Went to the dentist yesterday for a regular cleaning and since they hadn't run xrays in a while they ran some. Anyway, they found a carotid artery with some blockage and just wondering if any of you have ever had this and how it was treated.

I have my general practice doctor's appt already set up for tomorrow and he's expected to give the orders for a CT. Got a lil extra nervous that my doctor had me scheduled for June initially but when he saw the dentist xray moved me up to an appointment tomorrow. Also made the huge mistake of reading up on this on the internet (huge and stupid mistake) :/ . Anyway, just a lil nervous and curious to know if any of you have dealt with this.

Google says that calcified triticeous cartilage is often misdiagnosed as carotid atheroma. Hopefully it's that.

You come into my office tomorrow I'm ordering a carotid ultrasound. If abnormal then CTA of head and neck.

I would take the dental xrays with a grain of salt

Early detection is a good thing, IF that is indeed what they are seeing. It's better to see an issue and address it before it becomes a real problem.

My grandfather was diagnosed with 90% occlusion in one carotid and 100% in the other (this is what I was told ~7 years ago and I've learned my family is atrocious at accurate health info, so take it with a grain of salt). They ended up doing a bypass graft on one side and he improved dramatically for a while. Ultimately, the degree of blockage had damaged is brain tissue and he passed away from Alzheimer's/dementia related complications in his mid 80s.

It's still way too early to know anything for sure. I only give my granddads example to say if you catch it early you can be watching to make sure things like that don't occur. Praying for good news.

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Although it may not be the exam of choice, panoramic radiography can identify carotid artery atheromas and once they have been identified, the dentist must inform and instruct patients to seek medical evaluation as soon as possible.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134975/


Yes calcifications or atheromas can be detected in panorex... is it always the correct diagnosis, no. Is it better to be safe than sorry, yes.

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I really have to wonder if the dental x-rays, even a Panorex exam,are actually showing carotid artery disease. I'm curious as to whether they are not seeing salivary gland stones instead. A carotid doppler study would probably be the best place to start, as far as imaging goes. No ionizing radiation, no dye, cheaper, etc.

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Sialoliths are very common, but in a panorex usually not seen in the same area as a carotid atheroma or calcification would be seen.

The purpose of the panorex isn't to diagnose carotid artery disease but if there's an incidental finding it's best to refer and not be the "one that missed it". Even if it causes some false alarm, it's a better outcome to have the medical doctor then find that everything is normal vs. not saying anything and the patient having problems later. Just my opinion.

Of course other diagnostics would be better such as a carotid doppler like you mentioned. but the normal joe doesn't get those every few years... or at all. So if the incidental finding is seen, a referral to a medical doctor for those subsequent diagnostics is warranted.

My dad (a retired dentist, BTW) has had surgery for this twice, both in his 70s (he's about to turn 77 and doing well). CT or ultrasound should be definitive as to what's going on.

Dad went to a surgeon who only does carotid artery procedures. If you need a surgeon and can find one who specializes in it, I suggest going that route.

Never heard of carotid stenosis bring diagnosed this way but I guess it is possible

Agree with Kool that the next step would be a carotid duplex. Also keep in mind that even critical levels of blockage (>80%) only carry a stroke risk of 2-3% per year so unlikely to be an immediate risk

Thanks for the posts everyone and I did make it to the Dr yesterday and he's got me scheduled for an ultrasound which he believes will tell us if we need further imaging or not. He does see some discolorization within the scan that presents concern so we'll def take that next step. I'll keep you guys posted! Thanks and Gig 'Em!