Wisdom tooth removal is a common surgical procedure, and for most people, the recovery progresses smoothly. Stitches, or sutures, are frequently used to close the surgical site, helping to control bleeding and encourage proper gum tissue healing. Monitoring the surgical site closely is important to differentiate between the expected signs of normal healing and the concerning indicators of a developing infection.
Normal Appearance of Healing Stitches
Following a wisdom tooth extraction, the surgical site will look different from normal gum tissue. The area immediately surrounding the stitches is expected to appear pink or mildly red, reflecting the body’s natural inflammatory response to surgery. Minor swelling is typical for the first three days, usually peaking around the 48 to 72-hour mark before subsiding.
The stitches may be made of various materials and colors, such as black, blue, or white, and often dissolve on their own within seven to ten days. A small amount of light, clear oozing or pink-tinged saliva is normal and indicates the initial stages of wound closure. Additionally, a thin, white or yellowish layer of tissue, known as fibrin, may form over the socket; this protective layer is a normal part of the healing process, not pus.
Visual Indicators of Infected Stitches
The appearance of infected stitches differs significantly from a normally healing site, often involving a dramatic change in color and discharge. The most telling visual sign of infection is the presence of purulence, a thick, opaque fluid commonly known as pus. This discharge may be white, yellow, or greenish and often comes directly from the stitch site or the extraction socket.
The gum tissue around the stitches will display a deep or bright red color that extends noticeably beyond the immediate surgical boundary. This increased, intense redness indicates an inflammatory response disproportionate to normal healing. If swelling begins to worsen or significantly increase after the third day, when it should be decreasing, it signals a potential infection.
Infected tissue may appear puffy or distended, sometimes looking like it is pulling away from the sutures rather than holding them securely. The presence of an abscess, a localized collection of pus resembling a pimple near the extraction site, is a clear sign of bacterial infection. Unlike the normal fibrin layer, infected tissue can sometimes appear gray or necrotic. These visual changes require immediate attention if they develop or intensify several days after the procedure.
Systemic and Local Symptoms Accompanying Infection
A developing infection often triggers physical reactions beyond the surgical site. One common indicator is severe, throbbing pain that is not alleviated by prescribed pain medication. If the pain begins to worsen significantly after the third day, rather than improving, it should be considered a red flag.
A persistent, foul taste or odor (halitosis) is frequently associated with the presence of pus and bacteria in the surgical area. This unpleasant sensation will not improve with routine rinsing or brushing. Systemic symptoms, which affect the entire body, are particularly concerning, including a fever above 100.4°F (38°C), body aches, or chills. Local symptoms suggesting the infection is spreading include swollen lymph nodes in the neck or jaw area, along with difficulty opening the mouth fully, known as trismus.
Immediate Steps If Infection Is Suspected
If any visual or physical indicators of infection are noticed, immediately contact the oral surgeon or dentist who performed the procedure. Oral infections can progress rapidly, so do not delay contacting the provider if symptoms like high fever or uncontrolled pain are present. When calling, relay specific details, such as the exact color of any discharge, the degree of fever, and how the pain compares to initial post-operative discomfort.
Treatment involves professional intervention, often requiring the surgeon to clean the area thoroughly and prescribe oral antibiotics to eliminate the bacteria. While waiting for an appointment, a gentle rinse with warm salt water can help keep the area clean, but aggressive swishing or probing of the stitches must be avoided. Self-treating with home remedies is insufficient, as the infection requires both physical cleaning and targeted medication to resolve completely.