Sutures are frequently used following wisdom teeth removal to manage the surgical site and promote healing. These stitches hold the gum tissue in place over the extraction socket. By closing the wound, they stabilize the protective blood clot necessary for bone and soft tissue to mend. This stabilization also reduces the risk of food debris entering the area immediately after the procedure.
Identifying the Type of Stitches Used
The duration that sutures remain in the mouth depends entirely on the material the oral surgeon selected for the closure. Generally, there are two categories of stitches used in oral surgery: absorbable and non-absorbable. It is important to confirm with the surgical team which type was placed, as this determines the necessary follow-up care.
Absorbable sutures are the most common choice, engineered to break down biologically within the body. These materials are composed of synthetic polymers or natural substances that are safely metabolized by the tissue over time. Their use simplifies the recovery process because they eliminate the need for a separate appointment to have them removed.
Conversely, non-absorbable sutures, typically made from materials like silk or nylon, do not dissolve. These sutures must be physically removed by the surgeon during a follow-up visit. This appointment is usually scheduled approximately 7 to 14 days after the extraction to ensure initial healing has progressed sufficiently.
The Dissolvable Suture Timeline
For most patients with absorbable sutures, the material begins to loosen and break down quickly. The typical timeline is that these self-dissolving stitches start to noticeably loosen and fall out between 7 and 10 days after the extraction. This process is gradual, and the patient may notice small, thread-like pieces coming away from the site.
The full dissolution can vary widely depending on the specific suture material and the individual patient’s rate of healing. While most begin to disappear within the first week and a half, it can take up to two weeks for the bulk of the stitches to be gone. Tiny remnants may take up to a month to completely disappear in some cases.
Patients may feel the stitches becoming looser or slightly stringy before they completely fall out. If a stitch falls out entirely within the first few days, it is generally not a concern, provided there is no active bleeding or complication. The stitch’s primary role in securing the blood clot is usually complete after the first 24 to 48 hours. If multiple stitches come out prematurely accompanied by new or significant bleeding, the surgeon should be contacted for guidance.
Caring for the Surgical Site
Proper care for the surgical site ensures the sutures remain intact and prevents complications. During the first 24 hours, avoid rinsing or spitting, as this can dislodge the blood clot and lead to dry socket. After the first day, gentle rinsing with a warm saltwater solution can begin, using a half teaspoon of salt dissolved in a cup of warm water.
When rinsing, the patient should simply tilt their head to allow the solution to flow over the extraction site, avoiding vigorous swishing or spitting. Maintaining oral hygiene is important; patients should continue to brush their teeth but must carefully avoid directly brushing the immediate area of the sutures for about a week. A diet of soft foods is recommended to prevent excessive chewing that could stress the healing tissue.
Certain behaviors create negative pressure in the mouth, which can dislodge the blood clot. Patients must avoid using straws and refrain from smoking for at least several days following the procedure. The sucking motion from a straw or the chemicals and heat from smoking significantly increase the risk of dry socket and infection.
Monitoring the surgical site for signs of complication is necessary during the healing process. While mild pain and swelling are expected, patients should seek immediate attention if they notice signs such as pain that drastically increases after the second day or intense, throbbing pain radiating to the ear or jaw. Other warning signs include persistent, excessive bleeding beyond 24 hours, a foul odor, or visible pus, which can indicate a developing infection or dry socket.