Dental Panoramic Radiographs as Opportunistic Screening for Carotid Calcifications: A Case-Based Review

TL;DR

Dentists can spot signs of heart disease in routine dental X-rays, helping identify patients at risk.

Contribution

Highlights the potential of panoramic radiographs for opportunistic detection of carotid calcifications.

Findings

Carotid calcifications can be incidentally detected on dental panoramic radiographs.

Such findings may indicate increased risk of stroke and heart attack.

Dentists can play a preventive role by referring patients for further medical evaluation.

Abstract

The incidental detection of carotid artery calcifications on routine panoramic radiographs highlights the preventive role of dentists in identifying patients at cardiovascular risk. This case-based review describes the unexpected finding of unilateral radiopaque masses at the level of the cervical vertebrae C3-C4 on the right side of a panoramic radiograph, consistent with carotid artery calcifications. Such findings are clinically significant due to their possible association with cerebrovascular and cardiovascular events, including stroke and myocardial infarction. Although panoramic radiographs are not designed as screening tools for vascular disease, they may incidentally reveal calcifications in the carotid region, offering a unique opportunity for early recognition and timely medical referral. Emerging evidence suggests that the prevalence of these incidental findings is not negligible, reinforcing the need for increased awareness among dental professionals. While advanced imaging modalities are more accurate in detecting early vascular changes, panoramic radiographs are routinely performed in dental practice, making them a valuable tool for opportunistic detection. This case highlights the importance of interdisciplinary collaboration, where dentists play a pivotal role in the early identification of systemic conditions beyond the oral cavity, potentially reducing the risk of adverse vascular outcomes.

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