Palatal and Gingival Cysts of the Newborn

Throughout history, numerous investigators have reported a high prevalence of benign palatal mucosal cysts in newborns (see Palatal Cysts of the Newborn). In 1880, Prague pediatrician Alois Epstein first described the presence of small nodules in the oral cavities of newborns, which were later termed "Epstein pearls." However, it was not until 1967 that Alfred Fromm conducted the largest study on oral inclusion cysts, examining 1367 newborns. Fromm classified the cysts by location and composition into Epstein pearls, Bohn nodules, and dental lamina cysts, concluding that these lesions are common in infants.  Epstein pearls, Bohn nodules, and gingival cysts of the newborn (also known as dental lamina cysts) are remarkably similar lesions that have often been confused or used interchangeably over time. They share more similarities than differences, including clinical appearance, histology, and natural history of evolution; however, they differ in their embryological origins. Currently, the term "palatal cysts" refers to Epstein pearls and Bohn nodules, whereas "gingival cysts" refers to dental lamina cysts. Differentiating among these 3 entities clinically is not always possible or necessary, as diagnosis relies primarily on their clinical appearance, and the treatment approach is the same for all. However, healthcare professionals caring for newborns should be well-informed about these benign, self-resolving lesions to distinguish them from other conditions that require invasive management, such as congenital epulis of the newborn and natal or neonatal teeth.