Dental stitches (sutures) are threads used to close incisions after procedures like tooth extractions, gum surgeries, or implant placements. They hold the gum tissue edges together, stabilizing the wound and promoting initial healing. Sutures help prevent excessive bleeding and protect the delicate underlying blood clot necessary for proper recovery. This temporary measure optimizes the healing environment within the mouth.
Understanding Absorbable and Non-Absorbable Sutures
Whether dental stitches fall out on their own depends entirely on the material chosen, as sutures are categorized into two main types. Absorbable sutures are constructed from materials the body can naturally break down and metabolize over time. These materials, such as synthetic polymers (e.g., polyglycolic acid) or natural materials (e.g., purified gut), dissolve via enzymatic action or hydrolysis within the tissues.
Absorbable sutures are often chosen for procedures where the wound heals relatively quickly or when a patient cannot easily return for a follow-up appointment. They provide temporary support and disintegrate as they are absorbed by the body. The second type, non-absorbable sutures, are made from durable materials like silk, nylon, or polypropylene.
These threads are not broken down by the body and remain intact until manually removed by a dental professional. Non-absorbable sutures are preferred for situations requiring longer-lasting support or precise tissue alignment, such as complex grafting or implant surgeries. If non-absorbable stitches are used, a follow-up visit is necessary, typically within 7 to 14 days, for removal.
Timeline and Process for Dissolving Stitches
The timeframe for absorbable stitches to dissolve varies based on the material and the surgical site environment. Many synthetic sutures, such as PGA, lose their strength within 10 to 14 days and are fully absorbed within three to four weeks. Natural materials like plain gut sutures dissolve more rapidly, often breaking down in as little as 5 to 10 days.
Patients may notice the stitches feeling loose or small pieces of thread coming away, which indicates the normal dissolution process. Saliva and enzymes in the mouth help expedite the breakdown of the suture material. The location of the stitches also influences this timeline, as sutures in areas with more movement or moisture might dissolve differently.
Caring for the Surgical Site While Stitches Are In
Maintaining oral hygiene without disturbing the healing site is important while stitches are in place. For the first 24 hours after surgery, avoid all rinsing or spitting to protect the fragile blood clot in the wound. After this initial period, gentle rinsing with warm salt water (a mixture of one teaspoon of salt in one glass of warm water) is advised several times a day to aid cleansing and reduce swelling.
When brushing, use a soft-bristle toothbrush and carefully clean all areas except the immediate surgical site. Avoid aggressive brushing or stretching the cheek near the stitches, as this could unintentionally dislodge them before healing is sufficient. Dietary modifications are necessary, focusing on soft, non-chewy foods for the first few days and avoiding sharp, crunchy items that could irritate the sutures or become lodged in the wound.
Patients should avoid strenuous physical activity for at least 24 to 48 hours, as increased blood pressure can lead to bleeding at the surgical site. Smoking must be avoided completely, as it significantly impairs the healing process and increases the risk of complications.
Signs of Concern Requiring Professional Attention
While mild swelling, minimal bleeding, and discomfort are normal after oral surgery, certain signs indicate a complication requiring professional attention. Severe pain that suddenly worsens or does not improve with prescribed medication is concerning. A fever or persistent, increasing swelling in the face or jaw after the first 48 hours suggests a possible infection.
White or yellow discharge (pus) seeping from the surgical site is a clear sign of bacterial infection. Continuous, heavy bleeding that persists for more than 24 hours after the procedure, despite applying pressure, should prompt a call to the surgeon. If the stitches come out much earlier than expected and the wound edges gape open, professional evaluation is needed to ensure the incision is securely closed.