Females are far more susceptible than males due to the hormonal changes that occur in women during puberty, pregnancy, or menopause. Wait until after delivery to remove the lesion in pregnant women due to a greater tendency for recurrence during pregnancy. In a number of cases, mastication on the lesion causes bleeding and pain and requires surgical intervention before parturition. Some pyogenic granulomas regress after childbirth without surgical intervention. Early lesions bleed easily due to extreme vascularity.
Pyogenic granulomas can have a rapid growth pattern that can cause alarm.
The typical lesion involves the interproximal gingiva and increases in size to cover a portion of the adjacent teeth. A number of lesions will affect both the facial and lingual gingivae. As lesions mature, the vascularity decreases and the clinical appearance is more collagenous and pink. Pyogenic granulomas vary in size from a few millimeters to several centimeters and are painless. These tumors are soft to palpation.