Wisdom tooth removal, or third molar extraction, is a common oral surgery procedure. Whether stitches are used depends on the complexity of the extraction. While a simple removal of a fully erupted tooth might not require closure, most extractions involve some surgical intervention. Sutures are standard practice, especially if the tooth was impacted or required an incision into the gum tissue for access.
Why Stitches Are Used
The primary function of stitches, or sutures, is to close the surgical site and stabilize any soft tissue flap created by the surgeon. This closure promotes faster and more predictable healing of the gums. Stitches also help manage initial bleeding by holding the wound edges together.
Sutures also secure the blood clot that forms in the empty tooth socket. This blood clot acts as a natural protective barrier, shielding the underlying bone and nerves. Stabilizing this clot helps prevent dry socket, a painful complication that occurs when the clot is prematurely lost. If the extraction was simple and the tooth was easily removed, the need for soft tissue closure may be minimal or eliminated entirely.
Dissolving vs. Non-Dissolving Stitches
Surgeons typically use one of two main types of sutures: absorbable (dissolving) or non-absorbable. Dissolving stitches are the most frequently used type because they eliminate the need for a follow-up removal appointment. These sutures are made from materials like synthetic polymers or natural gut, which the body breaks down naturally over time through hydrolysis.
Dissolving stitches usually begin to feel loose or fall out entirely within five to ten days after surgery, though they may take up to a few weeks to completely disappear. The exact rate of dissolution depends on the material used, the suture size, and your individual healing response. Noticing small, dark threads coming away from the site is normal and signifies that the wound has healed enough for the stitches to be shed.
Non-dissolving, or non-absorbable, stitches are made from durable materials like silk or nylon that the body cannot break down. They are sometimes used for specific surgical needs where longer-term support or a stronger closure is desired. If you receive this type, a follow-up appointment is necessary. The surgeon typically removes these sutures about seven to ten days after the procedure, once the gum tissue has healed sufficiently.
Caring for the Stitch Site and Knowing When to Call the Dentist
Proper care of the stitched area is important for a smooth recovery and complication prevention. For the first twenty-four hours, avoid rinsing or spitting, as the suction can disrupt the blood clot and the stitches. Starting the day after surgery, begin gentle rinsing with warm salt water. Allow the solution to fall out of your mouth rather than spitting vigorously.
Stick to a soft-food diet for the first few days and avoid chewing directly on the surgical site to prevent food debris from getting lodged around the sutures. While maintaining oral hygiene is important, avoid brushing the immediate stitch site for the first three to seven days, focusing on the surrounding teeth. If you have dissolvable stitches, a small piece becoming loose or falling out after the first few days is not a cause for concern.
You must contact your dentist or oral surgeon immediately if you notice specific warning signs suggesting a complication. These signs include pain that begins to increase after the first three to four days, which is often when pain should be subsiding. Other symptoms requiring professional attention are excessive or persistent bleeding, pus discharge, a fever, or a foul taste or odor not relieved by gentle rinsing.