What Are Epstein Pearls?

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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.

What Are Epstein Pearls?

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 babies
  • More common in higher birthweight babies
  • More common in Japanese, White, and Black babies
  • A 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. 


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.


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.

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.
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  3. Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral lesions in neonatesInt J Clin Pediatr Dent. 2016;9(2):131–138. doi:10.5005/jp-journals-10005-1349

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By Chaunie Brusie, RN
Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing.