Wisdom teeth extraction is a common dental procedure, often performed in late teens or early twenties to alleviate discomfort and prevent oral health issues. After removal, oral surgeons frequently use stitches to aid healing and minimize complications at the surgical site.
Understanding Surgical Sutures
Oral surgeons utilize different types of sutures, categorized into absorbable (dissolvable) and non-absorbable. Absorbable sutures are typically preferred after wisdom teeth extraction due to their convenience, as they naturally break down and are absorbed by the body, eliminating the need for removal.
Absorbable sutures are composed of materials the body can safely process. Natural absorbable sutures, such as plain gut and chromic gut, absorb relatively quickly, typically within 3 to 10 days. Synthetic absorbable materials, like polyglycolic acid (PGA) and polyglactin 910 (Vicryl), are also common. PGA sutures are known for their predictable degradation rate and strength, often used in third molar extractions, absorbing in about 30 days. Polyglactin 910 is fully absorbed by 70 days.
The Dissolution Process
Dissolvable stitches, commonly used after wisdom teeth removal, gradually disappear through natural biological processes. The primary mechanisms for this dissolution are enzymatic degradation and hydrolysis. As the stitches dissolve, patients might notice small fragments in their mouth, which is normal.
The timeline for stitches to dissolve can vary, generally occurring within 5 to 10 days, though some may take up to two weeks or even a month, depending on the specific material used, the extent of the extraction, and individual healing rates. Saliva also plays a role, as its enzymes can help facilitate the breakdown of sutures. The process is gradual and typically does not require intervention from the patient.
Caring for the Surgical Site
Proper care of the surgical site is important for a smooth recovery and to allow the stitches to dissolve effectively. Oral hygiene should be gentle around the extraction area to avoid disturbing the stitches or the blood clot, which is important for healing and preventing dry socket.
Dietary considerations also play a role in protecting the surgical site. For the first few days, soft foods and liquids are recommended, such as yogurt, applesauce, mashed potatoes, and smoothies. Foods that are hard, crunchy, sticky, or have small seeds should be avoided, as they can irritate the wound or become trapped in the extraction site. Additionally, refrain from using straws, smoking, or engaging in strenuous physical activity, as these actions can create suction or pressure that may dislodge the blood clot or stitches.
Patients should be aware of signs that might indicate a complication and when to contact their oral surgeon. These signs include:
Excessive or persistent bleeding beyond 24 hours.
Severe pain that does not improve with medication.
Swelling that worsens after three days.
Signs of infection such as pus, fever, or foul taste/odor.
Contact your oral surgeon if stitches appear to come out prematurely within 48 hours and the wound reopens, or if they do not seem to be dissolving after a prolonged period (e.g., two weeks), contacting the oral surgeon is advisable.