Management of Gum Cysts in Newborns
Primary Recommendation
No treatment is required for gum cysts (dental lamina cysts) in newborns, as these are benign, self-limiting lesions that spontaneously resolve within weeks to months after birth. 1, 2, 3
Clinical Recognition and Reassurance
- Gum cysts in newborns are extremely common, occurring in up to 88.7% of infants, and represent transient developmental lesions arising from dental tissue remnants 4
- These lesions typically appear as small, white or yellowish nodules on the gums and do not increase in size 1
- The primary role of the clinician is to provide parental education and reassurance about the benign, self-resolving nature of these cysts to avoid unnecessary anxiety and intervention 2, 3
Key Diagnostic Considerations
- Distinguish gum cysts from natal teeth, particularly when lesions appear in the mandibular anterior region, as management differs significantly 1
- If the lesion is a natal tooth rather than a cyst, refer to the American Academy of Pediatrics guidelines: observe if minimally mobile and not causing feeding difficulties or trauma; smooth sharp edges if causing ulceration; and provide oral hygiene education 5
- Clinical diagnosis alone is sufficient—no biopsy or imaging is needed for typical presentations 1, 2, 3
Management Algorithm
For Typical Gum Cysts:
- Observation only with no surgical intervention 1, 2, 3
- Schedule follow-up visits to document spontaneous resolution, typically within 3-6 weeks of birth 3
- Educate parents that the cysts will shed naturally without treatment 1
Red Flags Requiring Referral:
- Refer to a pediatric dentist if the lesion increases in size, persists beyond several months, or if there is diagnostic uncertainty 6
- Immediate referral is warranted for any facial swelling of unknown origin or possible oral abnormality that does not fit the typical presentation of benign gum cysts 6
Common Pitfalls to Avoid
- Do not perform surgical excision or marsupialization on these self-limiting lesions in young infants, as this exposes the child to unnecessary procedural risks 2
- Avoid misdiagnosing as natal teeth, which may require different management including possible extraction if causing significant problems 5, 1
- Do not order unnecessary diagnostic tests or procedures when the clinical presentation is consistent with benign developmental cysts 2, 3
Parental Counseling Points
- Explain that gum cysts are a normal developmental finding present in the majority of newborns 4
- Reassure parents that no treatment is needed and the cysts will disappear on their own 1, 2, 3
- Advise parents to contact you if the lesions change in appearance, increase in size, or cause feeding difficulties 2
- Emphasize the importance of regular follow-up to monitor resolution 2