April 10, 2022
One dental condition that most parents have never heard of is Hutchinson teeth. The condition is caused by exposure to congenital syphilis and in some cases does not present itself until permanent teeth begin to grow in. The appearance of these misshapen teeth can be alarming, especially when parents do not understand the cause and symptoms. And though many dentists and physicians are aware of the condition, most will never witness a case or make a diagnosis. Here is what patients and parents should know regarding Hutchinson teeth.
Why is it called Hutchinson teeth?
The condition often involves teeth, ears, and eyes and is named after the English surgeon and syphilis specialist, Sir Jonathan Hutchinson. He was the first to reference the dental manifestations of congenital syphilis and Hutchison teeth form part of what has come to be known as the Hutchinson triad, or a common pattern of presentation for congenital syphilis including the keratitis of the cornea, sensorineural hearing loss, and dental abnormalities.
Specific features of Hutchinson teeth
At first, newborn babies may not show signs of exposure. And symptoms often develop as babies age and grow. Hutchinson teeth typically appear around age five, as permanent teeth begin to appear. Some features to watch for include peg-shaped teeth with a crescent-shaped notch. Teeth might also appear smaller, more widely spaced, and have discoloration or thinning of the enamel. Hutchinson teeth primarily effect the permanent molars and central incisors. They are also known as bud molars or moon molars.
What causes Hutchinson Teeth?
Babies have the greatest risk of developing Hutchinson teeth if the mother has had syphilis for less than two years. Exposure occurs while the baby is in the womb or during the birthing process. And the risk increases if the infection of the mother hasn’t been treated before the eighteenth week of pregnancy.
Can you have Hutchinson teeth without syphilis?
Notched upper central incisors can appear with no other evidence of syphilis. They occur as an inherited X-linked recessive trait. These deciduous teeth are known as nonsyphilitic dental dysplasia and are not to be confused with Hutchinson teeth. In these cases, the permanent teeth can develop normally and require no treatment.
Treatment for Hutchinson teeth
The first step upon the discovery of Hutchinson teeth is a visit to the pediatrician for a sure diagnosis. The doctor will use a lumbar puncture or a blood test to confirm syphilis. If needed, treatment can include medications like a shot of penicillin. If the condition has been present for more than a year, the child may require additional doses. And tooth damage that has occurred will require dental restorations. Treatments may include crowns, bridges, fillings, or even dental implants depending on the extent of the damage.
Preventing Hutchinson teeth
The best way to prevent Hutchinson teeth is to treat syphilis before becoming pregnant. A mother may not present any symptoms, which is why it is important to get tested for syphilis and other sexually transmitted infections (STIs) if you are pregnant or planning to become pregnant. For a mother with syphilis, it is important to get treatment before the sixteenth week of pregnancy, otherwise, babies may develop irreversible deafness, eye issues, and Hutchinson teeth.