The reason that children with cleft palates tend to have a greater prevalence of tooth decay than normal children is unclear. We hypothesized that children with cleft palates would have increased oral clearance times for foods and, consequently, higher levels of caries and caries-associated micro-organisms than control children. Children aged 6-16 yrs, with (n = 81) or without (n = 61) cleft palates, were studied. Children with cleft palates had DMFT and dmft scores greater (p < 0.01) than those of the control group. The number of caries-associated organisms was greater in the saliva of the cleft palate children (all p < 0.001). The oral hygiene, plaque and gingival index scores were greater (p < 0.0001), oral clearance was longer (p < 0.01), and levels of sucrose and starch-derived saccharides higher (p < 0.01) in the cleft palate group. However, salivary concentrations of organic acids were lower in the children with craniofacial disorders, probably reflecting the altered physiology of the more mature dental biofilm. The longer oral clearance times of foods and the consequent generation of fermentable sugars from starches may contribute to the higher caries prevalence observed in children with cleft palates.

The aim of this study was to design and investigate the use of an inexpensive method of monitoring the progress of demineralisation and subsequent remineralisation in artificial carious lesions. A small infrared (IR) reflectance meter was built which illuminated a 4 mm×4 mm area on the buccal surface of a tooth and measured the reflected IR intensity. Repeated measurements were taken over a period of 25 days, during which the enamel surface was exposed to demineralising and subsequently remineralising solutions. Thirty-six teeth were studied under a variety of de- and remineralising conditions. It was observed that the IR specular reflectance of the tooth surfaces decreased with time during lesion formation and increased with time during remineralisation. It is suggested that the decrease in IR specular reflectance during demineralisation and the increase during remineralisation are a result of continuous changes in the crystals at the enamel surface during these processes.

Children presenting with discoloured teeth commonly suffer from low self-esteem. This paper reports the findings from a questionnaire evaluating changes brought about by dental bleaching and the psychosocial effects of bleaching on 22 patients. All patients reported to like the overall appearance of their teeth following bleaching and reported a significant improvement in mental wellbeing. In the current climate where positive mental health is at the forefront of the minds of commissioners, health care providers, and the general public alike, this service evaluation demonstrates the positive effect that carefully planned dental bleaching can have on the mental wellbeing of under 18-year-olds with discoloured teeth.

Isolated bilateral macrodontia of the mandibular second premolars is a rare condition. We believe that the case reported here is the first in which isolated bilateral macrodontia of the mandibular second premolars presents with numerous dental anomalies affecting other teeth. A 14-year-old boy was referred to the Paediatric Dental Department of King’s College Hospital with a partially erupted mandibular left second premolar. Clinical and radiographic examination subsequently revealed macrodontia of both mandibular second premolar teeth and multiple other dental anomalies. This report discusses the presentation and multidisciplinary management of this case. Clinical relevance: This case report describes an already rare condition made even more extraordinary owing to its presentation with multiple other dental anomalies.

A 6-year-old girl was referred for assessment of an oral soft tissue swelling in the anterior maxilla. An asymptomatic, large, erythematous soft tissue mass developed on the alveolar ridge following the loss of the deciduous upper central incisor. Following excision of the lesion, a diagnosis of pyogenic granuloma was confirmed. This case demonstrates the unusual presentation of a pyogenic granuloma in a younger child. These lesions can arise as a reactive response to various stimulating factors and can grow rapidly. Management often involves excision but recurrence risk can be high. CPD/Clinical Relevance: Dentists should not only be aware of the common oral soft tissue changes but should also familiarize themselves with lesions that can occur atypically in children.