Let’s say that you’ve noticed these white-coloured bumps on your baby’s gums or their mouth’s roof. You’ll probably think of the first thing that comes to your mind, which is: “Are my baby’s teeth showing up earlier than usual?” Well, the answer is no.
While there are a few exceptions, most babies start teething around six months. If you notice some nodules/bumps/cysts/pimples before six months, they are not teeth. These are cysts of oral cavities.
Let’s take a look at them and understand the process behind their appearance, when they disappear, and what you can do to treat them.
Types Of White Bumps In Baby’s Mouth
These whitish bumps in your baby’s mouth are not harmful and are usually of five types – with Epstein pearls being the most common of them.
Here are the following cysts that you should know about:
1. Epstein Pearls
Usually, 60-85% of oral cysts are Epstein pearls. It’s a kind of gingival cyst that occurs in babies born to mothers above 40 years, babies who are heavier and born after the due date. However, they do not interfere with the usual teething process of your child.
Among the different racial groups, Japanese newborns are most commonly affected by Epstein pearls, followed by Caucasians and African-Americans.
Certain factors do influence the development of Epstein pearls, but there are no specific causes.
The appearance of Epstein pearls is primarily a developmental defect in newborns. During the 10th–11th week, when the nasal process and palate are about to assume their full form, multiple layers of the skin can sometimes get trapped between them.
As the mouth continues to develop, keratin (the protein found in your hair and nails) starts to deposit in the trapped layers of the skin. This leads to the formation of keratin-filled cysts known as Epstein pearls.
Usually, Epstein pearls form in groups of 2-6 and appear as whitish-yellowish bumps. You can confuse them with teeth, but Epstein pearls don’t cause any discomfort or irritation, unlike teething.
You’ll most likely notice these during feeding or when your baby yawns. They are benign, asymptomatic cysts that do not interfere with feeding or teething.
Diagnosis and Treatment
There are no particular tests to diagnose Epstein pearls. Instead, they are diagnosed clinically upon examination, and no further investigations are required.
As far as the treatment is concerned – there’s no treatment plan for Epstein pearls. They will usually regress or rupture within a few weeks to three months. Once they do, all the built-up keratin is released and eventually flushed out of your baby’s system.
Friction from feeding or sucking on a pacifier can also contribute to the rupture of Epstein pearls.
2. Bohn’s Nodules
Bohn’s Nodules can be confused with Epstein pearls, but they are not the same. Like Epstein bumps, these are keratin-filled cysts as well. However, they are the remnants of salivary glands.
These types of cysts are located on the lingual and buccal aspects of alveolar ridges. On the other hand, Bohn’s nodules are true epithelial cysts, with mucous glands of the mouth being their favourite site for making an appearance.
3. Congenital Epulis
Congenital epulis is a rare condition characterised by a reddish mass ranging from a few millimetres to a few centimetres. It is a benign tumour that can cause respiratory or feeding problems.
It’s soft, located on the gingival margin, and attaches to the tissue via a stem-like appendage. The only treatment option for congenital epulis is surgical resection making it unlikely to make a comeback.
4. Dental Lamina Cysts
Dental lamina cysts are unstable, solitary lesions that are incredibly transparent. They are more significant in size than Epstein pearls and often go away after a short period.
Their site of development is the crest of the alveolar mucosa in the oral cavities of babies.
5. Natal Teeth
As the name suggests, natal teeth are teeth that are present when the baby is born. They usually represent some developmental anomaly and require immediate medical attention.
Since natal teeth are loose at the root, they can be easily knocked off during feeding – allowing the baby to swallow them. Therefore, they need to be extracted as soon as possible.
Your Approach As A Parent
For starters – don’t panic. Panicking is not going to help with your baby’s problem. Epstein pearls don’t pose any threat and regress after a few weeks. So, it’s more likely that the paediatrician would ask you to stay put and watch the bumps wither away.
However, it would help if you didn’t try to pop these bumps. It is so because popping these cysts can expose them to opportunistic microorganisms that can cause serious infections. Thus, leading to more problems and complications for the baby that may actually harm your baby.
So please, don’t do that.
When Should You Seek Professional Help?
If your baby develops any of the following symptoms, seek help from a paediatrician as soon as possible:
- Bumps start bleeding
- The baby looks pretty irritated and agitated
- Bumps don’t appear to disappear after a month
- Baby looks like they are in a lot of pain/discomfort
It’s best to get professional help as soon as you can. Since these pearls do not intend to cause any discomfort to your baby – if they do, it means there’s something wrong.
It’s fairly easy to confuse Epstein pearls with other conditions as well. For example, cysts like dental lamina cysts, congenital epulis and Bohn’s nodules can be mistaken for Epstein pearls. Along with infections like oral thrush, which is a yeast infection primarily involving the mouth.
Therefore, it’s always better to have your queries answered by a doctor.
We understand how concerning any issue regarding your baby can be. In this case, the appearance of the Epstein pearls is indeed worrying for many parents. However, please know that your baby is not in pain and that these bumps usually resolve independently.
However, if there’s any pain or discomfort – we’d advise you to get your baby checked by a professional healthcare provider.