Granulation Tissue and Wound Healing in the Mouth

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Wounds can occur inside the mouth for many reasons, including accidents and surgical procedures. No matter the cause of the wound, the body will begin to heal it. Granulation tissue, which forms on the wound, plays an important role in the healing process.

The Wound Healing Process

Wounds inside the mouth heal in essentially the same way as wounds in any other part of the body, explains an article published in Frontiers in Physiology. First, a blood clot forms in the wound, which serves to seal the wound. Nearby blood vessels constrict to stop the bleeding. The immune system then works to remove debris, damaged tissues and microorganisms from the wound.

After those initial steps, granulation tissue starts to form in the wound. This very fragile tissue consists of small blood vessels, white blood cells and other connective tissue cells containing collagen, a protein that provides a foundation for new tissue growth.

Cells from the edges of the wound move across the wound surface in a process known as epithelialization. These cells work to eventually close the wound. As the healing process concludes, a scar may be left in the area.

Role in Oral Health

Granulation tissue plays a key role in the healing process and helps protect the wound from further damage. It is especially important in the case of larger wounds, like those left by tooth extractions. When a tooth is extracted, granulation tissue forms after about one week, according to the Frontiers in Physiology article. It protects the extraction site until the new bone can form, which takes about eight weeks.

During gum flap surgery, a specialist called a periodontist separates the gum tissue from the teeth and often removes granulation tissue in the process. This is intended to facilitate healing and reduce chances of infection. However, a study published by the Swiss Dental Journal found that granulation tissue may contain stem cells that could aid in repairing the gums. Removed or not, this tissue is a powerful product of your body that supports your health and ability to recover from injury.

Signs an Oral Wound Isn't Healing Properly

Wounds inside the mouth tend to heal more quickly than wounds elsewhere on the body, reports an article in Science Translational Medicine. Despite this, oral wounds can sometimes heal improperly. While granulation tissue promotes healing, if too much of this tissue forms in a wound, it actually slows the healing process. The healing process can also be halted if a wound bleeds excessively and the tissue isn't able to form properly.

The development of pus and a bad smell from the wound are also signs that your wound is healing abnormally. If you're concerned about an oral wound, talk to your dentist.

Oral Hygiene With a Mouth Injury

It can be hard to stick to your regular oral hygiene routine when you have a wound inside your mouth. However, brushing and flossing are still important during this time. Your dentist can provide advice on how to clean your teeth without disturbing the wound. For example, if you've had a tooth extracted, you should avoid cleaning the affected area until healing has begun, but you can brush and floss all the other teeth.

Wounds inside the mouth can be uncomfortable, but they generally heal quickly. If you have a wound inside your mouth, follow your dentist's care instructions.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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Each tooth has several distinct parts; here is an overview of each part:

  • Enamel – this is the outer and hardest part of the tooth that has the most mineralized tissue in the body. It can be damaged by decay if teeth are not cared for properly.

  • Dentin – this is the layer of the tooth under the enamel. If decay makes it through the enamel, it next attacks the dentin — where millions of tiny tubes lead directly to the dental pulp.

  • Pulp – this is the soft tissue found in the center of all teeth, where the nerve tissue and blood vessels are located. If tooth decay reaches the pulp, you usually feel pain and may require a root canal procedure.