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Paediatric dentistry

Having to Lego of a tooth

Sir, we wanted to discuss the presentation of a three-year-old patient's take on the Hall crown technique. Hall crowns have been described as a revolutionary treatment choice in paediatric dentistry and have been recommended as the gold standard in managing carious lesions covering two or more surfaces.1

The patient presented to our accident and emergency (A&E) department with what initially appeared from afar to be an extruded upper right central incisor (51). Closer examination revealed a bulbous, yellow, foreign object, with a gleaming smiling face on the surface. The object was identified as a Lego head. The patient had firmly positioned the toy over the crown of his tooth so that it was flush to the gingival margin. The object was able to spin around with ease upon the tooth. This caused a functional, occlusal and aesthetic concern, but more importantly, a possible airway risk.

Similar cases have been reported on older children.2,3,4 However, on this young boy, while attempts were made to remove the foreign object, due to his age, anxiety and compliance, removal under local anaesthetic was not possible. In addition, he did not want to part from his customised crown. It was therefore decided to remove the toy under general anaesthetic. While custom Lego tools have been reported to be useful in removing these offending pieces, we opted for our dependable healing forceps.5

The Lego head was successfully removed in theatre (Fig. 1), along with the tooth, which turned out to be carious. Thankfully, the patient was reunited with his toy, although we stressed the importance of placing Lego heads onto Lego bodies, not teeth. We are pleased to report that the patient left our department with a smile matching the one seen on his figurine.

Fig. 1
figure 1

The child patient in theatre about to have the Lego head removed from his tooth


  1. Roberts A, McKay A, Albadri S. The use of Hall technique preformed metal crowns by specialist paediatric dentists in the UK. Br Dent J 2018; 224: 48-52.

  2. Tajmehr N, Lawson J, Yesudian G. Let it go - Lego! Br Dent J 2020; 229: 212.

  3. Baker D C, Flaherty S D. Lego of that. Br Dent J 2008; 204: 657.

  4. Hampton R, Wong J, Singh M. Lego of that. Br Dent J 2012; 212: 105.

  5. Lovel S. Lego leverage. Br Dent J 2020; 229: 571.

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Shathur, A., Patel, A. & Boscarino, A. Having to Lego of a tooth. Br Dent J 230, 62 (2021).

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