They explained the "smoth head" Klingons in the Enterprise series. It was a result of human augmented DNA(remember Khan) combined with Klingon DNA and mutated because of Tykellian Flu(I think Tykellian, but it was a flu strain). The cure caused those Klingons infected to lose their cranial ridges. It was a widespread virus, so that explains how we saw "smoothies" in TOS.
They obviously "got better" because Koloth, Kor, and Kang had ridges on DS9 when they appeared.
"A sharp knife is nothing without a sharp eye"
-Koloth
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