Babies Health & Safety What Are Epstein Pearls? By Chaunie Brusie, RN Chaunie Brusie, RN LinkedIn Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing. Learn about our editorial process Updated on September 19, 2022 Medically reviewed by Sarah Rahal, MD Medically reviewed by Sarah Rahal, MD LinkedIn Sarah Rahal, MD is a double board-certified adult and pediatric neurologist and headache medicine specialist. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Characteristics Identification Causes Treatment Epstein pearls are very small cysts that appear in the mouths of 60% to 85% of newborns. They look like tiny, white bumps and generally appear along a baby's gums or on the roof of the mouth. Epstein pearls are named after Alois Epstein, a Czech pediatrician who first described them back in 1880. Epstein pearls are benign, meaning they are not dangerous to your baby. They do not require treatment and will go away on their own over the course of a few weeks. Verywell / Jessica Olah Characteristics of Epstein Pearls Epstein pearls contain keratin, a protein found in skin and other mucous membranes. They may resemble small pimples in your baby's mouth and are generally painless. Epstein pearls are: Known to appear on their own or in clusters of 2 to 6 Less common in first-born babiesMore common in higher birthweight babiesMore common in Japanese, White, and Black babiesA range of sizes, from less than a millimeter to several millimeters in diameter Identifying Epstein Pearls Although Epstein pearls are harmless and do not require treatment, it's best to have a pediatrician take a look at your child to make sure that's what you're dealing with. Bumps in your baby's mouth may be caused by another condition that might need medical treatment, such as thrush (a yeast infection). It can be difficult to distinguish Epstein pearls from other conditions on your own. In some very rare cases, small white bumps on the gums can even turn out to be something a little more surprising: natal teeth, which are developing teeth that can appear in the newborn period. Seek medical attention if the bumps do not go away, seem to get worse, or are bleeding, or if your baby appears to be in pain or is refusing to nurse or take a bottle. Your Guide to Breastfeeding Causes Epstein pearls are not preventable, nor are they caused by anything a parent did or didn’t do during pregnancy. When a baby's mouth reaches the final stages of development during pregnancy, 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." This is what leads to Epstein pearls. Treatment Sometimes, the friction from breastfeeding, drinking a bottle, using a teether, or sucking on a pacifier can break down the cysts and help them dissolve. Never squeeze Epstein pearls or try to pop the cysts. Not only will that not do any good, but it could introduce harmful bacteria into baby's bloodstream. A Word From Verywell Seeing anything you don't expect when looking at your child can be concerning. But rest assured that if they do have Epstein pearls, they are not in pain or in need of any treatment. In addition, these cysts eventually self-resolve naturally. Caring for Your Baby's First Tooth 5 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Diaz de Ortiz LE, Mendez MD. Epstein pearls. In: StatPearls [Internet]. StatPearls Publishing. Singh RK, Kumar R, Pandey RK, Singh K. Dental lamina cysts in a newborn infant. BMJ Case Rep. 2012;2012:bcr2012007061. doi:10.1136/bcr-2012-007061 Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral lesions in neonates. Int J Clin Pediatr Dent. 2016;9(2):131–138. doi:10.5005/jp-journals-10005-1349 Kiat-Amnuay S, Bouquot J. Breastfeeding keratosis: this frictional keratosis of newborns may mimic thrush. Pediatrics. 2013;132(3):e775-8. doi:10.1542/peds.2012-2796 Heerden WV, Zyl AV. Diagnosis and management of oral lesions and conditions in the newborn. S Afr Fam Pract. 2010;52(6):489-491. doi:10.1080/20786204.2010.10874032 By Chaunie Brusie, RN Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Featured Video