Abstract
Syphilis was the first sexually transmitted disease to be diagnosed in childhood. Most developed countries controlled syphilis effectively after the 1950s and congenital syphilis became rare. Since the late 1990s there has been a resurgence of syphilis in developed and developing countries and the WHO estimates that at least half a million infants die of congenital syphilis every year. The earliest reference to the dental manifestations of congenital syphilis was by Sir Jonathan Hutchinson, Assistant Surgeon at The London Hospital in 1861. Three main dental defects are described in congenital syphilis; Hutchinson’s incisors, Moon’s molars or bud molars, and Fournier’s molars or mulberry molars. Although many physicians, dentists, and pathologists in developed countries will be aware of the dental features of syphilis, most will never have seen a case or made the diagnosis. The purpose of this article is to review some of the history of congenital syphilis, remind healthcare professionals of the features, and bring to their attention that the changes are still prevalent and that milder cases can be mistaken for other causes of hypoplasia.
Similar content being viewed by others
References
Recent epidemiology of infectious syphilis and congenital syphilis in England. In: Health protection report. 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/336760/hpr4413_sphls.pdf. Accessed 5 Jan 2016.
Number and rates of selected STI diagnoses in the UK, 2009–2013. In: Public health England. 2015. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/437433/hpr2215_STI_NCSP_v6.pdf. Accessed 6 Jan 2016.
Meyer S, Trück J, Bosshard P, et al. Congenital syphilis in Switzerland: gone, forgotten, on the return. Swiss Med Wkly. 2012;. doi:10.4414/smw.2012.13325.
Syphilis, In: Sexually transmitted diseases surveillance. In: Centres for disease control and prevention. 2011. http://www.cdc.gov/std/stats11/syphilis.htm.
Eliminating congenital syphilis: A global health priority. In: Geneva World Health Organization.2005.http://www.who.int/reproductivehealth/publications/rtis/eliminating_congenital_syphilis.pdf.
Estreich S, Forster G. Sexually transmitted diseases in children: introduction. Sex Transm Infect. 1992;68(1):2–8. doi:10.1136/sti.68.1.2.
Lomax E. Infantile Syphilis as an Example of Nineteenth Century Belief in the Inheritance of Acquired Characteristics. J Hist Med Allied Sci. 1979;XXXIV(1):23–39. doi:10.1093/jhmas/xxxiv.1.23.
Gjestland T. The Oslo study of untreated syphilis: an epidemiologic investigation of the natural course of syphilitic infection based on a restudy of the Boeck-Bruusgaard material. Acta Derm Venereol (Stockh). 1955;35:1–368.
Gomez G, Kamb M, Newman L, Mark J, Broutet N, Hawkes S. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ. 2013;91(3):217–26. doi:10.2471/blt.12.107623.
Leão J, Gueiros L, Porter S. Oral manifestations of syphilis. Clinics. 2006;61(2):161–6. doi:10.1590/s1807-59322006000200012.
Hillson S, Grigson C, Bond S. Dental defects of congenital syphilis. Am J Phys Anthropol. 1998;107(1):25–40. doi:10.1002/(sici)1096-8644(199809)107:1<25:aid-ajpa3>3.0.co;2-c.
Hutchinson J. Clinical lecture on heredito-syphilitic struma: and on the teeth as a means of diagnosis. Br Med J. 1861;1(20):515–7. doi:10.1136/bmj.1.20.515.
Putkonen T. Dental changes in congenital syphilis. Relationship to other syphilitic stigmata. Acta Derm Venerol. 1962;43:240–9.
Bauer W. Tooth buds and jaws with patients with congenital syphilis. Correlation between distribution of Treponema pallidum and tissue reaction. Am J Surg Pathol. 1944;20:297–319.
Moon H. On irregular and defective tooth development. Trans Odontol Soc GB. 1877;9:223–43.
Fournier A. Syphilitic teeth. Dent Cosmos. 1884;26:12–25.
Waldron T. Henry moon and his molars. Dent Hist. 2014;59:17–24.
Jacobi K, Cook D, Corruccini R, Handler J. Congenital syphilis in the past: slaves at Newton Plantation, Barbados, West Indies. Am J Phys Anthropol. 1992;89(2):145–58. doi:10.1002/ajpa.1330890203.
Fiumara N. Manifestations of late congenital syphilis. An analysis of 271 patients. Arch Dermatol. 1970;102(1):78–83. doi:10.1001/archderm.102.1.78.
Mayes, et al. Stigmata of congenital syphilis on a high status juvenile at Yuguë, Oaxaca, Mexico. Dent Anthropol. 2009;22:73–84.
Crombie F, Manton D, Palamara J, Zalizniak I, Cochrane N, Reynolds E. Characterisation of developmentally hypomineralised human enamel. J Dent. 2013;41(7):611–8. doi:10.1016/j.jdent.2013.05.002.
Acknowledgments
Our thanks are due to the Royal College of Surgeons of England for permission to reproduce photographs of specimens.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nissanka-Jayasuriya, E.H., Odell, E.W. & Phillips, C. Dental Stigmata of Congenital Syphilis: A Historic Review With Present Day Relevance. Head and Neck Pathol 10, 327–331 (2016). https://doi.org/10.1007/s12105-016-0703-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12105-016-0703-z