What to Know About Epstein Pearls

epstein pearls
 Monashee Alonso/Getty 

If you've come across small, white bumps in your baby's mouth, you may be wondering what they are. Although there can be many causes of mysterious bumps when it comes to babies, they may be Epstein Pearls. 

Fortunately, Epstein Pearls are nothing to worry about, but here's what you should know about those little white bumps in your little one's mouth.

What Are Epstein Pearls? 

Epstein Pearls are very small cysts that can appear in a baby's mouth that look like tiny, white bumps. They were first described by Alois Epstein in 1880. They generally appear along a baby's gums or along the top of the roof of the mouth.

According to the British Medical Journal, Epstein Pearls are caused by entrapped epithelium during palate development. Or, in other words, skin that gets trapped while the baby's mouth structures are still forming in utero. When a baby's mouth reaches the final stages of develop, the sides of the jaw and the palate (roof of the mouth) begin to fuse together. When that happens, some of the layers of skin can get "stuck" and lead to Epstein Pearls. 

Epstein Pearls contain keratin, which is skin and other mucous membranes. They may resemble small pimples in your baby's mouth. You should never squeeze them or try to pop the cysts. Not only will that not do any good, but it could introduce harmful bacteria into baby's bloodstream since the gums connect directly to the blood.

Can Epstein Pearls Happen Anywhere Else?

Most of the time, Epstein Pearls only appear in a baby's mouth. Male infants, however, can also sometimes get Epstein Pearls on their foreskin—called preputial Epstein Pearls.

One study in the Indian Journal of Pediatrics explained that preputial and mouth Epstein Pearls don't have anything to do with each other; a baby can have both mouth pearls or preputial pearls, or one and not the other. What did seem to matter was if the baby was born at full-term. The majority of infants who have preputial pearls were born at full-term and weighed 3,000 grams or more. 

Are Epstein Pearls Dangerous? 

Epstein Pearls are benign cysts, meaning they are not dangerous or painful to your baby. They do not require treatment and will go away completely on their own or over the course of a few weeks. Sometimes, the friction of breastfeeding, drinking a bottle, or even using a pacifier can help break down the cysts to help them dissolve too. 

When Should You See a Doctor About Epstein Pearls? 

It can be difficult to distinguish if what you are seeing in your baby's mouth are actually Epstein Pearls or something else. Bumps in your baby's mouth may be caused by another condition that might need medical treatment, such as thrush (a yeast infection). And in some very rare cases, small white bumps on the gums can turn out to be something a little more surprising—natal teeth. Although it's very rare, some babies are born with developing teeth that can appear even in the newborn stages. 

A Word From Verywell

If your baby has small, white cysts around her gums or on the roof of her mouth, he or she might have Epstein Pearls. Epstein Pearls are small cysts that are formed while a baby's mouth is developing and although they may look alarming, they are generally painless for your little one. 

Although Epstein Pearls are harmless and do not require treatment, you should see a doctor if you are unsure if your baby has Epstein Pearls or another condition. You should also seek medical attention if the bumps do not go away, seem to get worse and/or are bleeding, and if your baby appears to be in pain or is refusing to nurse or take a bottle. 

Sources:

Faridi MM, Adhami S. Prepucial Epstein pearls. Indian J Pediatr. 1989;56(5):653-5

Patil, S., Rao, R. S., Majumdar, B., Jafer, M., Maralingannavar, M., & Sukumaran, A. (2016). Oral Lesions in NeonatesInternational Journal of Clinical Pediatric Dentistry9(2), 131–138. http://doi.org/10.5005/jp-journals-10005-1349. 

Singh, R. K., Kumar, R., Pandey, R. K., & Singh, K. (2012). Dental lamina cysts in a newborn infant. BMJ Case Reports2012, bcr2012007061. http://doi.org/10.1136/bcr-2012-007061.