Epstein Pearls: Causes, Symptoms, and Treatment

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When your little one starts teething, it gets very exciting to watch those tiny pearly whites finally make an appearance. Usually, this process can make your baby a little irritable and the tiny tot would chew on anything he or she can find. However, there are instances when there’s a slight ‘bump’ in the process and instead of a brand new tooth, you might notice tiny white or yellow bumps on the roof of your little one’s mouth. These bumps are called Epstein pearls and are not usually a cause of worry. Let’s learn more about this condition so that you are better equipped to help your infant.

What are Epstein pearls?

Epstein pearls, also known as gingival cysts, are those white bumps that appear in your baby’s mouth and often resemble baby teeth. While it’s normal to worry about your child’s health, these Epstein pearls in newborns is a benign form of acne that occurs in the mouth. These bumps are quite small and less than a few millimetres in diameter. You don’t have to panic as these gingival cysts do not get bigger with time. It can either occur as a single cyst or in groups of two to six lesions.Epstein pearls occur in 60 to 85 per cent of newborns and are more common in babies who:

  • Have a higher birth weight

  • Are born to older mothers

  • Are born past their due dates

Since Epstein pearls resemble baby teeth, you need to learn how to tell them apart. Understanding the symptoms of the condition can help you identify the condition.

Symptoms of Epstein pearls

  • The Epstein pearls are yellowish or white and are only visible when babies open their mouth to yawn or cry.

  • These gingival cysts are barely noticeable and tend to be smaller than three millimetres in diameter.

  • These bumps are harmless and do not cause any severe discomfort to the little one. It does not interfere with the feeding process.

  • Very often, people confuse Epstein pearls with another condition called milia, which causes keratin-filled bumps. The only difference between these conditions is their location; While Epstein pearls appear only on the roof of the mouth and gums, milia can occur anywhere on the skin.

Causes of Epstein pearls

There’s no clear cause of Epstein pearls, but it occurs in 80 per cent of newborns. The condition doesn’t make itself evident till the baby is three months old. This condition occurs due to a build-up of keratin, the same material that your nails and hair are made of, in the soft and hard palates. When the skin in the little one’s mouth gets trapped during the development process, this trapped skin gets filled with keratin. These tiny bumps are formed in the womb itself and cannot be prevented.

Treating Epstein pearls

While Epstein pearls are harmless, it’s advisable to take your baby to the doctor if he shows signs of pain or irritability. The doctor can differentiate between Epstein pearls and milia by the appearance of the bumps. Based on the symptoms, the doctor would check for oral thrush or natal teeth (teeth that they are born with).

While this is a common condition, there is no particular Epstein pearl treatment method that can get rid of these bumps. In most cases, the bumps disappear on their own within a week or two after birth. The friction that occurs in the little one’s mouth during breastfeeding or bottle-feeding or when they use a pacifier can break down and dissolve the bumps. And, when your baby’s teeth finally appear, you can start brushing them to keep them healthy and clean. To ensure that your baby gets the best brushing experience, you can try Oral-B Kids Manual Toothbrush, which has soft, cup-shaped bristles to surround and gently clean baby teeth. The power tip bristles can clean well and even reach the back teeth with ease. Moreover, this toothbrush has a control grip that helps small hands maintain a steady hold on the toothbrush while they brush. And, once your kid turns three, you can also introduce them to Oral-B Kids Electric Toothbrush, which have soft bristles to protect your little one’s gums and a small head for easy brushing. These toothbrushes work hard and remove plaque tooth-by-tooth, so that you won’t have to spend a lot of time helping your baby brush. Inculcating good dental habits from an early age will prevent dental issues from arising in future.

When to see a doctor

The only time you need to consult a doctor for these bumps is when you are worried that these bumps occur due to a different reason. The following conditions display signs and symptoms that resemble Epstein pearls and are difficult to distinguish.

  • Oral thrush


    This condition is characterised by the appearance of white spots in the baby’s mouth. This fungal infection occurs when Candida yeast enters the mouth and infects the tissues. It causes white bumps or patches in the mouth, including the insides of the tongue and cheeks. Though this condition isn’t quite serious, it causes some difficulty and discomfort while feeding.

  • Hand, foot, and mouth disease


    This viral condition affects children under the age of five and causes sores in the mouth that blister. It starts off as small red dots in the back of the mouth and eventually turns into sores that are painful and can make the baby fussy.

  • Newborn (natal) teeth


    A rare condition that causes a newborn baby to have teeth. The natal teeth appear on the gums and often resemble Epstein pearls.

Epstein pearls can become a cause of worry to parents. However, this condition is not serious, and while there’s no treatment available, it goes away on its own. Explore Oral-B’s kids’ dental products and teach them the importance of good oral health to avoid dental problems in future.