Sharp Teeth is a defensive mutation that allows the player to deal damage to every enemy on the screen every time they get damaged.
The damage is equal to 2.5x the amount of HP you lost per hit.
Trying to damage yourself to under 4 HP with explosive damage while having Boiling Veins or taking overkill damage won't trigger the mutation and respectively not deal the full damage taken, instead only the amount of damage taken minus the overkill following the multiplier.
Building
Sharp Teeth is a niche mutation, mostly due to its mediocre risk/reward ratio. It works best with characters that can damage themselves without putting themselves at risk or the ones with large amounts of health/health gain, but even then it's not recommended.
Other Mutations
Synergies
While risky, Sharp Teeth is decent with health mutations such as Second Stomach /Bloodlust in order to regain lost health
.Strong Spirit can help with taking a heavy hit to dish out some Sharp Teeth damage and surviving afterwards, though not encouraged to give Strong Spirit up
Similar Niches
Gamma Guts, especially alongside Scarier Face can be a good alternative if your main issue is dealing with contact damage enemies, though they fall out of line the longer you loop
Anti-Synergies
Besides for the way it triggers, there aren't many mutations that pulls any anti-synergies, but that's a matter of playstyle.
Characters
Desirable
Crystal built into an extra HP build can some decent use out of Sharp Teeth
Rebel's active ability can allow her to trigger Sharp Teeth without coming into contact with enemies for a solid 2.5/5 damage
Lower Priority
Skeleton can make use out of Sharp Teeth as well through the downside of his active, but it's not recommended as Skeleton's passives weigh him down enough, so picking Sharp Teeth might be an opportunity to lose on some useful mutations to rectify his downsides.
Undesirable
Melting can't make any use out of Sharp Teeth as any damage taken could lead to his death due to his low max HP.
Crowns
Synergies
Sharp Teeth has a notable synergy with the Crown of Haste due to the increase in HP of medkit pickups from 2 to 3 HP.
Sharp Teeth can sort of work with the crown of protection as you will gain health from weapons.
The Crown of Hatred can help trigger Sharp Teeth as every chest will damage you for 1 HP.
Anti-Synergies
Sharp Teeth doesn't mix well with the Crown of Risk as it will reduce the chance for pickups by 50% while damaged, severely crippling health pickups.
Sharp Teeth gets less potency with the Crown of Death.