Study aims to predict strokes using dental X-rays

Mike Zacharias

Richard Madden’s research might make dentists an important tool in determining whether patients are at risk for strokes.

For more than 20 years, medical researchers have tried to determine if dental panoramic X-rays can predict those at risk for a stroke.

Researchers from the School of Dentistry and the HealthPartners Research Foundation said they joined the cause to determine how reliable the X-rays can be.

The panoramic X-rays, done before many oral surgeries, sometimes show calcification of the carotid arteries, located in the neck.

A person’s risk for stroke increases when these arteries narrow.

The researchers are trying to determine whether calcification of these arteries indicate a narrowing as well.

“What no one has ever done is determine if that X-ray, the
calcification that we’re seeing … is reliable at predicting narrowing of that vessel, which is a risk factor for a stroke,” said Madden, the principal research investigator and a clinical assistant professor in the division of oral medicine, diagnosis and radiology.

Madden said the importance of this research is determining whether this common dental tool can help predict those at risk for a stroke or to discern if the topic warrants further study.

To check for narrowing of the carotid arteries, patients have a carotid ultrasound. Past research involved sending a patient to get an ultrasound after calcification was seen in their X-ray. This research was inconclusive, Madden said.

The current research is being done differently, said Colleen Doyen of the School of Dentistry’s Oral Health Clinical Research Center. It is more cost-effective and less invasive.

“This one is done better,” Doyen said. “It starts instead with a patient who has already had the carotid ultrasound … and then we are taking a look at the (panoramic) X-ray of those people.”

HealthPartners patients already having a carotid ultrasound are invited to participate in the study, regardless of the ultrasound’s results. If the patients accept the invitation, they will have a panoramic X-ray completed at the University. The X-rays will be compared with the ultrasound to determine if calcification has a relationship to the narrowing of carotid arteries and how reliable the X-rays are in identifying it.

Examinations for gum disease also are being conducted to check for correlations.

“When you look at the ramifications of a stroke, in not only death but the incredible disabling effect that it has on the individuals, the families and the health care system as a whole, anything we can do to reduce that we feel … should be a great service to the patients we all serve.” said Charles Salmen, the principal investigator for HealthPartners Research Foundation.

The initial study, which began in September, will include 100 patients and take close to a year to finish. If a relationship between calcification and artery narrowing is found, researchers will study the results more conclusively.


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