Globally, around 1.5 percent of all pregnant women test positive for the sexually transmitted disease syphilis. Unfortunately, congenital syphilis can kill an unborn child, with other serious side effects for children that survive the infection. Children with congenital syphilis sometimes suffer from a condition called Hutchinson teeth. Learn more about the effects of congenital syphilis in children, and find out how the condition can affect a child's teeth.
About congenital syphilis
If a pregnant woman has syphilis, she can pass a bacterium called Treponema pallidum to her unborn child through the placenta. Shockingly, around half of all children infected in this way die. In newborn children, symptoms can include fever, failure to gain weight, a serious rash and watery fluid from the nose.
In some cases, children don't show the symptoms of congenital syphilis until a few years after birth. These children may show other, more serious symptoms, including bone pain, vision problems and deafness. Some children also develop Hutchinson teeth.
If a doctor diagnoses and treats congenital syphilis, a child can still develop Hutchinson teeth later in life.
Hutchinson teeth symptoms
Doctors and dentists have several names for this condition, including Hutchinson's incisor and Hutchinson-Boeck teeth. Scientists named the condition after a prominent British surgeon who first linked the symptoms with congenital syphilis.
Hutchinson teeth show several unusual physical properties. Affected teeth are generally smaller and wider apart than normal, and the teeth also have unusual notches on their biting surfaces. In some cases, the teeth develop an unusual shape, and the sides of each tooth can taper. The condition most commonly affects the upper central incisors, and dentists normally see the problem in a child's permanent teeth.
Hutchinson teeth often form one of three conditions commonly called Hutchinson's triad. As well as problems with the incisors, affected children also suffer from sensorineural (or eighth nerve) hearing loss and interstitial keratitis, where the cornea becomes cloudy.
Diagnosis
A dentist will normally detect Hutchinson teeth by the physical symptoms. The unusual shape and biting surface are strong clues that the patient has the condition. That aside, it's also important to test the child for congenital syphilis, to make sure a doctor deals with the underlying condition.
If a doctor suspects the problem at birth, he or she will normally check the placenta for signs of infection. The newborn child may also show symptoms, such as liver or bone inflammation. Doctors often routinely test for syphilis during pregnancy with one or more types of blood test.
In older children, a doctor may need other tests to spot the disease. He or she may use a bone X-ray, lumbar puncture or eye examination to check for the bacterium that causes syphilis.
Treatment
The only treatment option available to deal with congenital syphilis is penicillin. Most people need several weekly doses of the medicine to cure the infection. Left untreated, congenital syphilis can cause permanent blindness, deafness and facial deformities.
Once a doctor has tackled the syphilis infection, a dentist can sometimes help deal with the symptoms of Hutchinson teeth. Treatment options will normally look at ways to improve the teeth's appearance. That aside, children with the condition are generally at higher risk of caries and uneven dental wear, so regular dental checkups are also vital.
Hutchinson teeth are often crooked, so a dentist may suggest a form of tooth straightening to help improve the child's smile. In many cases, your dentist may refer your child to a specialist orthodontist, who will discuss the available options with you. Some children benefit from orthodontic metal braces, which slowly apply pressure to the crooked teeth.
Hutchinson's incisor is a relatively rare condition that occurs when a child suffers with congenital syphilis. It's important to seek medical attention for syphilis as soon as possible, but a dentist can also help you consider ways to improve an affected child's teeth.