Dental stitches, formally known as sutures, are used following many oral surgical procedures, such as tooth extractions, gum grafts, or dental implant placement. Their function is to gently hold the gum tissue edges together, stabilizing the wound and promoting optimal healing by keeping the underlying blood clot secure. Stitches reduce bleeding, protect the surgical site from debris, and allow the gum tissues to fuse. Understanding the materials and colors of these threads can help patients feel more informed about their recovery.
Identifying Common Suture Colors and Materials
The color of a dental suture indicates the material type and its absorbability status. This visual coding helps the surgeon select the correct suture for the surgical site. Materials fall into two primary categories: those that dissolve on their own (absorbable) and those that require removal (non-absorbable).
Dark colors, such as black or dark blue, typically signify non-absorbable materials like braided silk or synthetic nylon. Silk is a natural material chosen for its excellent handling and knot-tying properties. The dark color provides high contrast against the pink gum tissue, making the suture easy for the dentist to locate and remove later. These materials are used when prolonged tissue approximation or high tensile strength is required.
Violet or light blue threads often indicate synthetic absorbable materials, such as Polyglactin 910 (Vicryl). These synthetic sutures are designed to break down through a process called hydrolysis. Clear, white, or tan sutures are also commonly absorbable, including materials like plain or chromic gut. These materials are less noticeable in the mouth and are broken down by the body’s enzymes.
The Timeline for Dissolving or Removal
The timeline for stitches depends on whether the surgeon selected an absorbable or non-absorbable material. Absorbable sutures are used in most routine procedures and are designed to lose strength and break down over a predictable period. This process is generally complete within 7 to 14 days, though some may start to feel loose or fall out as early as five days.
The dissolution of synthetic sutures like Polyglactin occurs through hydrolysis, a slow chemical reaction. Natural gut sutures are absorbed faster due to enzymatic breakdown, typically within 5 to 10 days, depending on whether they are plain or chromic-treated for longer retention. If a small piece of an absorbable stitch falls out prematurely, it is usually not a cause for concern, provided the wound appears closed and there is no excessive bleeding.
Non-absorbable stitches, such as those made from silk or nylon, remain intact until manually removed by the dental professional. This removal appointment is typically scheduled 7 to 14 days after surgery, once the gum tissue has healed sufficiently to hold itself together. The removal process is quick and generally painless, involving the cutting of the thread near the tissue and a gentle pull to slide the stitch out.
Post-Operative Care and Warning Signs
Post-Operative Instructions
Proper care is necessary while the stitches are in place to ensure the surgical site heals cleanly and quickly. Patients should avoid aggressive rinsing or spitting for the first 24 hours to prevent dislodging the protective blood clot. After the initial period, gently rinsing with warm salt water several times a day can help keep the area clean and aid healing.
To protect the surgical site and prevent premature opening of the wound, patients should:
- Brush gently, avoiding the surgical site itself for the first few days.
- Eat a soft diet to prevent sharp or hard foods from irritating the wound or catching on the stitches.
- Resist the urge to pull, pick at, or disturb the stitches with their tongue.
- Avoid sucking motions, such as drinking through a straw or smoking, as they can create negative pressure that dislodges the blood clot or the stitches.
Warning Signs
While some minor oozing, mild swelling, or discomfort is normal, patients must monitor for specific warning signs of a complication. Call your dental office immediately if you experience excessive or uncontrolled bleeding that does not stop with pressure. Signs of infection require prompt attention, including increasing pain or swelling after the third day, a foul odor, or the presence of pus. If non-absorbable stitches come loose or the incision appears to open before the scheduled removal, contact your provider for guidance.