Hutchinson Teeth

What are Hutchinson's Teeth?

The term "Hutchinson's teeth" refers to a symptom of syphilis infection transmitted from mother to child either before birth or during childbirth. This anomaly is characterized by triangular or screw-shaped teeth and often accompanied by large gaps between the teeth and weakened enamel. Hutchinson's teeth are named after the English surgeon and syphilis specialist Sir Jonathan Hutchinson and are part of the so-called "Hutchinson's triad," which includes symptoms affecting the eyes, ears, and teeth.

Causes of Hutchinson's Teeth

The cause of Hutchinson's teeth is exposure to syphilis (a bacterial infection) before or during birth.

Syphilis is commonly considered a sexually transmitted infection (STI). It begins as a sore on the genitals, rectum, or mouth. The infection then spreads through contact with these sores to mucous membranes or the skin.

Syphilis sores can be painless in the early stages of infection. In fact, some people may not know they are infected for years. Additional symptoms can include a rash all over the body, flu-like symptoms (fever, muscle aches, sore throat), and hair loss. These symptoms may come and go.

The risk of a baby developing Hutchinson's teeth and other symptoms is highest if the mother has syphilis during pregnancy, especially if the infection was not treated before the 18th week of pregnancy.

Exposure occurs while the baby is still in the womb through the placenta or during the birth process.

Symptoms of Hutchinson's Teeth

The symptoms of Hutchinson's teeth are often not visible at birth but may appear as the child grows. Affected children often experience symptoms of the so-called Hutchinson's triad, which include:

1. Inner ear problems (labyrinthitis) leading to hearing loss.
2. Eye problems (interstitial keratitis) involving inflammation of the cornea.
3. Dental anomalies (Hutchinson's teeth).

Hutchinson's teeth can be recognized around the age of five when permanent teeth appear. This anomaly typically affects the permanent central incisors and the large molars. Specific features include:

• Wedge-shaped with a half-moon notch.
• Thinned or altered enamel.
• Smaller teeth.
• Wide-spaced teeth.

If you're unsure whether your child's teeth exhibit these characteristics, consult your pediatrician or dentist.

Treatment of Hutchinson's Teeth

To treat Hutchinson's teeth, consult your pediatrician first and take any necessary medications.

A blood test or sometimes a lumbar puncture can confirm the diagnosis of syphilis. Treatment options include a penicillin injection. If the disease has been present for longer than a year, your child may need additional doses.

Any existing tooth damage cannot be reversed without dental treatments. These are known as dental restorations.

There are several options for dental restoration:

• Crowns: Dentists place crowns on teeth to restore them to their normal size, shape, and function.
• Bridges: These artificial teeth help close gaps between teeth. Bridges also correct bite problems and restore the natural appearance of the face and smile.
• Fillings: Dental fillings are a common method to fill cavities or holes caused by weakened enamel and other issues. These can be made of composite material (tooth-colored), dental amalgam (silver), or gold.
• Dental Implants: A titanium metal post is surgically implanted into the jawbone to serve as a foundation for crowns or bridges. Implants can only be placed once the jaw is fully developed, usually during puberty or young adulthood.

Discuss with your dentist which treatments are best suited for your child.

Prevention of Hutchinson's Teeth

The best way to prevent Hutchinson's teeth is to treat syphilis before pregnancy. You may or may not have symptoms, so it's important to get tested to be safe.

In particular, get tested for syphilis and other sexually transmitted infections if:

• You have another sexually transmitted infection.
• You have not practiced safe sex since your last test and have had multiple sexual partners.
• You are pregnant or planning to become pregnant. In this case, it's crucial to treat the infection before the 16th week of pregnancy. After the 18th week, the disease can be cured, but babies can still have irreversible hearing loss, eye problems, Hutchinson's teeth, and bone and joint problems.

Regular Dental Care

Once teeth erupt, it's important to care for them regardless of their condition.

• Brush teeth twice daily with fluoride toothpaste.
• Clean between teeth daily with dental floss.
• Limit sugary drinks and snacks.
• Consider using fluoride mouthwash.
• Visit the dentist regularly for check-ups.

In summary, while Hutchinson's teeth are irreversible, treating underlying syphilis is crucial to prevent other associated health issues.

If permanent teeth emerge, you can discuss with your child's pediatrician and dentist about cosmetic procedures that may help improve the appearance of the teeth.

If you are pregnant or planning a pregnancy and suspect exposure to syphilis, it's important to get tested for syphilis as soon as possible to treat the infection.