Spotting a few grain-like white bumps inside a newborn’s mouth can be alarming. These are commonly called Epstein pearls or gum cysts, and they are generally described as harmless and not in need of treatment.
Why They Happen
Health references describe Epstein pearls as small white or yellowish cysts on the gums or palate that are filled with keratin, a protein found in skin. They are linked to leftover tissue from the way the mouth forms before birth and are considered a normal part of oral development. Different names are sometimes used for bumps on the gum ridge versus the middle of the palate, but both are usually described as painless and benign. Nothing a parent did during feeding or care causes them.
How They Change Over Time
They are usually noticed in the first weeks of life and typically go away on their own without treatment. Many sources say this happens within a few weeks to months, though how fast varies from baby to baby. By the time the first teeth begin to come in, they are often gone. A firm lump that stays in the same spot or keeps growing, especially after teeth appear, is worth having checked.
What to Do at Home
Watching and waiting is the usual advice. After feeds, a clean, damp gauze or soft cloth can be used to wipe the gums and tongue gently once or twice a day. Do not try to pop, scrape or squeeze the bumps, because that can cause irritation or infection. Wash hands before touching the baby’s mouth, and clean pacifiers, bottle nipples and toys regularly. Mention the bumps at the next well-baby visit so a clinician can take a look.
Common Misunderstandings
Some parents think the bumps are early teeth, but they are cysts, not teeth. Others confuse them with oral thrush, which is usually a milk-curd-like white coating on the tongue and inside the cheeks that does not wipe off easily, rather than separate round bumps on the gums. It is also easy to blame these painless bumps for feeding trouble, so if a baby is fussy at feeds, other causes deserve a look.
When to Seek Care
Call a pediatrician or pediatric dentist if a bump grows, turns red or swollen, bleeds or has pus, does not go away after several months, or the baby refuses to feed or has a fever. If the mouth swells and the baby has trouble breathing, turns blue around the lips or is limp and hard to wake, seek emergency care right away. This information is based on U.S. and international sources; if you live elsewhere, check with a local pediatrician. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.