Dental stitches, or sutures, are standard following oral procedures like tooth extractions or gum surgery. Their primary function is to hold the edges of the gum tissue together securely, stabilizing the blood clot that forms in the socket. This allows the underlying surgical site to heal without disruption and is necessary for bone and tissue regeneration. While concern is understandable if a stitch loosens or falls out, whether this is normal depends entirely on the type of material your dentist used.
Understanding the Two Types of Dental Sutures
Dental professionals choose one of two fundamental suture types based on the procedure and required healing time. Non-absorbable sutures are made from durable materials like silk, nylon, or polyester. These materials maintain their structural integrity to provide prolonged tissue support, especially in areas subject to tension. Since they do not break down, they must be manually removed by your dentist, typically within 7 to 10 days after the surgery.
The second category is the absorbable, or dissolvable, suture, which is common in routine oral surgery. They are crafted from materials like natural gut or synthetic polymers, such as polyglycolic acid. Absorbable sutures are broken down naturally by the body through processes like hydrolysis. This eliminates the need for a follow-up appointment solely for stitch removal, offering greater convenience.
When Is It Normal for Stitches to Fall Out?
If dissolvable sutures were used, it is normal for them to fall out. The dissolution process causes the thread to lose its tensile strength, and the small remnants are shed once the wound edges have bonded successfully. This means the tissue no longer needs the physical support of the thread.
The standard timeframe for absorbable stitches to loosen and fall out is typically between 3 and 10 days, though some materials last up to two or three weeks. You may notice small, dark pieces of thread in your mouth or on your toothbrush as the material dissolves. A loose stitch hanging in the mouth is often a sign that the thread is partially dissolved and being naturally pushed out by the healing gum tissue.
Signs That Suture Loss Requires Immediate Attention
While a loose stitch often signals healthy healing, premature suture loss that exposes the surgical site requires immediate attention. A serious warning sign is the onset of severe, throbbing pain that worsens a few days after the procedure, indicating a dry socket. This painful condition occurs when the protective blood clot is dislodged or fails to form, leaving the underlying bone and nerve exposed.
Signs of infection or complications are a serious concern. Contact your dental office immediately if you experience any of the following:
- Prolonged or increasing swelling after the first three days.
- A persistent foul odor or bad taste in the mouth, or the presence of pus or thick discharge.
- Excessive bleeding that is a continuous flow and cannot be controlled by biting down on gauze.
- Fever or pain radiating into your ear or neck on the side of the surgery.
Protecting the Healing Site After Suture Removal or Dissolution
Once the sutures are gone, the focus shifts to protecting the newly closed tissue and the underlying blood clot. Gentle oral hygiene is necessary to prevent debris from accumulating in the healing socket. Continue to brush your teeth gently, taking care to avoid directly scrubbing the surgical site for several more days.
Avoid aggressive rinsing or swishing for the first 24 hours, as the force can dislodge the forming blood clot. After this initial period, you can begin using a warm saltwater solution to keep the area clean and promote tissue healing. This gentle rinse should be allowed to bathe the area rather than being forcefully swished.
Dietary modifications remain important; favor soft foods and chew on the side opposite the surgical site until advised otherwise. Actions that create negative pressure, such as smoking or using a straw, must be avoided. These actions can easily disrupt the delicate healing process and compromise the integrity of the blood clot.