What Is an Epstein Pearl?

Medically Reviewed on6/7/2022
Epstein pearl
Epstein pearls are whitish-yellow cysts seen on the gums and roof of the mouth in a newborn baby. These white bumps are harmless and usually go away on their own.

AnEpstein pearl is a small, nonprogressive, self-resolving conditionoften seen in the mouth (oralcavity) of anewbornbaby. These manifest aspearly whitish-yellowbumpsseen over the gums or roof of a baby’s mouth(palate).

Epstein pearls are small white bumps, typically less than a few millimeters, and do not grow bigger over time.

Epstein pearls are also known as:

  • Bohn’s nodules,
  • Gingivalcysts, and
  • Palatal cysts.

The Epstein pearls are named after Dr. Alois Epstein, a Czech pediatrician, who first described them. They are formed during the intrauterine life due to the entrapment of keratin (a type of structural protein present in hair, skin, and nails) within the soft and hard palates.

  • These are often seen in a cluster of two to six pearls.
  • Sometimes, a single pearl may look like a baby tooth breaking through and worry the parents.
  • Additionally, the pearls often feel firm to the touch and can be hard to tell the difference.

Epstein pearls are harmless. They do not causepainor feeding problems in a baby. They will spontaneously disappear within two to three months and will not hamper the baby’s regularteething. The lesions are hardly ever seen after three months of age.

If the baby cries frequently or refuses to feed, it is not due to these pearls. It is better to take them to the doctor.

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No, one should not try to pop or rupture the Epstein pearl. Doing so can cause bleeding, irritation, infection, or even gum damage. Also, people may inadvertently introduce germs into the baby’s mouth and bloodstream, causingsepsis, a serious systemic infection.

How do you treat an Epstein pearl?

Most of these cysts involute or spontaneously rupture in a few weeks from appearing. No ointment, medication, or surgical procedure is required to treat Epstein pearls.

There is no test to detect an Epstein pearl. The doctor will examine the roof of the mouth and mouthcavityto diagnose the condition. Most of these cysts will eventually get smaller and go away in the next few weeks.

What are precocious teeth?

Unlike Epstein pearls, precociousteethare actualteeth. These may be present at birth (natal teeth) or may grow during the first month of birth (neonatalteeth). These precocious teeth are uncommon and may often accompany congenital defects.

Natal teeth are uncommon and seen on the lower gum, where the central incisor teeth will later appear. They may be wobbly because they have incomplete root structures.

  • The natal teeth may cause irritation and injury to the infant’s tongue whennursingand hence, require removal.
  • These teeth can also be uncomfortable for a nursing mother.
  • As such, the teeth are often removed shortly after birth because they are a choking hazard (surgery is done before the baby is discharged).

Consult your doctor in case of neonatal teeth. The doctor will take dental X-ray scans to determine if the teeth are normal milk teeth or extras, as well as the extent of development of the root, enamel, and dentin and their relationship to other teeth.

Sometimes, conservative treatments for precocious teeth may suffice, such as:

  • Changes in feeding technique
  • Smoothing sharp edges of the tooth
  • Application of a special resin over the edge of the tooth, so the tongue glides over
  • Applying protective rings to the gums
  • Dental hygieneincluding topical fluoride application

QUESTION

Newborn babies don't sleep very much.See Answer

Do babies get sick when teething?

Teething
Teething may cause slight discomfort in babies; however, if a child is sick for a long time, it may be due to another condition.

Teethingmay cause slight discomfort inbabies. However, if the child appears to be sick, fussy, or cranky for a longer time, it can be due to conditions other than teething.

Teething usually begins around four to eight months and continues until 30 to 36 months of age. Initially, the lower front teeth appear, and finally, the last set of molars appear.

Some babies may experience thefollowing symptomsduring the teething period:

  • Increased tendency to put things in their mouth
  • Irritability or fussiness that comes and goes
  • Disruptedsleep
  • Swelling or inflammation of the gums
  • Drooling
  • Loss of appetite
  • Rasharound the mouth
  • Mild temperature (never higher than 100 °F)
  • Diarrhea
  • Increased biting
  • Gum-rubbing
  • Ear-rubbing
  • Is less interested in solids
  • Chews on toys or other objects
  • Brings hands to mouth

If your baby experiences these symptoms, do not blame it only on teething and delay treatment. The child could be sick and needs immediate medical intervention. Symptoms include:

  • Fever: If thefeverreaches 101 °F, immediately contact the pediatrician because it could be a sign of infection.
  • Diarrhea: If thestoolbecomes watery and persists for more than a day, it could be a sign of a more severe infection. Contact your child’s pediatrician if you observe watery stools.
  • Prolonged fussiness: If your baby constantly cries to a point where they can’t be consoled or find it difficult tosleep, contact your pediatrician immediately.
  • Rashesover the body:Rashesspreading across their torso, arms, or legs should be brought to your pediatrician’s attention.
  • Runny nose: Runny nose that lasts for more than 10 days isn’t a sign of teething but for a sign of infection. You should immediately contact the pediatrician.
  • Cough: If your baby has a continuouscoughwith a high fever andcold, it could be a sign offlu. You should contact your infant’s doctor immediately.
  • Cheek rubbing and ear pulling: Please contact your doctor if your baby’s ear pulling or cheek rubbing persists or is accompanied by a high fever. It may indicate anear infection.

These could be signs of an infection that may simultaneously occur with teething. It is necessary to consult a pediatrician if you find any unusual symptoms other than these symptoms.

Medically Reviewed on6/7/2022
References
Diaz de Ortiz LE, Mendez MD. Epstein Pearls. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. .

DermNet New Zealand. Natal and neonatal teeth. .

Children's Hospital Los Angeles. Your Infant is Teething: Know the Signs and Symptoms. July 10, 2020. .