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White Bumps in the Mouth: Can It Be Early Teething?

If you've noticed white or yellow bumps in the mouth of your baby, the first thought that comes to mind might be that the baby's teeth are making an early entrance. However, these bumps are known as Epstein pearls and are completely normal. Read on to find out more about them.

What are these whitish-yellow bumps in the mouth of a newborn?

When your baby is a few months old, you'll likely notice what looks like white or yellow pimples in the mouth. These bumps appear on the upper palate, though you might also notice them perched along the gum line. In this position, they can resemble baby teeth pushing through the gum.

While the bumps in the mouth of your little one might seem unsightly and can sometimes make you feel bad for the baby, they are actually completely normal. Between 60 and 85% of babies come into the world with these Epstein pearls. They are also referred to as palatal cysts or gingival cysts, and they're more common in some babies than others. There is increased occurrence in babies:

  • Born before or on their due date
  • Born to mothers who have already given birth to other children
  • Who are heavier

These bumps are harmless and will usually resolve within a few weeks or months of the baby living in the outside world.

What causes bumps in the mouth of a baby?

This kind of benign mouth cyst in a baby develops during your pregnancy. It’s completely normal, and there’s nothing that you could have done to prevent it.

When you are around 8 weeks into your pregnancy, your baby’s palate begins forming. Each maxillary process — the part of the unborn baby that forms the upper jaw and associated features — expands laterally to form the baby’s upper palate. The two processes meet halfway, fusing with the smaller premaxillary process to form the nasal septum. By the fourth month, the palate is fully formed.

During this stage, the outer lining gets trapped between the planes of the palate and the nasal process. This forms cysts that are filled with keratin — the protein in nails and hair. It is for this reason that they are often likened to milia, which are similar white bumps on the baby’s face.

The main reason that it’s recommended you get this cyst in the mouth diagnosed is to ensure that it is not a natal tooth or some other kind of disease. Natal teeth are teeth that babies are born with — they emerge from the womb with one or more teeth already present in the oral cavity.

Sometimes these cysts are signs of an infection like oral thrush, a yeast infection of the mouth. The pimple inside the mouth could be a dental lamina cyst, though this type of cyst is usually larger than an Epstein pearl and firm to the touch.

It's also possible that the bumps could be Bohn nodules. These are usually clustered and are found on along the alveolar ridge, behind the line of teeth. Although they might appear white and firm, they differ from the pearls by virtue of consisting mucous glands and ducts.

You might also notice that the blister inside the lip is attached via a stalk to the lining of the gum. This is known as a congenital epulis. The bump could be a congenital ranula — a translucent nodule on the floor of the mouth next to the tongue web.

With all these possibilities for what the mouth cyst or blister inside the lip could be, it’s advisable to ask your child's pediatrician about it. The doctor will usually need no lab work or imaging done to diagnose Epstein pearls. However, some conditions present in a similar manner to the pearls, and he or she may do a differential diagnosis to rule them out.

How to treat cysts in the mouth of a baby

When it comes to gingival cysts, there is no treatment necessary as the bumps usually rupture and dump the keratin contained in them into the mouth. This often happens in the first weeks and months of life outside the womb. Sometimes, breastfeeding can help resolve gingival cysts, as the light friction when the baby suckles can painlessly rupture the Epstein pearls.

When you notice a cyst or Epstein pearl within the oral cavity of your little one, you might be tempted to feel it out, or even try to pop it. The benign nature of the cyst means it will go away of its own accord, so it's best not to intervene. Popping or rupturing the cysts breaks the skin and presents an opportunity for bacteria and fungi to get into the blood and soft tissues, which can cause an infection. You should, therefore, keep your hands off any mouth cyst.

So, if you see a white bump in the mouth of your baby, you needn’t worry. It’s most likely an Epstein pearl, which is benign and will resolve itself in a few weeks. However, if it persists past the first month, check in with your pediatrician so that they can see what the growth is.





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