Removing stitches following oral surgery. -

How stitches are removed - The procedure.  |  Does it hurt?  |  What will you feel?  |  How long does it take?  |  Precautions following suture removal.  |  Can you take stitches out yourself?

Removing dental sutures (stitches).

This page outlines the steps a dentist uses when removing stitches placed following oral surgery. And as you'll find out as you read, it's typically a quick, easy and pain free process.

When is this appointment scheduled?

In most cases, on the same day that your oral surgery is performed, your dentist's staff will schedule a return visit for you for suture removal. The timing of this appointment can vary depending on the specifics of your procedure. You'll simply need to follow through with the instructions you are given.

Not all kinds of stitches need to be removed.

With some procedures, your dentist may have chosen to place resorbable stitches. If so, they'll dissolve away on their own and will not need to be removed.


How this page is organized.

As a start for our topic, we first outline the procedural steps your dentist follows when taking out sutures. While viewing them, hopefully you'll notice what a simple and quick process this typically is.

Then lower down on this page, we describe what the process is like for the patient. We answer things like what you'll feel, will it hurt, what can be done if you do feel things, how long does the process take, etc...

And as a final section, we discuss when, why and how this procedure might be performed on an at-home basis.


How sutures are removed. - The procedure.

1) An anesthetic is not usually administered.

The process of removing stitches can be expected to be quite painless. And since that's the norm, it's rare that a dentist will administer an anesthetic beforehand.

2) The area will be cleansed.

As a first step, your dentist will clean the tissue in the region where your stitches have been placed.

  • If accessible and practical, they may dab or wipe the area with a piece of gauze that's been moistened with hydrogen peroxide solution. (3% hydrogen peroxide cut 50:50 with sterile water.)
  • Or they may have their patient swish with the hydrogen peroxide solution or else another antibacterial rinse. (The use of chlorhexidine, a prescription antibacterial mouthwash, is a common choice.)

While this step is generally considered a best practice, it's effectiveness in preventing the introduction of bacteria into your wound, and therefore a need to perform it, is debatable. (Brown)

Picture of tooth extraction sockets with a suture placed.
3) The suture will need to be lifted up.

Since your dentist will need to cut the suture thread, they'll first need to lift your stitch up off the tissue it's lying on, just far enough that there's room for the tip of their scissors.

They'll probably use a pair of cotton pliers (dental tweezers) for this task.

4) The suture thread will be clipped.

Using a pair of fine-pointed scissors, your dentist will cut the raised suture.

Instead of right in the middle, they'll clip the thread down close to the surface of your gums. (Doing so minimizes the length of contaminated suture thread that will ultimately need to be pulled through your tissues.)

5) The suture is pulled out.

Now cut, your dentist will grab the free end of the thread with their cotton pliers and pull it out of your gum tissue.

  • They'll make sure to grab the end that has the suture's knot, thus insuring that it's not the knot end that gets pulled (ripped) through your tissues.
  • The motion they'll use is a steady gentle pull. The loose end of the thread will pull on through your gums quite easily.
  • As they pull, they'll pull in a direction toward the wound.

    (Pulling up or away from the wound has the potential to place tension on it, which might result in reopening it.)

  • Your dentist might further favor your wound by supporting it with their fingers, gauze or a dental instrument as they pull the suture thread out.

6) This process is repeated until all of the sutures have been removed.

  • In the case of interrupted stitches (those that are individually placed and tied off), the above steps are repeated for each suture still left to remove.
  • As mentioned above, the goal is always to pull as little suture thread through your tissues as possible. So in the case of continuous sutures (a series of stitches tied off using a single knot), each loop will be cut individually with that section then being removed.

7) The area is then cleansed again.

Once all of your stitches have been removed, there may be a few drops of blood where they have been taken out. Or there may be some loose dental plaque or debris that was harbored under them that is now apparent.

So as a final clean up, and like above, your dentist may swab the area or ask you to rinse.

Section references - Modi, Atterbury, Brown

Precautions to take following suture removal.

The wound left by your stitches.

Following suture removal, the level of bleeding that persists should be minimal, and more likely non-existent. And the tiny wounds that they've left behind should be of little inconvenience or concern. So generally speaking, no special precautions are required for these openings and they can be expected to heal promptly.

This is important.

It's imperative for you to understand that even though your stitches have been taken out, your surgical site hasn't yet fully healed.

It will take a total of at least 4 to 5 weeks of healing before your gum tissue has reattached to its underlying bone as firmly as adjacent tissues. (Ask your dentist what time frame applies for your case.) So in the mean time, you must continue to favor and take precautions with your surgical area.


What will you (the patient) experience during suture removal?

Things you probably will feel as your stitch is taken out.

  • At the start of the process, you'll likely feel a firm tug on your stitch as your dentist lifts it up with their tweezers so they can position their scissors to cut it.
  • As they pull the suture thread through your gums, it's not expected that you'll feel anything. The thread should just glide through them.

Does getting stitches out hurt?

No, if you don't squirm around and just stay still, you really shouldn't feel anything at all except the little tug as each stitch is lifted up and cut.

And actually, if your stitches have sagged or loosened up any at all, you may not even feel that.

What if it does hurt?

If this is what you interpret, it's probably because you're confusing the sensation of pressure with pain. Or anticipate that feeling pressure means you will soon feel pain. (Both scenarios are extremely common in dentistry.)

Anyway, if you find you're uncomfortable your dentist can apply a topical anesthetic. This is the same type of numbing gel that they rub onto gums before giving a shot.

With this application, the gel is simply rubbed onto the sutured area with a cotton swab (Q-tip). In a matter of minutes, it will produce its numbing effect and your procedure can be completed.

How long does it take to get stitches out?

The entire procedure, start to finish, is typically measured in a matter of a few minutes. Depending on the level of visibility and access the dentist has, cutting and pulling any one individual loop of suture thread out might run on the order of 5 to 10 seconds. This is a quick procedure.


Can you remove dental stitches by yourself?

The answer to this question is yes you can. But doing so without consulting with your dentist first makes a poor choice.

That's because when a dentist removes stitches they'll also look to make sure everything looks correct and normal with your surgical area. They'll look for signs of infection. They'll also evaluate how your wound's healing has progressed.

As an example, and a worse case scenario, it may be that when even one stitch is clipped that your wound will start to reopen.

And while your dentist won't always be able to predict if this complication will occur, they do know how to approach your procedure so if it does it remains manageable. And of course, they, unlike you, have the ability to place new sutures if needed.

Loose sutures.

We will concede that a patient removing a loose stitch on their own might be indicated. But once again, only after conferring with their dentist first.

At-home stitch removal.

If the situation arises where a DYI approach is appropriate (and sanctioned by your dentist), the instructions above can be followed.

  • It seems obvious that for many locations in the mouth, self-removal may make a poor or impossible plan due to poor visibility, access or dexterity. If so, you may need someone else to actually perform your procedure.
  • One difficulty you may have is finding a pair of scissors small enough for the job. Tiny sewing/embroidery scissors can make a good choice.
  • The mouth is hardly a sterile environment. And in theory, the tools you use may not even come into contact with your person. However, they should be clean.

    Technically speaking, they should be boiled in water for 20 minutes before being used. In lieu of this, cleaning them with rubbing alcohol might reasonably suffice. Let your dentist provide you with an opinion.

  • As you remove each stitch, it's expected that you will see a drop of blood where its thread has come out of your gum tissue.

    But if you notice any more bleeding than that, and especially if you find that your wound has started to open up, you should stop what you are doing and contact your dentist.

 
 
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Comments

Sutures

After my stitches are removed so I have to do anything special

J

No, nothing special. The tiny holes where the stitches have come out are such a small wound that they'll be of no concern.

The idea is that the stitches tacked the gums in place until enough healing had taken place to take over that job. So you'll want to still favor your extraction site so not to disrupt this newly attached healing tissue, we explain more so above (take a look at the graph).

Sutures & Extractions

I was looking for answers about what happens if sutures are left in when they should have been taken out... You have a lot of good information on this page that I was reading about sutures and placement and everything but nothing is said about what exactly is the downfall if the patient doesn't go back to the dentist like they should've to get the sutures removed?What does the body do with them and what is the patient risking by leaving them in?? You did answer the question so briefly but you could be a little bit more specific as to what will happen if they stay in.

Lynzi

Here's a paper that seems to have evaluated the issue of your question (what happens to stitches when they're not taken out). It studied tissue response to various types of suture materials, for time periods 3 weeks to one year.

Page 145 states:
"From clinical experience, silk is known to be absorbed and evidence of this was found in this study."
(Our note: Silk sutures are frequently used with oral surgery procedures.)

That statement seems to suggest that in a lot of cases involving silk, things just take care of themselves. No remnants remain after time.

However, much of this paper discusses how retained sutures might end up being encapsulated by the tissues they are in and some type of persistent local pathology being associated with them (because the body considers them a foreign object).

I had a molar extracted a

I had a molar extracted a week ago and had a check up today. My sutures were hanging on by a thread so they removed them. Everything looked perfect but now the white stuff that was covering the socket is now sinking inside the socket??? What does that mean? There is no pain at all. Happened after I ate but no food is stuck in there.

ES

We're not really going to have an answer for you. A call to your dentist's office might provide an explanation.

At 1 week the socket is only filled with (soft) granulation tissue. As you continue to read that page, you'll learn that it's only from this point on that new bone begins to form, and the socket itself will not be fully ossified for weeks to come.

Stitching

My son just had oral surgery and removed his stitching hours after it’s not bleeding but should we get In contact with the dentist right away

Chris

We have an entire page (lost stitches page) that discusses considerations that would be involved with the scenario you report. There are a couple of factors involved, with the most important ones being whether the stitches were primarily placed as a means to control bleeding, or for tissue stabilization during the healing process (or both). Probably only your son's dentist can answer these questions, so you should report to them what has happened and let them advise you what needs to be done as a result.


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