After a tooth extraction, dental stitches, also known as sutures, are often placed. They help manage the extraction site and support the initial stages of healing.
Purpose of Stitches in Healing
Stitches hold gum tissue edges together, promoting proper healing and faster recovery. This closure also helps control bleeding by compressing the site, aiding in the formation of a stable blood clot. The blood clot is a protective layer over the underlying bone and nerve endings. Stitches also act as a barrier, reducing the risk of food particles and bacteria entering the wound, thereby lowering the chance of infection. By stabilizing this blood clot and keeping the wound closed, sutures help prevent complications such as dry socket.
Identifying Undone Stitches
It is important to recognize the signs if stitches come undone prematurely. You might visually notice loose threads or a gap in the gum where the tissue was previously held together. Sometimes, a hole may become visible at the extraction site. Physically, you might experience a feeling of something loose in your mouth or increased discomfort. While a whitish film can be a normal sign of healing, an exposed bone or a significant opening indicates dislodged stitches.
Immediate Actions and When to Seek Help
If you suspect your stitches have come undone, remain calm and avoid disturbing the area with your tongue or fingers. Gently rinse your mouth with warm salt water (about half a teaspoon of salt in a cup of warm water) to help keep the area clean. Do not swish vigorously, but rather let the water gently wash over the site.
Contact your dentist or oral surgeon promptly if you notice concerning symptoms. These include persistent or worsening pain not improving with medication, excessive bleeding lasting more than 30 minutes after applying gentle pressure, or signs of infection. Indicators of infection might be fever, increased swelling, pus or discharge from the extraction site, or a foul taste or odor. A large, visible opening at the extraction site also warrants immediate professional evaluation.
Potential Complications
If stitches come undone prematurely, there is an increased risk of certain complications. The most significant concern is a dry socket, medically known as alveolar osteitis. This condition occurs when the protective blood clot at the extraction site either fails to form properly or becomes dislodged, leaving the underlying bone and nerves exposed.
Symptoms of dry socket typically develop one to three days after the extraction and include severe, throbbing pain that may radiate to your ear, eye, temple, or neck. You might also notice an empty-looking socket where the blood clot should be, visible bone, or experience bad breath and an unpleasant taste. While dry socket is painful, it rarely leads to serious complications, but it can delay the healing process. Another potential issue from undone stitches is an increased risk of infection, as the open wound is more susceptible to bacteria.
Preventing Stitches from Coming Undone
To minimize the risk of stitches coming undone, follow all post-operative instructions provided by your dental professional. Avoid vigorous rinsing or spitting, especially during the first 24 hours, as this can dislodge the blood clot and stitches. Refrain from using straws, as the suction created can also disturb the healing site.
Stick to a diet of soft foods for several days, avoiding crunchy, hard, or chewy items that could snag or put pressure on the stitches. Smoking should also be avoided, as it can interfere with the healing process. Resist the urge to touch the extraction site with your fingers or tongue. When brushing your teeth, be gentle and avoid the immediate area of the stitches.