If you’re a parent with a newborn, you probably find yourself checking every inch of your baby. Every sound, spot, or tiny bump can make you worry, and that’s completely normal.
Many parents notice what looks like a small white bump, or even a few, on their baby’s gums or the roof of their mouth and start to panic. Is it an infection? Could it be a tooth coming in already? Should you call the doctor right away?
Most of the time, what you’re seeing is something called an Epstein pearl. These little bumps are very common and, in most cases, nothing to worry about. Still, hearing “it’s normal” doesn’t always make the concern go away.
This post will walk parents and caregivers in the greater Acadiana area through what Epstein pearls actually are, why they form, and how to tell them apart from other things you might see in your baby’s mouth. If you’re caring for a newborn and want some peace of mind, keep reading.
What Epstein Pearls are in Newborns
Epstein pearls are tiny cysts that form inside a newborn’s mouth. They look like small white or yellowish bumps that feel firm to the touch. You might see them along the gums or, more often, down the middle of the roof of the mouth where the two halves of the palate meet.
They can show up on their own or in small clusters. Some babies have just one or two, while others may have several scattered around. They don’t cause pain, and your baby won’t even notice them. They usually don’t interfere with feeding either.
What Epstein Pearls Contain
Epstein pearls are filled with keratin, a protein your body naturally produces. It’s the same material that makes up your hair, nails, and the outer layer of your skin. In babies, keratin can sometimes get trapped under the skin during development, which leads to the formation of these tiny cysts.
As your baby developed in the womb, skin cells in the mouth were forming and layering. Occasionally, a few of those cells get caught in places they shouldn’t be, creating a small buildup under the tissue. That buildup of keratin forms a firm bump just beneath the surface.
This is a completely normal part of fetal development. It has nothing to do with anything you did or didn’t do during pregnancy. It’s also not a sign that anything is wrong with your baby. It doesn’t grow, it doesn’t spread, and it’s not harmful. It simply remains there until your baby’s body naturally breaks it down and it disappears on its own.
How Long Epstein Pearls Last
Epstein pearls don’t stick around for long. Most disappear on their own within a few weeks after birth. Some might last a little longer, up to a couple of months, but that’s still completely normal.
Epstein Pearl vs Tooth in Newborns
It’s common for parents to wonder if the white bump they’re seeing is actually a tooth. While it’s rare, some babies are born with teeth or develop them within the first month of life. These are known as natal teeth (present at birth) or neonatal teeth (appear within the first 30 days).
So how can you tell the difference?
Epstein pearls are smooth, round, and sit on top of the gums or the roof of the mouth. They don’t have sharp edges and don’t move. A tooth, however, will feel hard and sharp. Natal teeth usually show up on the lower gum, right where the bottom front teeth eventually come in.
If you gently touch the bump with a clean finger, an Epstein pearl will feel like a small ball of wax. A tooth will feel solid, like enamel. The biggest difference is that Epstein pearls go away on their own within a few weeks, while teeth obviously don’t.
Read more: Baby Born With Teeth: How Common Is It and Should You Worry?
Epstein Pearls vs Bohn’s Nodules in Newborns
Another common mix-up is between Epstein pearls and Bohn’s nodules. Both are small white or yellowish cysts that can appear in a newborn’s mouth, and they look so similar that it’s easy to confuse them.
The difference lies in what they’re made from and where they show up. Bohn’s nodules form from leftover mucous gland tissue, while Epstein pearls form from trapped skin cells. Bohn’s nodules usually appear on the sides of the gums or toward the back of the palate, while Epstein pearls are typically found along the midline of the roof of the mouth.
Bohn’s nodules can take a few months to disappear, while Epstein pearls usually fade within a few weeks. Both are completely harmless, don’t require any treatment, and won’t cause any issues for your baby.
What Not to Do
Don’t try to pop, scrape, or remove the bumps yourself. It can be tempting, especially if you’re used to dealing with pimples or blisters, but Epstein pearls are not the same. Trying to remove them can introduce bacteria into your baby’s mouth, cause irritation, or even lead to an infection. The best thing you can do is leave them alone and let your baby’s body take care of it naturally.
When to Call a Doctor
Epstein pearls are harmless, but sometimes bumps in a baby’s mouth can be a sign of something else. You should contact your pediatrician or pediatric dentist if the bumps look red, swollen, or seem to be causing discomfort. If your baby is having trouble feeding, appears unusually fussy, or if the bumps start to bleed or ooze, it’s a good idea to have them checked out.
If the bumps don’t go away after a few months or seem to be getting larger instead of smaller, it’s also worth getting a professional opinion.
Being a parent can feel overwhelming, and it’s natural to worry about every little thing. Having clear information can help you feel more confident about what’s normal and when to get help.
If you’re unsure about what you’re seeing in your baby’s mouth or just want to talk it through with a professional, give our pediatric dental office in Lafayette a call. We’re here for families across the greater Acadiana area, including Lafayette, Breaux Bridge, Carencro, Youngsville, and Broussard. Your baby’s oral health matters, and so does your peace of mind.