The pyogenic granuloma is a relatively common reactive, tumor-like overgrowth of granulation tissue that occurs as a result of local irritation. It may occur at any age, but is most commonly seen in teenagers and young adults. It is more common in females than in males. They can develop almost anywhere in the oral cavity, but are most commonly seen on the gingiva. The one shown here happened in a 12 year old girl as a result of irritation from plaque accumulation under an orthodontic wire. Granulation tissue is red, raised and bleeds easily. These can grow to be fairly large, up to ten mm.