Finding a white spot on your baby’s gums can be alarming, but these spots are common in infants and newborns. They are rarely a sign of a serious underlying health issue. White spots generally fall into three categories: harmless developmental cysts, treatable infections, or those related to tooth emergence. Understanding the appearance and location of the spot helps determine the likely cause and whether a healthcare provider visit is necessary.
Harmless and Temporary Causes
The most frequent causes of white spots are benign developmental cysts that resolve spontaneously without treatment. These small, firm bumps are remnants of tissue trapped during development in the womb and are a normal part of oral development.
Bohn’s Nodules
Bohn’s nodules appear as small, white or yellow-white bumps along the gum line, often on the upper jaw. They are remnants of mucous or salivary gland tissue collected along the alveolar ridge. These nodules are firm, painless, and typically disappear within a few weeks or months as the tissue naturally breaks down.
Epstein Pearls
Epstein pearls are similar but are found along the midline of the roof of the mouth (palate). They are small, white-yellow bumps formed from trapped keratin. Although located away from the gums, they are sometimes mistaken for gum spots and are equally harmless, usually resolving quickly as the baby feeds.
Eruption Cysts
An eruption cyst forms over a tooth preparing to break through the gum tissue. This fluid-filled sac can appear translucent, white, or slightly bluish. These cysts are a direct result of the tooth emerging and will rupture harmlessly on their own once the tooth surface pierces the gum.
White Spots Caused by Infection
When white patches appear as a widespread coating rather than isolated, firm nodules, the cause is often Oral Thrush. This condition is caused by an overgrowth of the yeast Candida albicans, which naturally exists in the mouth. Since a baby’s immune system is still maturing, this yeast can proliferate easily, especially in the first six months of life.
Oral thrush presents as creamy, milky-white patches on the gums, tongue, inner cheeks, and sometimes the roof of the mouth. These patches often resemble cottage cheese and are difficult to wipe away. If the patches are rubbed off, the underlying tissue may look red and can sometimes bleed, which signals infection.
A baby with oral thrush may show discomfort, such as fussiness or irritability, and may refuse to feed due to soreness. The fungal infection can also be passed back and forth during breastfeeding, leading to pain and cracking on the mother’s nipples. Treatment usually involves a prescription antifungal medication, often a liquid oral suspension applied directly to the affected areas.
To prevent reinfection, hygiene protocols are important during and after treatment. This includes thoroughly sterilizing bottles, pacifiers, and any toys the baby puts in their mouth. A healthcare provider may also prescribe a topical antifungal cream if the yeast has spread to the diaper area, resulting in a persistent rash.
Addressing Teething and Trauma
The process of a tooth emerging can create a temporary white appearance on the gum tissue that mimics a spot. As a tooth moves closer to the surface, the pressure causes the overlying gum tissue to become pale or ischemic, appearing white just before eruption. This paleness is temporary and is usually accompanied by common teething symptoms, such as increased drooling and fussiness.
Minor trauma to the delicate oral lining can also result in a small white patch or ulceration. This irritation can be caused by vigorous cleaning, pressure from a hard toy, or friction from a bottle nipple. These small areas of irritation are usually shallow and temporary, healing on their own once the source of the trauma is removed.
When to Seek Professional Guidance
While most white spots are benign or easily treatable, consulting a pediatrician or pediatric dentist is the best course for an accurate diagnosis. A healthcare provider can perform a visual inspection to differentiate between harmless cysts and a fungal infection, or rule out rare conditions like natal or neonatal teeth.
Specific red flags indicate a need for prompt professional attention. If the white spots are accompanied by a fever, a refusal to feed, or signs of significant pain, contact a doctor immediately. Similarly, a professional assessment is necessary if the spots spread rapidly, start bleeding easily, or do not show signs of resolving after several weeks. The doctor will determine the appropriate treatment, such as antifungal drops for thrush, or confirm the spot is a benign issue that will resolve naturally.