What Are Epstein Pearls?

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.

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.

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. 

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.

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.