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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Congenital or Other Oral Findings
  1. Inclusion Cysts
  2. Natal and Neonatal Teeth
  3. Congenital Epulis
  4. Ankyloglossia
  5. Cleft Lip/Palate
  6. Bifid Uvula
  7. Ranula/Mucocele
  8. Eruption Cyst/Hematoma
  9. Bony Tori (“Torus Palatinus or Mandibularis�)
  10. Diastema
  11. Macroglossia
  12. Micrognathia

Inclusion Cysts
Small, white or translucent papules or cysts are present in newborns. Usually asymptomatic and resolve spontaneously by 3 months of age.

There are 3 types of inclusion cysts found in newborns

  • Epstein’s Pearls
    Epstein’s Pearls are epithelial remnants of palatal fusion located along the mid-palatal raphe of the hard palate. Resolve spontaneously with no need for evaluation or intervention.
  • Bohn’s Nodules
    Bohn’s Nodules are heterotopic salivary gland remnants located on the buccal or lingual surface of the alveolar ridge (not the crest), or on the hard palate, away from the raphe. 
  • Dental lamina cysts
    Dental lamina cysts are located on the crest of the alveolar ridge.

No treatment is necessary.

Natal and Neonatal Teeth
Some infants erupt teeth, usually lower incisors, before birth (natal teeth) or shortly thereafter (neonatal teeth). Most often primary (not extra) teeth. No treatment is generally indicated. Extraction may be considered only if teeth are mobile, interfere with breastfeeding, or lead to Riga-Fede ulceration. Avoid wiggling as not to loosen the tooth.

Refer to Chapter 2: Dental Development for more information or view the image in the Chapter 11 Photo Gallery.

Congenital Epulis
Pedunculated, non-tender, spongy mass is usually located on the anterior maxillary alveolar ridge. Congenital Epulis is benign in nature and may regress spontaneously. If it is large and interferes with feeding, excision may be required. Recurrence is unlikely.

Fast Facts
Inclusion cysts are extremely common, with Epstein's pearls being the most common variant.
Inclusion cysts usually resolve spontaneously by 3 months of age.
An Epulis is a benign, pedunculated mass.

Chapter Photo Gallery
View the Chapter 11 Photo Gallery.
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