Whitish nodules on the maxillary alveolar ridge in a neonate

A term 3 kg female healthy neonate was brought to us for the evaluation of multiple, small, white, and round lesions on the gingival surface. Intraoral examination revealed multiple discrete pearly white nodules clustered along the center of the upper alveolar ridge [Figure 1]. These were firm to hard on touch and varied from 1 to 5 mm in size. No other abnormality was seen in any other parts of the oral cavity. The lesions did not interfere with the infant’s breastfeeding. Based on the clinical presentation and the characteristic appearance of the lesion, a diagnosis of Bohn’s nodules was made. As the lesion is self-limiting, the child was kept under observation after giving reassurance to the parents.

Close

Figure 1:

Multiple soft to firm whitish nodules (Bohn’s nodules) on the maxillary alveolar ridge.

Export to PPT

Bohn’s nodules are keratin cysts derived from remnants of odontogenic epithelium or minor salivary glands. They occur on the junction of the hard and soft palate and along the alveolar ridges, more commonly on the maxillary than the mandibular. These nodules are self-limiting, rarely seen after 3 months of age.^[1]

They must be differentiated from other developmental oral inclusion cysts (Epstein pearl and gingival cyst) and natal/neonatal teeth which are commonly located along the midpalatine raphe, mandibular anterior region and mandibular ridge (as central incisors), respectively.^[2] Therefore, recognition of the lesion is essential to avoid unnecessary treatment. Parents should be given reassurance regarding the innocuous nature and self-limiting course of the nodules to relieve their anxiety.