Not always. Stitches after a tooth extraction depend on the type of extraction and how much tissue was disturbed. Simple extractions, where the tooth is visible and pulled straight out, often heal fine without any stitches at all. Surgical extractions, like wisdom teeth removal or any procedure that requires cutting into the gum tissue, almost always involve stitches to close the wound.
When Stitches Are Needed
The main factor is whether your dentist or oral surgeon had to make an incision. If a gum flap was lifted to access a tooth buried beneath the surface (an impacted tooth), that flap needs to be repositioned and sutured back into place. Surgical removal of wisdom teeth is the most common scenario, but stitches can also follow extractions involving broken roots, teeth fractured at the gumline, or any case where bone was trimmed to free the tooth.
Stitches serve two purposes: they hold the tissue together so it can heal, and they help control bleeding by keeping the wound edges close. Oxidized cellulose materials are sometimes placed inside the empty socket as an additional measure to slow bleeding, with sutures layered on top to secure everything.
For a straightforward extraction of a fully erupted tooth, the socket typically fills with a blood clot on its own and heals without stitches. Your dentist may still place one or two sutures if the socket is large or if you have a condition that affects clotting.
Dissolvable vs. Non-Dissolvable Stitches
Most dental stitches after extractions are the dissolvable type. These break down on their own through a chemical process called hydrolysis, so you never need a separate appointment to have them taken out. The timeline varies quite a bit depending on the material used:
- Fast-absorbing stitches: Some materials lose hold in as few as 3 to 4 days. These are used when only short-term wound support is needed.
- Medium-duration stitches: Materials like polyglycolic acid last about 15 days in the mouth before they fall away.
- Longer-lasting stitches: Polyglactin 910 holds its strength for 3 to 4 weeks and is fully absorbed within about 70 days. Monocryl is completely gone in roughly 90 days.
Non-dissolvable stitches, typically silk or nylon, are used when the tissue needs to stay stabilized for a longer period. These must be removed by your dentist, usually at a follow-up visit 7 to 10 days after the procedure. Removal is quick and rarely painful.
Open Healing vs. Closed Healing
When stitches fully seal the socket beneath a gum flap, that’s called primary closure. When the socket is left partially open to the mouth and heals from the inside out, that’s secondary healing. You might assume sealing everything shut would be better, but research on impacted wisdom teeth tells a different story.
A study comparing both approaches found that leaving the wound partially open actually produced less postoperative swelling and pain than tight suturing did. Hermetically sealing the socket can trap fluids and pressure beneath the tissue, increasing discomfort in the days after surgery. This is why your surgeon may place a few stitches to loosely reposition the tissue without pulling it completely closed, giving the area room to drain while still protecting the clot underneath.
What to Expect While Stitches Are In
Mild irritation around the suture site is normal. You may feel the knot or tail of the stitch with your tongue, and the area may be slightly swollen or tender for a few days. As dissolvable stitches break down, small pieces may come loose in your mouth. This is expected and not a cause for concern as long as several days have passed since your procedure.
Some people experience more noticeable reactions. Redness, localized swelling, or a small firm bump near the stitch can signal suture irritation or, rarely, a sensitivity to the material itself. These reactions can also include itching or the stitch poking through the tissue surface. Mild symptoms usually resolve once the suture dissolves or is removed, but worsening redness, pus, fever, or a foul smell from the site suggest infection rather than simple irritation.
If a Stitch Falls Out Early
A stitch coming loose after 3 or 4 days is usually not a problem, since the tissue has already begun knitting together. The critical window is the first 24 hours. If a stitch falls out within a day of your extraction, the wound edges may separate before a stable clot has formed, which can lead to prolonged bleeding or a painful condition called dry socket.
Contact your oral surgeon if stitches come out within the first 24 hours, if bleeding picks up noticeably after a stitch loosens, or if you see increasing swelling or pain beyond what you were told to expect. In most cases, a loose stitch after the first couple of days just means the material dissolved a bit faster than average, and healing will continue normally without it.
Caring for Your Stitches
For the first 24 hours, avoid rinsing, spitting forcefully, or using a straw. All of these create suction or pressure that can dislodge both the stitches and the blood clot underneath. After the first day, gentle saltwater rinses (half a teaspoon of salt in a cup of warm water) help keep the area clean without disturbing the sutures.
Stick to soft foods and chew on the opposite side of your mouth. Avoid poking the stitches with your tongue or fingers, even though they will feel strange. Brushing is fine in the rest of your mouth, but steer clear of the extraction site for the first few days to avoid snagging a suture with your toothbrush bristles.