Bohn's nodules: Unusual oral lesions in a newborn

Sir,

A term, male neonate, weighing 2602 g, delivered vaginally, was noted in the maternity ward to have two small, pearly white, round lumps on the maxillary gums (Fig. 1) on his second day of life. His carers thought they could be natal teeth.

OPEN IN VIEWER

Figure 1.

Multiple shiny white cysts (Bohn's nodules) visible in the maxillary area.

On examination, whitish, firm, non-tender nodules 2–3 mm in size, without local signs of inflammation, were present on the lingual surface of upper gingiva opposite to the site of eruption of canine teeth. Further examination revealed multiple clustered whitish papules on the inner aspect of maxillary gums as well. The possibility of Bohn's nodules was confirmed by dental consultation. On follow-up, these lesions resolved spontaneously over the next two weeks.

Bohn's nodules are of three types of benign keratin filled cysts which may be found in the oral cavity of neonates. Based on their location, they are referred as Epstein pearls, Bohn nodules or dental laminar cysts. ¹ Pearly white keratin filled nodules near the median raphe of the palate are known as Epstein pearls, whereas similar lesions on gingiva are called as Bohn nodules. ² They may also be found on the hard palate but aside from the midline. Identical lesions on the crest of the alveolar ridges are called dental laminar cysts, and arise from epithelial remnants of the degenerating dental lamina and natal teeth.

Bohn's nodules generally resolve on their own and spontaneously rupture within a few weeks to a few months. It is important to inform family members about the benign and self-limiting nature of these nodules, as no additional treatment is required.