Long before baby teeth erupt, your little one may develop small bumps on her gum line. Known as Epstein pearls, these nodules are quite common in newborns. While they’re not a cause for concern, here’s what you should know about them.
What are Epstein pearls?
When your baby cries or yawns, you may notice tiny cysts along the gums or roof of her mouth. It might look like your newborn is teething already, but these benign bumps are actually a type of gingival cysts known as Epstein pearls.
Epstein pearls are very common — up to 85 percent of babies develop them at one point or another during infancy. They occur more in babies whose mothers have had multiple pregnancies, overdue babies and newborns who have a higher birth weight.
Testing is not needed to diagnose Epstein pearls. Your pediatrician will examine your baby's mouth to determine if she has Epstein pearls or another oral condition. Similar-looking benign cysts, such as Bohn's nodules, can appear in other areas of your little one's mouth.
Symptoms of Epstein pearls
Epstein pearls appear as small bumps along the gum line or roof of your baby’s mouth. They are typically:
White or yellow
1 to 3 millimeters in size
Firm to the touch
Epstein pearls do not cause any symptoms beyond their appearance. They are not painful — which is good news for your baby (and you).
How do you treat Epstein pearls?
Treatment is not necessary for Epstein pearls. They often dissolve as the result of friction with the nipple while nursing or drinking from a bottle. Epstein pearls generally go away within a few weeks, though some cases may take up to a few months to disappear.
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Do not attempt to rupture the cysts of Epstein pearls, as that can allow bacteria to enter the bloodstream and lead to unnecessary irritation, inflammation or infection.
What do Epstein pearls look like?
The appearance of Epstein pearls can vary from baby to baby. They often look like milia, or the tiny white bumps that can develop on your newborn’s skin, especially around the nose, chin or cheeks.
Epstein pearls can also appear as isolated bumps or small clusters of up to six or so cysts along the gum or roof of your baby’s mouth.
What causes Epstein pearls?
In the first trimester of pregnancy, the two halves of a baby's jaw and palate begin to fuse together. During this process, small collections of cells can get trapped and eventually turn into cysts filled with keratin, which results in the little bumps you’re seeing now known as Epstein pearls. There’s nothing you can do to prevent them.
Epstein pearls are not a sign of any issues with your little bundle of joy — they don’t interfere with feeding or future dental development.
Do I need to take baby to the doctor for Epstein pearls?
While most cases of Epstein pearls resolve on their own well in advance of that first toothless grin, you may want to schedule a visit with the pediatrician if the nodules haven’t disappeared after a few months, or if your baby has any other unusual oral symptoms, such as:
White patches or bumps on the lips, cheeks or tongue, which could be a sign of an oral yeast infection known as thrush
Mouth sores that blister, which could be a sign of hand, foot and mouth disease (also known as coxsackievirus)
Natal teeth, a rare condition where actual teeth are present at birth
While you may feel alarmed when you see these bumps in your baby’s mouth, rest assured that your little one is likely just fine. Epstein pearls should disappear on their own in time.
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