It was my first time doing tooth extraction. Last semester, I had no chance to experience holding a forcep. Luckily today, a patient came into the clinic with refference letter from Intensive Theraphy Unit (ITU) seeking extraction for her teeth due to heavily carious and necrotic (non-vital) teeth.
Little did I know, during the presentation case to the Dr Hamed, he asked about the clinical sign of the patient of 5th decade age. At first, my assistant and I were startled a few seconds because we had a few double checked with all the extraoral and intraoral examination. It was really unnoticeable until he pointed out about the shape of the incisor teeth! It was peg-shaped incisor teeth! Then we promptly asked the patient to open her mouth and found a multiple poorly developed molar. From the clinical features, we suspected that the patient has Congenital Syphilis.
I feel like sharing some information about the disease and hope these kind of clinical features would not be missed in future.
Other clinical finding that should be found in such patient would be:
-poorly developed maxilla/ Bulldog face
-Bullous eruptions
-Rhagades (fissures, cracks, or linear lesion in skin; angle of mouth & nose)
-Hutchinson triad; 8th nerve deafness, Hutchinson incisor, and interstitial keratisis.
-Du Bois sign (shortness of little finger)
-Higaoumenakis sign (unilateral enlargement sternoclavicular of clavicle)
Hutchinson Incisor -Wiki-
Mulberry Molar -Wiki-
Barely notice the Mulberry shaped of permenant first molar in my patient:(
My surgical tools.
Alhamdulillah, exodontia went smooth without any complication. Insya Allah, I will be more aware in future and not neglect even a small abnormality structure in the mouth.
Hope to write more. Till then, bye!
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