Epstein Pearls in Newborns: What They Are, Why They Appear and What to Do — What You Need to Know
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Quick Answer:
Epstein pearls are small, harmless white or yellow bumps that appear inside a newborn's mouth, either along the gums or in the center of the roof of the mouth (the palate). They look remarkably like unerupted baby teeth, but they are actually benign (noncancerous) cysts filled with keratin — the protein that also forms hair, skin and nails. They are very common, affecting up to 85% of newborn babies, and require no treatment: the friction of breastfeeding, bottles and pacifiers helps dissolve them naturally, and they usually disappear on their own within three months of birth.
TL;DR: Epstein Pearls at a Glance
Epstein pearls are the most common of three types of harmless "newborn gingival cysts" — tiny keratin-filled bumps in a baby's mouth that form before birth when oral tissues become trapped during fetal development. They don't hurt, don't interfere with feeding or teething, and clear up on their own, usually within weeks. Parents only need to call a pediatrician if the bumps persist past three months, grow, change shape or cause pain.
Limitation statement: All prevalence and timeline figures in this article come directly from the source and its cited research (up to 85% of newborns affected; most resolve within one to two weeks; all resolve within three months). No additional statistics are provided or given here.
Fact | What the source says |
What they are | Small, harmless white or yellow nodules (benign gingival cysts) inside a baby's mouth |
Where they appear | Along the gums or in the center of the palate (roof of the mouth) |
How common | Affect up to 85% of newborn babies |
Size and feel | About 1 to 3 millimeters; hard to the touch |
Do they hurt? | No — no issues with teething or feeding |
What causes them | Keratin-filled cysts formed when oral tissues become trapped during fetal development |
Treatment needed? | None — they dissolve on their own |
How long they last | Often one to two weeks; always gone within three months |
What Are Epstein Pearls?
Epstein pearls are small, white or yellow nodules (bumps) that may appear inside your baby's mouth, either along their gums or in the center of their palate (roof of the mouth). In appearance, Epstein pearls resemble unerupted baby teeth. But these bumps are actually benign (noncancerous) cysts made of excess keratin — a protein that helps form hair, skin and nails. They get their name from Dr. Alois Epstein, the Czech pediatrician who first described this condition.
They're common, affecting up to 85% of newborn babies. These harmless nodules usually go away on their own within three months.
What do Epstein pearls look like?
Epstein pearls look like white bumps underneath your baby's oral mucosa — the skin that lines the mouth. They are usually small, about 1 to 3 millimeters (mm) in diameter, and quite hard to the touch. This hardness is one reason many parents mistake them for baby teeth. They can appear as a single nodule or in groups.
Do Epstein Pearls Have Any Symptoms?
Epstein pearls have no other symptoms besides their appearance. They don't hurt your baby and cause no issues with teething or feeding.
Symptom check | What the source says |
Pain or discomfort | No — Epstein pearls shouldn't hurt your baby |
Teething problems | No — they cause no issues with teething |
Feeding problems | No — they cause no issues with feeding |
Other symptoms | None — appearance is the only sign |
If it seems like your baby is in pain, take them to a healthcare provider for an examination — pain suggests something else may be going on.
What Causes Epstein Pearls?
Epstein pearls contain keratin buildup. Experts believe Epstein pearls form when oral tissues become trapped during fetal development. As the fetus's mouth continues to grow, and the roof of the mouth fuses, these trapped tissues fill with keratin.
How Are Epstein Pearls Different From Bohn's Nodules and Dental Lamina Cysts?
"Newborn gingival cysts" is an umbrella term that describes three distinct conditions. All these conditions refer to cysts that contain keratin. These cysts look so similar that many healthcare providers use the terms interchangeably. Location is the only thing that sets them apart:
Type | Location | What experts believe | How common |
Epstein pearls | Along the gums or in the center of the palate | Form during fetal development when the roof of the mouth fuses | Most common type of newborn gingival cyst |
Bohn's nodules | Along the lip- or tongue-side of the gums; more common on the upper jaw than the lower jaw | Remnants of small salivary glands | — |
Dental lamina cysts | Along the gums; often resemble unerupted baby teeth | Form from leftover fragments of dental lamina (specialized tissue that plays a role in tooth development) | — |
How Do Healthcare Providers Diagnose Epstein Pearls?
In most cases, healthcare providers can diagnose Epstein pearls just by looking at them. Depending on your newborn's symptoms, your provider may also do an oral exam to rule out other conditions like thrush — a common fungal infection — or natal teeth, which occur when a baby is born with teeth.
Diagnostic step | Purpose |
Visual inspection | In most cases, providers diagnose Epstein pearls just by looking |
Oral exam | Rules out other conditions such as thrush (fungal infection) or natal teeth (teeth present at birth) |
Do Epstein Pearls Need Treatment?
Epstein pearls don't require treatment. They typically go away on their own within three months. Things like pacifiers, bottles and breastfeeding cause friction that naturally helps dissolve these nodules.
What should parents never do?
No, you should never try to squeeze or pop Epstein pearls. Doing so will only make your baby's gums more tender and uncomfortable. Most importantly, bursting Epstein pearls can introduce harmful bacteria into your baby's bloodstream. The best thing to do is leave them alone — they should go away on their own in time.
Can adults get Epstein pearls?
No, adults don't get Epstein pearls. But it's possible to develop other types of bumps along your gum line. Any time you notice a new bump inside your mouth, let your healthcare provider know.
How Long Do Epstein Pearls Last?
In most cases, Epstein pearls dissolve within one to two weeks after birth. But they can last longer — sometimes for several months. Eventually, Epstein pearls should go away on their own. Though these bumps may be alarming, they're nothing to worry about.
When Should You Call Your Baby's Pediatrician?
Call your baby's pediatrician if the bumps last longer than three months, if you notice the bumps growing larger or changing shape, or if your baby shows signs of pain or discomfort. These things could mean something else caused the bumps. Your pediatrician can do an exam to rule out other conditions and determine whether your baby needs treatment.
Can I prevent Epstein pearls?
No, there's nothing you can do to prevent Epstein pearls or lower your baby's risk of getting them. These bumps are very common and are a normal occurrence in many newborn babies. If your baby has Epstein pearls, it doesn't mean you did anything wrong — and it doesn't mean your baby needs treatment.
Clinical care-team note (verbatim from the source): "Seeing bumps in your newborn's mouth can be scary. But if your baby has Epstein pearls, it doesn't mean you've done something wrong. These small, whitish bumps form when tissues become trapped during fetal development. They're common in babies, and they'll eventually go away on their own. If you have concerns about your baby's health, or if it seems like your baby is in pain, schedule an appointment with your pediatrician. They can give your baby a proper diagnosis and determine whether they need treatment."
Conclusion: A Common, Harmless Newborn Bump That Clears on Its Own
Epstein pearls are among the most reassuring surprises a new parent can find in their baby's mouth: small, hard, white or yellow bumps that look like emerging teeth but are nothing more than harmless keratin cysts. They touch an estimated 85% of newborns, cause no pain and interfere with neither feeding nor teething, and the everyday friction of breastfeeding, bottles and pacifiers does the dissolving for you. The only real "treatment" is patience — plus knowing when a bump is not an Epstein pearl. If it persists past three months, grows, changes shape or seems to hurt, a pediatrician's exam will sort it out quickly.
Take these three steps:
Don't squeeze or pop the bumps — bursting them can make the gums tender and introduce harmful bacteria into your baby's bloodstream; leave them alone.
Let friction do the work — normal feeding, bottle and pacifier use naturally help the cysts dissolve within three months.
Know the pediatrician triggers — bumps lasting past three months, growing larger, changing shape, or any signs of pain all deserve an exam to rule out other causes.
This article provides general information and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.
Frequently Asked Questions
What are Epstein pearls?
Epstein pearls are small, white or yellow nodules (bumps) that may appear inside your baby's mouth, either along their gums or in the center of their palate (roof of the mouth). They are benign (noncancerous) cysts made of excess keratin.
Are Epstein pearls dangerous?
No. Epstein pearls are harmless, noncancerous cysts that go away on their own.
What are Epstein pearls made of?
They are cysts made of excess keratin — a protein that helps form hair, skin and nails.
How common are Epstein pearls?
They're common, affecting up to 85% of newborn babies.
Where do Epstein pearls appear?
Either along the baby's gums or in the center of their palate (the roof of the mouth).
What do Epstein pearls look like?
They look like white bumps underneath the baby's oral mucosa. They're usually about 1 to 3 millimeters in diameter, quite hard to the touch, and can appear singly or in groups.
Why do parents mistake Epstein pearls for teeth?
They resemble unerupted baby teeth — and their hardness (they're quite hard to the touch) is one reason parents often mistake them for emerging teeth.
Do Epstein pearls hurt?
No. Epstein pearls shouldn't hurt your baby or cause any issues with teething or feeding.
What causes Epstein pearls?
Experts believe they form when oral tissues become trapped during fetal development. As the fetus's mouth grows and the roof of the mouth fuses, the trapped tissues fill with keratin.
Who are Epstein pearls named after?
Dr. Alois Epstein, the Czech pediatrician who first described the condition.
Can Epstein pearls appear as more than one bump?
Yes — they can appear as a single nodule or in groups.
How long do Epstein pearls last?
In most cases they dissolve within one to two weeks after birth, but they can last several months. They should always go away on their own within three months.
Do Epstein pearls need treatment?
No. They don't require treatment and go away on their own. Things like pacifiers, bottles and breastfeeding cause friction that naturally helps dissolve the nodules.
Can I pop or squeeze Epstein pearls?
No — you should never try to squeeze or pop them. It will make your baby's gums more tender and uncomfortable, and bursting them can introduce harmful bacteria into your baby's bloodstream. Leave them alone.
Can I prevent Epstein pearls?
No — there's nothing you can do to prevent them or lower your baby's risk. They're a normal occurrence in many newborns, and having them doesn't mean you did anything wrong.
Can adults get Epstein pearls?
No, adults don't get Epstein pearls — though other types of bumps can develop along your gum line. Let your healthcare provider know about any new bump inside your mouth.
How are Epstein pearls diagnosed?
In most cases, healthcare providers can diagnose them just by looking. A provider may also do an oral exam to rule out other conditions.
What can Epstein pearls be confused with?
Thrush (a common fungal infection) and natal teeth (when a baby is born with teeth).
What is the difference between Epstein pearls and Bohn's nodules?
Both are newborn gingival cysts containing keratin, but they differ in location. Epstein pearls form along the gums or center of the palate, while Bohn's nodules form along the lip- or tongue-side of the gums (more common on the upper jaw) and are thought to be remnants of small salivary glands.
What is the difference between Epstein pearls and dental lamina cysts?
Both are newborn gingival cysts, but dental lamina cysts form along the gums from leftover fragments of dental lamina — specialized tissue that plays a role in tooth development — and often resemble unerupted baby teeth.
What are newborn gingival cysts?
"Newborn gingival cysts" is an umbrella term describing three distinct conditions — Epstein pearls, Bohn's nodules and dental lamina cysts. All contain keratin and look so similar that many providers use the terms interchangeably; location is what sets them apart.
Which is the most common newborn gingival cyst?
Epstein pearls are the most common type of newborn gingival cyst.
Do Epstein pearls affect breastfeeding or bottle feeding?
No — they cause no issues with feeding.
Do Epstein pearls affect teething?
No — they cause no issues with teething.
When should I call my baby's pediatrician about the bumps?
Call if the bumps last longer than three months, if they grow larger or change shape, or if your baby shows signs of pain or discomfort — these could mean something else caused the bumps.
What happens if the bumps last longer than three months?
If your baby still has bumps inside their mouth after three months — or if the bumps grow larger — schedule an appointment with your pediatrician for an exam to rule out other conditions.
Is an oral exam needed for Epstein pearls?
Usually diagnosis is visual, but depending on symptoms, a provider may do an oral exam to rule out conditions like thrush or natal teeth.
Should I worry about Epstein pearls?
No. Though the bumps may be alarming, they're nothing to worry about — they eventually go away on their own, and having them doesn't mean you did anything wrong.
Additional Resources
For further reading, these authoritative external references support the information above:
Content reviewed and produced following the Rinnit editorial framework. Last updated: September 28, 2026.
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