Eruption Cyst: Symptoms, Types, Causes and Treatment

Eruption cysts are a common, yet often misunderstood, oral condition especially seen in young children as their teeth begin to emerge. Recognizing and understanding eruption cysts is important for parents, caregivers, and dental professionals alike, as this knowledge can help to ease anxieties, guide appropriate care, and prevent unnecessary interventions. In this comprehensive article, we will delve into the symptoms, types, causes, and treatment options for eruption cysts, providing you with a clear and evidence-based understanding of this benign oral phenomenon.

Symptoms of Eruption Cyst

Eruption cysts may appear alarming to parents due to their color and sudden onset, but these cysts typically cause minimal discomfort and resolve on their own. Understanding the key signs makes it easier to differentiate them from more serious dental conditions.

Appearance	Location	Sensation	Source
Bluish swelling	Over erupting tooth	Usually painless	1 2 4 5
Raised, soft mass	Alveolar ridge	Sometimes tender, may bleed	1 2 5
Variable size	Most common in incisors/molars	Can become symptomatic if infected	1 5

Table 1: Key Symptoms

What Do Eruption Cysts Look Like?

Eruption cysts are generally observed as a bluish or translucent swelling on the gum, situated directly over a tooth that is about to erupt. The color may range from pinkish to deep blue or purple, mainly due to fluid accumulation or minor bleeding inside the cyst 1 2 5. They are typically soft and fluctuant to touch, and their size can vary from a few millimeters to over a centimeter, depending on the size or number of underlying teeth.

Where Do They Occur?

The most common locations for eruption cysts are the alveolar ridges, especially over the primary mandibular central incisors and permanent first molars 1 5. However, they can appear over any tooth that is in the process of erupting, including natal (present at birth), primary (baby), and permanent teeth 1 5.

Do Eruption Cysts Hurt?

Most eruption cysts are asymptomatic and painless, which means children may not even notice them. Occasionally, the cyst may become tender, especially if it becomes infected or traumatized. In some cases, the cyst may bleed if it is accidentally bitten or subjected to trauma 2 4 5.

When Should You Worry?

While most eruption cysts are harmless, symptoms that warrant attention include:

• Persistent pain or tenderness
• Signs of infection (such as pus, swelling, or fever)
• Bleeding that does not stop
• Delayed eruption of the tooth

If any of these symptoms occur, a dental professional should be consulted to determine if intervention is needed.

Types of Eruption Cyst

Eruption cysts, though sharing similar features, can present in various forms based on the tooth involved, the patient’s age, and specific clinical characteristics.

Tooth Type	Age Group	Features	Source
Natal/Neonatal	Infants	Associated with teeth present at birth	1 3
Primary	Young children	Most common, often in incisors/molars	1 5
Permanent	Older children	Often over first permanent molars/incisors	1 4 5

Table 2: Eruption Cyst Types

Eruption Cyst by Tooth Type

• Natal/Neonatal Teeth: Rarely, eruption cysts can occur in newborns with teeth present at or shortly after birth. These are called natal or neonatal teeth and are sometimes associated with eruption cysts 1 3.
• Primary Teeth: Most eruption cysts are associated with the eruption of primary (baby) teeth, especially the mandibular central incisors and maxillary first molars 1 5. These are most common in children aged 5 months to 6 years.
• Permanent Teeth: As children grow, eruption cysts can also occur over erupting permanent teeth, particularly the first molars and central incisors 1 4 5. These usually affect children in the 6–12 year age group.

Multiple vs. Single Cysts

While most children develop a single eruption cyst at a time, multiple cysts can occur, especially in cases of delayed or abnormal tooth eruption 5. In a small subset of cases, more than one cyst may be observed in the same child.

Clinical Variations

Eruption cysts may also be classified based on their appearance:

• Simple Eruption Cyst: Contains clear or straw-colored fluid.
• Eruption Hematoma: Contains blood, giving the cyst a darker bluish-purple color, often following minor trauma to the area 1 5.

Causes of Eruption Cyst

Understanding what leads to the formation of an eruption cyst can help demystify this condition and reassure parents about its benign nature.

Cause	Description	At-Risk Group	Source
Developmental	Accumulation of fluid above erupting tooth	Children (0–12 yrs)	1 5
Trauma	Minor injury to gum over erupting tooth	Infants/children	1 5
Inflammation	Mild infection or irritation	Susceptible children	2 5

Table 3: Causes of Eruption Cyst

Developmental Process

The primary cause of eruption cysts is a developmental process. As a tooth moves towards the surface, the tissue overlying the crown may separate from the epithelium, creating a pocket where fluid accumulates. This results in a soft, cystic swelling above the erupting tooth 1 5.

Role of Trauma

Minor trauma to the gums—such as biting, chewing hard foods, or accidental knocks—can cause bleeding into the cystic space. This may convert a clear eruption cyst into an eruption hematoma, making it appear more bluish or purple 1 5.

Inflammation or Infection

Sometimes, mild infection or inflammation of the gum tissue overlying the erupting tooth can contribute to cyst formation or aggravate an existing cyst, making it more noticeable or symptomatic 2 5.

Predisposing Factors

Certain factors may increase the risk of developing eruption cysts:

• Age: Most common in infants and young children, but can occur up to age 12 1 5.
• Tooth Eruption Sequence: Teeth that erupt early (natal/neonatal) or late may be more likely to develop cysts 1 3.
• History of Trauma: Children with previous gum injuries may be at higher risk 5.

Treatment of Eruption Cyst

Most eruption cysts do not require intervention. However, when symptoms arise, several safe and effective treatments are available.

Management	Indication	Description/Outcome	Source
Observation	Asymptomatic cysts	Most resolve spontaneously	1 2 4 5
Surgical	Symptomatic cysts	Incision & drainage/marsupialization	1 2 4 5
Extraction	Rare, severe cases	Removal of non-viable tooth	1
Laser	Pediatric patients	Minimally invasive, no stitches	4 6

Table 4: Treatment Options

Observation and Reassurance

• Most Common Approach: The vast majority of eruption cysts require no treatment and will resolve as the underlying tooth erupts through the gum 1 2 4 5.
• Parental Guidance: Parents should be reassured that the cyst is benign and will likely disappear on its own within a few days to weeks.

Surgical Intervention

• Indications: If the cyst becomes painful, infected, bleeds excessively, or interferes with tooth eruption, a minor surgical procedure may be necessary 1 2 4 5.
• Procedures:
  • Incision and Drainage: A small incision is made over the cyst to release fluid and expose the erupting tooth, relieving pressure and promoting eruption 2 4 5.
  • Marsupialization: In some cases, opening the cyst widely and suturing the edges to the gum can prevent recurrence and facilitate eruption 1.

Extraction

• Rarely Needed: Extraction of the associated tooth is only considered in rare cases where the tooth is non-viable or causing persistent problems 1.

Laser Treatment

• Modern Techniques: Laser-assisted procedures, such as those using diode or Er,Cr:YSGG lasers, offer a bloodless, painless option for children who may be anxious or uncooperative 4 6.
• Advantages: These methods reduce postoperative discomfort, swelling, and infection risk, and are well tolerated by pediatric patients 4 6.

Aftercare and Monitoring

• Follow-Up: Children who undergo surgical or laser treatment should be monitored for proper healing and eruption of the tooth.
• Oral Hygiene: Good oral hygiene should be maintained to prevent infection during the healing process.

Conclusion

Eruption cysts are a common and benign occurrence during childhood tooth eruption. While their appearance can be startling, they are rarely a cause for concern. Here’s what you need to remember:

• Eruption cysts are soft, bluish swellings over erupting teeth, most often seen in children.
• They can occur with natal, primary, or permanent teeth, with primary incisors and molars being most commonly affected.
• Causes include normal developmental processes, minor trauma, or mild inflammation.
• Most cysts resolve on their own; treatment is only needed for symptomatic cases, with surgical and laser treatments being safe and effective options.

By understanding eruption cysts, parents and caregivers can be reassured and equipped to seek professional help only when it’s truly necessary—ensuring healthy, happy smiles for years to come.