Wisdom teeth extraction often involves stitches to aid healing. If these stitches come out earlier than expected, understanding their role and the implications of premature removal can help guide appropriate action.
Understanding Wisdom Tooth Stitches
After a wisdom tooth extraction, stitches (sutures) are commonly placed to help close the surgical site. Their primary purpose is to hold the gum tissue edges together, which promotes faster healing and helps stabilize the area. Stitches also play a significant role in securing the blood clot that forms in the empty tooth socket, which is crucial for preventing a painful complication called dry socket.
Oral surgeons most frequently use dissolvable stitches for wisdom tooth extractions. These stitches are made to break down naturally and be absorbed by the body, eliminating the need for removal. Dissolvable stitches typically disintegrate within 7 to 10 days, though some types might take up to a month, depending on the material and extraction extent. Non-dissolvable stitches are less common for this procedure but require manual removal by a dentist, usually within 7 to 10 days.
Risks of Premature Stitch Removal
If wisdom tooth stitches come out prematurely, it can pose several complications for the healing process. The most immediate concern is the disruption of the protective blood clot within the extraction socket. Stitches help keep this clot securely in place, which is fundamental for uneventful healing.
If stitches are lost too soon, the blood clot may dislodge or dissolve, leading to dry socket. This occurs when the underlying bone and nerves in the socket are exposed to air, food particles, and bacteria, resulting in intense pain that can radiate to the ear, temple, or neck. Dry socket typically develops three to five days after extraction and can significantly delay healing, often requiring medicated dressings.
Premature stitch removal can also delay surgical site healing. Stitches keep the gum tissue approximated, allowing the wound to close efficiently. Without this closure, the open wound might heal more slowly, prolonging the recovery period. An exposed surgical site is also more susceptible to food impaction and bacterial contamination, increasing the risk of infection. Bacteria can enter the wound, leading to swelling, increased pain, and potentially the formation of pus or an abscess.
When to Seek Professional Advice
While it can be normal for dissolvable stitches to come out as healing progresses, certain signs indicate a need to contact your oral surgeon or dentist. Prompt professional evaluation is important if you experience increasing pain that worsens, especially after the first few days. Persistent or increasing swelling in the gums, cheeks, or face beyond 48 hours is also a concerning symptom.
Other warning signs include a fever, particularly if it exceeds 101°F, which can signal an infection. The presence of pus or any unusual discharge from the extraction site, a foul odor, or a persistent bad taste in your mouth are clear indicators of potential infection and warrant immediate attention. Difficulty opening your mouth, limited jaw movement, or continuous bleeding that does not subside with pressure from gauze are also reasons to seek professional guidance.
Managing Your Recovery
Even if stitches come out earlier than anticipated, consistent and gentle post-operative care remains crucial for a smooth recovery. Maintaining good oral hygiene is fundamental, but it must be done carefully to avoid disturbing the healing site. After the initial 24 hours, gentle rinsing with warm salt water (half a teaspoon of salt in 8 ounces of warm water) two to three times a day can help keep the area clean and reduce inflammation. It is important to avoid vigorous swishing or spitting, as this can dislodge the blood clot and lead to complications like dry socket.
Dietary modifications are also advised during the initial healing phase. Sticking to soft, easily chewed foods for the first few days helps prevent irritation to the surgical site. Avoiding hard, crunchy, or seedy foods is important, as these can get trapped in the socket. It is also recommended to refrain from using straws, smoking, and consuming alcoholic beverages, as these activities can create suction or introduce irritants that may compromise the blood clot and delay healing. Following all specific post-operative instructions provided by your dentist or oral surgeon is the most effective way to support the healing process.