Wisdom tooth extraction is a common oral surgery performed to remove third molars. Following the procedure, the surgical site is often closed with sutures to promote initial healing and secure the protective blood clot. This guide provides clarity on the different types of sutures used and the anticipated timeline for their resolution.
Suture Types and Expected Timelines
Surgeons primarily use one of two types of material to close the wound after removing a wisdom tooth. Absorbable sutures are the most common choice, designed to break down naturally as the gum tissue heals underneath. These stitches are often made from specialized synthetic polymers or natural materials like chromic gut, which the body’s enzymes gradually hydrolyze over time.
The timeline for absorbable sutures to resolve typically begins around five to ten days post-surgery. Patients may notice the stitches loosening, changing color, or seeing small fragments come away during gentle rinsing. While the initial breakdown starts quickly, some materials can take up to two weeks to fully dissolve and disappear entirely.
The precise rate of dissolution depends on the specific material chosen by the surgeon and the individual patient’s biological response. The constant moisture and enzyme activity within the mouth contribute to this natural degradation process.
Less frequently, a surgeon may elect to use non-absorbable sutures to close the surgical site. These materials, such as silk or nylon, are inert and do not break down on their own. They are used when the surgeon requires stronger tissue approximation or a specific healing environment, such as in more complex extractions.
When non-absorbable stitches are used, they must be manually removed by a dental professional during a follow-up appointment. This procedure is typically scheduled between seven and ten days after the initial extraction. Patients should never attempt to remove these stitches themselves, as this can severely damage the newly formed gum tissue and disrupt the healing process.
Caring for the Extraction Site
Protecting the sutures while they are in place ensures proper wound closure and prevents complications. Immediately following the surgery, patients should avoid disturbing the surgical area, including refraining from touching the stitches with fingers or the tongue. Any disruption risks dislodging the protective blood clot, which is fundamental for bone and tissue regeneration.
Oral hygiene requires modification during the first week of recovery to protect the delicate sutures. Patients should avoid direct brushing of the extraction site itself until cleared by the surgeon. Instead, focus on gently cleaning the surrounding teeth to maintain overall oral cleanliness without stressing the healing gums.
Starting 24 hours after the surgery, gentle rinsing with a warm salt water solution is recommended several times a day. This helps keep the area clean and reduces bacteria buildup without providing the suction or force that could pull the stitches loose. Rinsing should involve tilting the head to let the water flow over the site rather than vigorous swishing.
Dietary modifications are necessary to minimize stress on the healing gums and stitches. Consuming only soft foods, such as yogurt, mashed potatoes, and smoothies, is advised for the first few days. Patients should entirely avoid hard, crunchy, or chewy foods that could catch on the stitches or require excessive jaw movement.
Physical activity should be strictly limited for the first few days while the stitches are present. Strenuous exercise increases blood pressure, which can lead to throbbing, swelling, or even cause the sutures to fail. Restricting movement allows the body’s resources to focus on tissue repair and clot stabilization.
Troubleshooting Common Suture Issues
Deviations from the expected timeline can cause understandable concern, but not every change is a complication. Sometimes, a stitch may come loose slightly earlier than expected, which usually only affects the very outer part of the suture. If the wound remains closed and bleeding does not resume, this small change is a natural part of the breakdown process.
A more serious issue arises if the entire wound appears to open up, potentially exposing the underlying bone. If this happens, or if heavy bleeding returns, immediate contact with the oral surgeon is necessary, as the protective blood clot may be compromised. Dislodging this clot is the primary cause of a painful condition known as alveolar osteitis, or dry socket.
Patients using absorbable sutures sometimes worry when the stitches remain past the two-week mark. While most dissolve within this period, some materials are designed for a slower degradation rate, or the patient’s biological environment may slow the process. If the stitches are still present and causing no discomfort by the time of the scheduled follow-up, the surgeon can easily remove any remaining material.
It is helpful to recognize the signs of normal healing versus potential infection. A white or yellowish layer of tissue forming over the wound is typically fibrin and granulation tissue, a healthy sign of regeneration. Signs requiring immediate attention include:
- Persistent, severe pain that medication does not manage.
- Excessive swelling that worsens after three days.
- A persistent foul odor.
- Pus discharge.