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What Is a Mulberry Molar?

By Rebecca Harkin
Updated Mar 03, 2024
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Mulberry molars are physically defective permanent molars. The deformity is caused by congenital syphilis. This type of abnormality is characterized by dwarfed molars with cusps covered with globular enamel growths. These teeth are functional but can be cosmetically fixed with crowns, bridges, or implants.

Just above the gum line, the mulberry molar looks normal. A deformity becomes apparent towards the cusp or top grinding surface of the tooth. Here, the size of the mulberry molar is diminished in all aspects, creating a stumpy version of a conventional molar. The cause of the molar atrophy is thought to be enamel hypoplasia, or a deficiency in tooth enamel. The underlying dentin and pulp of the tooth is normal, but the enamel covering or molar sheath is thin and deformed, creating a smaller version of an typical tooth.

The grinding surface of a mulberry molar is also corrupted. Normally, the grinding surface of a molar has a pit and is surrounded by a circular ridge at the top of the tooth, which is used for grinding. The cusp deformity of the mulberry molar is characterized by an extremely shallow or completely absent pit. Instead, the pit area is filled with globular structures bunched together all along the top surface of the cusp. This type of deformity is also thought to be caused by enamel hypoplasia.

Mulberry molars are typically functional and do not need treatment. If the deformity is severe or the person is bothered by the teeth, there are several options. The teeth can be covered with a permanent cast crown, stainless steel crown, or the molars can be removed and an implant or bridge can be put in place of the mulberry molar.

A mulberry molar is caused by congenital syphilis, which is passed from the mother to the child in the uterus through the placenta. Since this particular symptom of congenital syphilis manifests later in childhood with the eruption of the permanent molars, it is a late stage marker for the disease. Hutchinson’s teeth, marked by dwarfed teeth and deformed cusps that are spaced abnormally far apart, are another dental deformity caused by congenital syphilis. Mulberry molars and Hutchinson’s teeth will often occur together. Pregnant women with syphilis should tell their doctors about the condition and be treated for it during pregnancy, otherwise the baby should be screened for the disease after birth and treated with penicillin if necessary.

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Discussion Comments
By JaneAir — On Feb 14, 2012

@sunnySkys - It's because of stuff like this I think it would be a good idea to test all pregnant women for STI's. So many of them can be passed along to the child with results ranging from annoying to life threatening!

I know a lot of women might protest about being tested during their pregnancies, but I think it's better to be safe than sorry. There's always the possible of having an STI you didn't know about, or your partner cheating on you.

I personally would rather find out, get proper treatment, and avoid passing the disease along to my child.

By sunnySkys — On Feb 13, 2012

@Azuza - I understand why someone might want a crown too. But keep in mind crowns can get expensive! I had one done recently and it ended up being around a thousand dollars (with insurance!) Also, I had some complications after the procedure so I was in a lot of pain for a few weeks.

Anyway, I feel bad for both the parent and the child in this situation. Imagine your child's first molars growing in, and then realizing you gave them syphilis! It must be a horrible feeling.

By Azuza — On Feb 12, 2012

I can totally understand why someone with mulberry teeth might prefer to have a crown put over it. People look at your face every single day! Having a nice smile and nice teeth is considered essential for being attractive and well groomed. There's a definite stigma attached to anyone who looks like they "don't take care of their teeth."

The good news is that getting a crown done isn't too big of a deal. I have several crowns, and the process was fairly painless. Also, they look exactly like regular teeth. I get compliments on my smile and pretty teeth all the time. No one has ever noticed that one of my four front teeth on the top is a crown!

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