TEETH

By Gary M. White, MD

Note: This page lists dermatologic diseases that have classic dental findings.

Barrel-Shaped

Congenital Syphilis. Hutchinson's teeth--barrel-shaped incisors with a notch at the cutting edge--occur in congenital syphilis. Figure 3 is Hutchinson's teeth [BMJ Case Rep. 2011 Dec 21;2011].

Blue

Minocycline Pigmentation
Minocycline Pigmentation of the Teeth

Brown and Fluorescent

Erythropoietic Porphyria. The teeth are brown but may fluoresce red with the Wood's lamp in congenital erythropoietic porphyria, also known as Gunther's Disease. This disease presents in the first few months of life with erythema, swelling, and blistering of the sun-exposed skin.

Conical (Tiger) Teeth

Hypohidrotic Ectodermal Dysplasia and Hidrotic Ectodermal Dysplasia. Dentition and hair are abnormal similarly in both types of ectodermal dysplasia but hereditary patterns of nails and sweat glands involvement are different. Specifically, a decrease in the number of teeth and conical, peg-shaped or tiger teeth are seen. Figure 4 shows peg-shaped incisors and multiple missing teeth in a 13-year-old male with X-linked hypohidrotic ectodermal dysplasia [Am J Med Genet C Semin Med Genet. 2013 Nov; 163(4)]. Figure 2 shows conical shaped teeth [J Nat Sci Biol Med. 2013 Jul-Dec; 4(2): 445–450].

Natal Teeth

Pachyonychia Congenita. Some babies with pachyonychia congenita have prenatal or natal teeth, which are teeth that are present at birth or in early infancy.

Permanent Loss

Papillon-Lefèvre Syndrome. There is permanent loss of deciduous teeth. [Clin Cosmet Investig Dent. 2015 Jul 15;7:75-81]

Miscellaneous

Gardner Syndrome. Patients may suffer from multiple impacted or unerupted teeth, supernumerary teeth, hypodontia, compound odontomas, and dentigerous cysts. [Dent Res J (Isfahan). 2014 Mar;11(2):276-80]

AEC Syndrome. Patients may have widely spaced teeth.

Tuberous Sclerosis. Dental pits are present in nearly all patients [J Am Acad Dermatol. 2007 May; 56(5): 786–790].

Epidermolysis Bullosa. Patients with all forms of epidermolysis bullosa may suffer from caries, enamel hypoplasia, and rapid attrition of teeth. The recessive form of DEB has the most significant oral lesions including microstomia, ankyloglossia, and rampant caries.

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