After wisdom teeth removal, stitches are often placed to help the extraction site heal properly. They close the wound, controlling bleeding and protecting the underlying bone and nerves from bacteria and food debris. By bringing gum tissue edges together, stitches facilitate faster healing and reduce infection risk.
Understanding Stitches and Their Removal
Following wisdom tooth extraction, the type of stitches used will determine how and when they are removed. Oral surgeons typically use two main types: dissolvable (absorbable) and non-dissolvable (non-absorbable) stitches.
Dissolvable stitches break down naturally as the wound heals. They are made from materials like gut or synthetic polymers such as polyglycolic acid or Vicryl. These stitches usually dissolve and fall out within 5 to 10 days, though some can take up to a few weeks, depending on the material, stitch size, and individual healing rate. Patients might notice small fragments coming loose, which is normal.
Non-dissolvable stitches, made from materials like silk or nylon, do not break down on their own and require removal by a dental professional. If used, the dentist or oral surgeon will schedule a follow-up appointment within 7 to 14 days after surgery to remove them. It is important not to attempt to remove any stitches yourself, as this can disrupt healing and potentially introduce infection.
Caring for Your Stitches
Proper care of the surgical site is important while stitches are present to support healing and prevent complications. Oral hygiene is a primary part of this care. After the initial 24 hours post-surgery, gentle rinsing with warm salt water is recommended several times a day, prepared by dissolving about half a teaspoon of salt in 8 ounces of warm water. Avoid vigorous swishing or spitting, as this can dislodge blood clots and stitches.
Brushing teeth can resume the day after surgery, but be gentle around the surgical area and avoid brushing directly over the stitches for several days. Use a soft-bristled toothbrush carefully for other areas of the mouth. Maintaining cleanliness prevents food particles and bacteria from accumulating around the stitches, which could lead to infection.
Dietary considerations are important during healing. Consume soft foods and liquids for the first few days, such as yogurt, mashed potatoes, and blended soups. Avoiding crunchy, sticky, or hard foods prevents irritation to the surgical site and reduces the risk of dislodging stitches or blood clots. Refrain from using straws, as the suction created can dislodge the protective blood clot, potentially leading to dry socket. Smoking should also be avoided for at least 72 hours, as it can delay healing and increase complication risks.
When to Seek Dental Advice
While some discomfort and swelling are normal after wisdom tooth removal, certain signs indicate a need for professional dental advice. Increasing pain not managed by prescribed medication, especially if it worsens after the initial few days, warrants attention. Persistent swelling beyond 72 hours or swelling that interferes with swallowing can also be a cause for concern.
Signs of infection include a foul taste or odor in the mouth that rinsing does not resolve, fever (especially above 101°F), or pus or discharge from the extraction site. Excessive bleeding that continues after applying pressure with gauze for an extended period should also prompt a call to the dentist. If stitches come out prematurely, particularly non-dissolvable ones, or if dissolvable stitches do not seem to be dissolving after an extended period, contact the dental office. These symptoms could indicate complications requiring prompt evaluation and treatment.