Gingival cysts of the newborn
Epstein pearls are whitish-yellow cysts. These form on the gums and roof of the mouth in a newborn baby.
Milia are a similar type of skin problem in babies.
Epstein pearls occur only in newborns and are very common. They are seen in about 4 out of 5 newborns.
The symptoms are whitish-yellow nodules that appear on the gums or the roof of the mouth. They sometimes look like emerging teeth.
Exams and Tests
An exam confirms that these are cysts and not natal teeth.
No treatment is necessary. The condition is harmless.
Epstein pearls disappear within 1 to 2 weeks of birth.
When to Contact a Medical Professional
If you are concerned about Epstein pearls in your infant, talk to your health care provider during a routine well-baby checkup.
Khorsand K, Sidbury R. Common newborn dermatoses. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 106.
Kim WE. Disorders of the mucous membranes. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 684.
Turner EG, Dean JA. Eruption of the teeth: local, systemic, and congenital factors that influence the process. In: Dean JA, ed. McDonald and Avery’s Dentistry for the Child and Adolescent. 11th ed. St Louis, MO: Elsevier; 2022:chap 20.
Last reviewed on: 1/29/2022
Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.