Palatal defects of the oral cavity can be either congenital or acquired following trauma or surgical excision of malignant disease. Palatal defects can greatly affect function and subsequent quality of life. Rehabilitation using a removable obturator can be a preferable treatment option as it allows regular review post-surgery. This case study reports on the design and construction of a removable “speech bulb” obturator. A 50-year-old female patient presented complaining of nasal regurgitation and looseness of her current palatal obturator. She had previously undergone wide surgical excision of her soft palate under general anaesthesia due to adenoid cystic carcinoma. Treatment consisted of the provision of a new removable obturator, paying careful attention to the design of the “speech bulb” itself. The design of the “speech bulb” is crucial to optimise function, and the method of prosthesis fabrication is fully described. This case highlights the impact of obturator fit on a patient’s quality of life and will be of benefit to clinicians from many disciplines including dentists, oral and maxillofacial surgeons, Ear, Nose & Throat (ENT) surgeons and speech and language therapists.

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Introduction Silver diamine fluoride (SDF) is an option for biologic caries management that is not well utilised in the United Kingdom (UK). Caries in the primary dentition is common in the UK, and despite current treatment options many children require invasive treatment and multiple extractions. SDF could provide an alternative and due to their clinical expertise paediatric dentists are well placed to discuss this. Methods Fourteen semi-structured interviews were carried out with paediatric dentists across the UK. This was a heterogeneous sample including working across different settings, with differing levels of experience and both academic and NHS primary employment. Thematic analysis was undertaken with respondent validation. Results Participants felt SDF could be useful where patients have caries in their primary dentition, are asymptomatic and cannot manage other treatment options. The five themes influencing their views were child factors, parental influence, external influences, the clinician’s knowledge, experience and beliefs and the properties of SDF. Conclusion Paediatric dentists interviewed feel that there is a role for SDF in caries management in the UK. They believe case selection and communication with families is important.

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Drug-related hospital admissions are common, and up to 25% of patients presenting to emergency departments with injuries test positive for alcohol and drug use. This case reports on a 55-year-old male who attended the emergency department (ED) at the Royal United Hospital, Bath, UK. He presented after sustaining significant soft tissue trauma to his tongue, following recreational drug use of an unknown substance. His injuries included the amputation and loss of the anterior third of his tongue, having suffered a bite from another individual. This unusual case describes the patient’s injuries and subsequent management, both in the emergency department and during follow-up. This case will be of benefit to clinicians from many disciplines including dentists, oral and maxillofacial surgeons, ENT surgeons and speech and language therapists.