Objectives: This study investigated the possible role for dentists in the early detection and/or prevention of thrombolytic cerebrovascular attacks (stroke) using ultrasound. Methods: 100 subjects completed a survey concerning their atherosclerosis 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 (Model: Titan, SonoSite Inc., Bothell, WA). Images were subsequently interpreted. Results: From the 100 subjects studied: 64 female/36 male; 80 Caucasian, 6 African American, 6 Asian, 2 Hispanic, and 6 other/unreported. The average age of the study population was 42 years (ranging from 18 to 80 years) and 36 subjects were older than 50. Based on body-mass index determinations, 53 individuals were healthy, 29 overweight, 11 obese and 1 extremely obese. 14 individuals reported high cholesterol levels, 2 diabetes, 6 were smokers (avg: 0.5 pack/day), and 16 were past smokers (avg: 1 pack/day). All subjects reported blood pressure within normal limits, some controlled by medication. We found images suggestive of atherosclerotic plaque build-up in two Caucasian females: one 59 year-old with risk factors including: past smoker, high cholesterol, 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. Conclusions: 2% of the patient adult population may have carotid blockages detectable by ultrasound. 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. The dentist is particularly well suited for this role because he/she sees patients every 6 months while a physician can go years without seeing his/her patients. This study was supported by the NIH Grant UL1-RR024153.