For routine tooth extractions, the most stitches that you'd end up with would be one but that is if you even need it in the first place. However, for more complicated surgical extractions such as impacted wisdom teeth removal, you may require much more than a single stitch.
We will explain why that is the case and all of the scenarios for when one is enough and also when you may need more of them.
Table of contents:
Routine extractions need one stitch
The vast majority of routine tooth removals will only require a single stitch if it needs it. Although to the untrained eye it may look like it has multiple stitches over the socket but we assure you it is just a single suture.
The most common dental suturing technique is the figure 8 stitch.
It is one continuous stitch that is done in a figure 8 fashion.
It looks like an "X" or cross sign over the tooth socket.
Removal of it also requires just a single snip.
Below is an image of what it looks like on a demonstration model.
The reason that dentists like it is because it is a very efficient suturing technique. You only need to tie the surgical knot once and it closes up the entire surgical site. Time costs money you know!
Video of figure 8 suture
It may be hard to discern from the photo that it is actually one continuous suture which is why we made a video. We'll show you how to place this suture and demonstrate to you that it's really just a single stitch, albeit a long one.
Stitches aren't necessary for every extraction
Believe it or not but you don't need stitches after every tooth extraction or wisdom tooth removal for that matter. The discerning factor depends on whether or not your procedure was a routine one or a surgical one.
When stitches are needed after tooth removal:
Surgical extractions. Got an impacted wisdom tooth which requires jaw bone removal via drilling to extract? You can bet you'll leave the dentist with wisdom teeth stitches.
Loose flapping gums. Perhaps you needed multiple teeth removed and post-extraction the gums are loose and flapping in the mouth. You'd heal faster if the soft tissue were stitched down.
Wound approximation. Did your dentist pick up a scalpel at any point during the procedure? If the gingiva (gums) were cut at any point, they will need to be sutured back up. It's only right that your dentist clean up after themself.
When stitches are not needed after tooth removal:
Routine extractions. Non-surgical teeth removal that do not involve multiple teeth, use of a scalpel, or drilling away bone will not require stitches. There is essentially nothing to stitch up if that is the case.
Surgical wisdom teeth removal needs more stitches
As a general rule of thumb, surgical removal of impacted wisdom teeth will typically require multiple stitches to be placed. A single stitch will be insufficient to close the surgical site because it is simply too large.
Below is an image of a common flap design for removing impacted wisdom teeth. The traced out marking is essentially where your dentist makes an incision with a scalpel in order to reveal the impacted molar underneath the gums.
As you can clearly see in the photo above, the incision line is fairly long and quite large. Placing one suture will be insufficient for closing the extraction site. If you placed a single stitch in the middle, there would be a gaping hole to both sides of where the knot is.
In other words, you will need multiple stitches in order to approximate the wound edges better and to reduce the dead air space. Both of these two things will expedite healing and reduce recovery time.
In summary, the larger the incision the more stitches you will need. There is a direct correlation between the size of the flap design and how many you'd need to close the wound.
Will they dissolve on their own?
For the most part, dentists tend to use dissolvable stitches whenever they can because it is typically preferred by patients. The advantage is that they do not require a suture removal appointment so it saves you a visit.
The only exception is if you were to get a bone graft with a membrane in conjunction with your extraction. In these situations your doctor will most likely use a non-dissolvable suture because it needs to stay in longer for the graft to integrate with your jaw bone.
However, whether or not they will be absorbable will ultimately depend on your dentist's preference. If they feel like using a non-absorbable one on the day of your procedure, you will leave the office with a non-dissolving one!
Taking proper care of them by doing the right things will ensure that they stay in for the intended period of time while healing. If you do the wrong things, they may fall out too soon.
Don't play around with them.
Gentle brush the area to remove plaque from them.
Definitely don't try to pull on them or remove them yourself.
In case you were wondering, they do not prevent dry sockets. Their purpose is to help expedite the gum closing over in the surgical site.
Most commonly for a routine tooth extraction, the most stitches that you'd probably get is just one single suture. Although you may need more if the procedure is more complicated such as if you were getting impacted wisdom teeth surgically removed.
With that being said, there are many instances where removing a tooth doesn't actually require any stitches at all. It really depends on the condition of your tooth. If you need them your dentist will put them in for you but if you don't, they won't give you any.