Babies Health & Safety What Are Epstein Pearls? By 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 Chaunie Brusie, RN Medically reviewed by Medically reviewed by Joel Forman, MD on April 12, 2018 Joel Forman, MD, is a board-certified pediatrician and associate professor of pediatrics, environmental medicine, and public health at Mount Sinai School of Medicine. Learn about our Review Board Joel Forman, MD Updated on February 02, 2021 Print 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. They are seen in 60% to 85% of newborns. Epstein pearls are benign cysts, 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. Here's what you should know about those little white bumps in your little one's mouth. Verywell / Jessica Olah Characteristics of Epstein Pearls Epstein Pearls contain keratin, which is found in skin and other mucous membranes. They may resemble small pimples in your baby's mouth. They are generally painless. Some characteristics include that they are: Less common in first-born babies May appear on their own or in clusters of 2 to 6 More common in higher birthweight babies More common in Japanese, White, and Black babies Range in size from less than a millimeter to several millimeters in diameter Identifying Epstein Pearls 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. It can be difficult to distinguish if what you are seeing in your baby's mouth are actually Epstein pearls. 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 in the newborn stages. You should 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. Your Resource Guide to Breastfeeding Causes According to a 2012 study published in British Medical Journal, Epstein Pearls are caused by entrapped epithelium during palate development. This means that skin gets trapped while the baby's mouth structures are still forming in utero. When a baby's mouth reaches the final stages of development, 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 are not preventable, nor caused by anything a parent did or didn’t do during pregnancy. Treatment Sometimes, the friction of breastfeeding, drinking a bottle, or even using a pacifier can help break down the cysts to help them dissolve. You can even give your baby a teething tool to help them rub their gums on the toy to try to break up the pearls. You should 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 since the gums connect directly to the blood. A Word From Verywell It may be surprising—or alarming—to see small, white cysts around your baby's gums or on the roof of their mouth, but don't worry. Thankfully, Epstein pearls are harmless, painless, and go away on their own. Was this page helpful? Thanks for your feedback! Track your baby’s most exciting moments with our milestone checklist. Get it free when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. StatPearls. Updated October 1, 2020. 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. 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