“The Great Imitator”: Resurgence of Syphilis and the Role of the Dental Provider in Diagnosis, Treatment, and Prevention.

Anna Matthews RDH, MS

With its tumultuous and murky history, syphilis has influenced the scientific developments in various medical fields, including microbiology, immunology, pharmacology, and bioethics.

It is a communicable infectious disease that can have chronic and dangerous consequences, but is also easily treatable with antibiotics. Having declined sharply since effective treatment with penicillin was introduced in the 1940s, the disease is on the rise again in the U.S. and worldwide. Prevalence of congenital syphilis, a leading cause of stillbirths worldwide, has also been increasing. Oral and peri-oral lesions can be present in all stages of the disease, from primary to tertiary, and specific dental manifestations are associated with congenital syphilis. Dental professionals, who may be the first clinicians to evaluate the manifestations of disease in patients seeking treatment for their oral lesions, must be familiar with clinical presentation, diagnosis, prevention and treatment protocols.

Participants will learn:

• Epidemiology of syphilis and co-infection with other sexually transmitted diseases and HIV infection;
• Etiology and pathogenesis of syphilis;
• General and oral/peri-oral manifestations of syphilis in primary, secondary, and tertiary stages and dental abnormalities associated with congenital syphilis;
• Diagnosis and differential diagnosis of syphilis;
• Treatment protocols and prevention strategies, including vaccine development.

Additional Resources:

• https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm
• https://www.cdc.gov/stopsyphilis/toolkit/HealthCareProviders/DocPocket.pdf
• https://www.cdc.gov/tuskegee/timeline.htm