A full term newborn boy, weighing 3 kg, born out of an uncomplicated pregnancy, was brought to us for evaluation of a few small, white and round bumps on the gingival surface. Examination of the oral cavity showed multiple, firm, pearly-white papules measuring 2 to 4 mm in diameter, grouped over the vestibular aspect of the alveolar ridge of the maxillary arch (Fig. 1). Two similar lesions were seen on the mandibular area. These lesions were asymptomatic, non-tender, and fixed to the mucosa. Oral mucosa was otherwise normal. A few milia were noted on his chin. Detailed systemic examination was normal. No specific therapy was prescribed. Within a couple of months, most of the lesions subsided spontaneously. Based on the clinical features and the natural course of the disease, a diagnosis of Bohn’s nodule was made.

Fig. 1 Pearly-white papules (Bohn’s nodules) on alveolar ridge of a neonate.

Bohn’s nodules are keratin cysts derived from remnants of odontogenic epithelium over the dental lamina or may be remnants of minor salivary glands. They occur on the alveolar ridge, more commonly on the maxillary than mandibular. Common differential diagnoses include other developmental oral inclusion cysts (Epstein pearl, Dental laminar cyst) and natal teeth. Epstein pearl is a small, firm, white, keratin-filled cyst, located on the mid palatine raphe. Dental laminar cyst (gingival cyst) is a yellow-white cystic lesion over the alveolar crest that arises from epithelial remnants of the degenerating dental lamina. Natal teeth usually erupt in the centre of mandibular ridge as central incisors. They have little root structure and are attached to the end of the gum by soft tissue.