Sutures or Stitches after Tooth Extraction

Suture literally means to join. Surgical suture is a stitch which is used by the dentists to hold the tissues together.  If the tooth comes out in one piece without much trauma to the surrounding tissues, then sutures/ stitches are not usually placed. Sutures are given after the surgical tooth extractions and in extractions where there is much of trauma to the surrounding tissues.

Sutures are made of variety of materials and come in several sizes. The two basic types of suture materials are resorbable that the body is capable of easily breaking down the material and nonresorbable sutures. In general, the resorbable sutures don’t require removal whereas the non-resorbable sutures do.

Resorbable sutures:

The resorbable sutures which are commonly used are: Gut, polyglycolic acid and copolymer of glycolic and lactic acid. Gut is fabricated from submucosa of sheep intestines or serosa of beef intestine. If prolonged suture strength is required, then gut is treated with basic chromium salts. These sutures are known as chromic cat gut suture.  Plain gut sutures retain their strength for 5-7days whereas the chromic sutures maintain strength for 9-14days.

 Resorbable sutures are highly reactive as compared to nonresorbable sutures and evoke an intense inflammatory reaction which may affect the healing.

Nonresorbable sutures:

The most commonly used non-resorbable sutures are: Silk, nylon, polyester and polypropylene.  Nonresorbable sutures are either monofilamentous, multifilamentous or both. Multifilamentous form increases the strength. Silk and polyester sutures are available in multifilamentous form. Polypropylene is the mono filamentous form.  Nylon comes in both mono filamentous and multifilamentous form.

Non resorbable sutures

All nonresorbable sutures have some reactivity. Silk evokes the most intense inflammatory response.  Polyester is much less reactive than silk and nylon is less reactive than polyester and polypropylene has least tendency to induce inflammation.   

When non-resorbable sutures are given by the dentist, then they are to be removed. They are mostly removed a week after the extraction.  Gut sutures are most commonly used resorbable sutures which may be there for couple of days to couple of weeks and then will resorb.

The most common problem with the dissolvable sutures is that they sometimes don’t dissolve even after few weeks. In such a case, the dentist can remove the stitches themselves if they don’t come out themselves.

Post-operative care of sutured wounds:

Postoperative care of sutured wounds is important. Sutured wounds within the oral cavity should be kept clean by having the patient rinse frequently with normal saline, hydrogen peroxide diluted with saline or fresh tap water. There should be no food deposits around the stitches. The teeth near the stitches can be brushed but don’t brush over the gum area.

If the stitches become loose or are dislodged before a week, then there is no cause for alarm. The most important thing is that the clot should remain in its position and there should be no excessive bleeding.

No pain during sutures removal

Many of people are worried that the removal of the stitches or the sutures will cause pain. Removal of stitches is an entirely painless procedure and there is no need of giving the local anesthesia and numbing the area before removing the sutures. The sutures are snipped using a pair of tiny tweezers. The tweezers will pull out the sutures with almost no pain and takes only few seconds. The patient just feels a small pinch while stitches removal but there is no pain.
 

 

 User Comments on -  Sutures or Stitches after Tooth Extraction


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Posted By : Jay Jay on 09-Jun-2014 03:33 PM
I had a 3hr long extraction with levering, pushing + pulling, the dentist ended up not only dividing the tooth into three, but drilling into the jaw bone as well. She put dissolvable sutures in, that were firm and blue (fishing line) after 10days no sign of dissolving so I removed them myself(Im a nurse) the suture line is completely un-united and Im swirling with salt water and spraying with colloidal silver. To enable the gum to unite will this gravitate together or will it cause a food trap and possibly infect the root of the tooth next to it and the jaw bone. There is no sign of infection or pain, but the sides are not uniting. What do I do? Its now day 15 post tooth removal?
 


Posted By : Andrea on 04-Jun-2014 11:26 AM
Hello, I had my wisdom removed six days ago and I don't have any pain, but the only thing bothering me is that it looks like I have on my stitches like tartar looking, I do brush my teeth carefully and rinse with warm salt water, but don't touch the stitches because I'm scared. What should I do?
 


Posted By : Ruth on 04-Feb-2014 06:04 PM
5 days ago I had two bottom molars (back left) extracted. I was told they were simple extractions, but during the procedure the very back molar "snapped" off unexpectedly, I could hear the snap & the dentist even said he wasn't expecting that to happen. Other than that, the experience was very fast & painless, even the injections to numb the area was painless & I was very pleased about that! Now however, I am still experiencing some pain in that area. I would say about a 4 on the pain level scale of 1 to 10, 10 of course being the most pain. I know that's not too bad, but I was expecting there to be no pain after so many days. The area looks good, I don't believe a dry socket is present at either site. I chew all food on the opposite side, but partials seem to gravitate to that area. I rinse ever so lightly & even that scares me because of the chances of getting a dry socket. My question is, what should I be doing at this stage & should I return to the dentist? They didn't tell me I needed a follow up appointment. Thank you for taking the time to read my rambling!
 


Posted By : Dr.Ritz on 17-Sep-2012 09:48 PM

Hi BRENDA, Yes, you should get the sutured area treated. Otherwise it will impair the normal healing and prolong the clot formation. Also start doing warm saline gargles today. It will help you ward off the bacterial accumulation in the site and try to maintain a good oral hygiene. Avoid smoking and spitting. This might dislodge the clot that is formed. After taking meals, always do gently gargles.

 


Posted By : brenda on 15-Sep-2012 11:20 PM
I had my tooth extracted yesterday and the doctor cut my gum, now I have a laceration should I get it sutured?
 

 
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