A 9-month-old girl was taken to Accident and Emergency by her worried parents when they noted an apparent hole on looking into her mouth. The child had stopped sucking her thumb 2 weeks previously but remained well otherwise. After examination she was suspected of having a palatal defect that had been missed on neonatal screening, and was referred to the local cleft palate team. On review at clinic 2 weeks later the palatal defect was, in fact, found to be a small mirror stuck between the hard and soft palate. This was removed under general anaesthetic later that day and the child was discharged home. Oral foreign bodies, although not common in children of this age, carry a risk of ingestion or aspiration if not detected, and the diagnosis must be considered in any previously well child noted to have an apparent change in the appearance of the oropharynx.

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Figure 1 Photograph looking into the child’s mouth (lower lip held open with swab). A small mirror is seen wedged firmly between the hard and soft palate.