Epstein Pearls in Newborns 2025: Symptoms, Causes, Pictures & Treatment Costs

If your newborn has small white or yellowish bumps along their gum line or the roof of their mouth, these are most likely Epstein pearls—benign gingival cysts unique to infants.

Epstein pearls are quite prevalent, affecting approximately 60 to 85 percent of newborn babies. They are more frequently observed in infants born to older mothers, those born after their due dates, and babies with higher birth weights.

Though these bumps may appear unusual, they pose no health risks. Continue reading to understand more about Epstein pearls, including their occurrence exclusively in newborns.

Recognizing Epstein Pearls: Symptoms and Appearance

Epstein pearls do not cause discomfort or symptoms beyond their visible presence. Typically, you will notice small whitish-yellow nodules, ranging from 1 to 3 millimeters, on your baby's gums or the roof of the mouth. They can sometimes resemble emerging teeth.

Do Adults Get Epstein Pearls?

Epstein pearls are exclusive to newborns and do not occur in adults. However, adults may develop dental cysts that resemble Epstein pearls but usually form near the roots of non-vital or impacted teeth. These cysts generally remain symptom-free unless infected, which can cause pain and swelling.

If untreated, adult dental cysts may enlarge and exert pressure on surrounding teeth, potentially weakening the jawbone. Such cysts can be effectively treated with minor surgical procedures, often accompanied by removal of dead root tissue to prevent recurrence.

What Causes Epstein Pearls?

Epstein pearls form during fetal development when epithelial cells become trapped along the gum line or palate. These trapped cells accumulate keratin, a natural protein in the skin, forming small cysts. Since these cysts develop in utero, they are not caused by any actions or inactions during pregnancy and cannot be prevented.

When Should You Consult a Doctor?

While Epstein pearls are harmless and typically require no medical intervention, consult your pediatrician if your baby shows signs of discomfort or unusual irritability. Doctors can distinguish Epstein pearls visually and may also check for other conditions like natal teeth—rare teeth present at birth—or oral thrush, a yeast infection causing white patches in the mouth.

Epstein pearls usually resolve naturally within a few weeks after birth but can sometimes persist for several months. If the bumps remain unchanged or grow, a medical evaluation is advisable to rule out other causes.

Treatment and Prognosis

No treatment is necessary for Epstein pearls. They tend to disappear spontaneously within one to two weeks as normal feeding motions help break down the cysts.

Although Epstein pearls might be concerning to new parents, they are benign and painless. Persistent discomfort in your baby should prompt a consultation with a healthcare provider to ensure proper care.

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