After a tooth extraction, there are instances where you would get stitches but there are also situations where you wouldn't get sutures. People often wonder whether it would be beneficial to get the tooth socket stitched up regardless of their condition.
Our purpose today is to clarify when you need to get stitches after tooth removal and when you don't. We'll also go over the pros and cons to getting sutures for your extraction socket.
Table of Contents:
When stitches are necessary
Stitches are needed after a tooth extraction if the edges of the wound can be well approximated or if the gums are loose.
Wound approximation. If an incision was made during the procedure, the edges from the incision line can be re-approximated with sutures.
Loose gingiva. After the tooth has been removed, the gums can be very loose and "flappy". If that is the case, the gums can be sutured down so they don't move around.
Both of these two situations describe a surgical tooth extraction and not a routine one. If your dentist needs to make an incision or start drilling away bone to extract the tooth, you'll most likely need stitches afterwards.
Examples of a surgical extraction:
Impacted wisdom tooth. They can be partially or fully impacted in the jaw bone.
Tooth that is broken down to the gum line. These teeth are so broken down that there is no tooth structure for your dentist to grab with forceps.
Routine extraction that turns surgical. Complications can arise mid procedure such as the crown of the tooth breaking and leaving just the roots stuck in the bone.
Essentially, your dentist is making a mess in your mouth when they are cutting into the gums and drilling away bone. It is only right that they clean it up and make it tidy by stitching everything back together.
When stitches are not needed
Routine teeth removal that are not surgical, often do not require stitches afterwards because there is nothing to suture. Non-surgical extractions don't require incisions to be made so there are no wound edges to approximate.
You're probably thinking... there is a giant gum hole after the tooth was taken out, how could there be nothing to stitch? Well, it's a little hard to describe in words so we've made a video to visually show you what we mean by "there is nothing to suture".
Video key points:
There isn't excess gums after the extraction to suture.
Wound approximation works best for incisions or lacerations.
The video should give you a good idea of how the sutures work but if you wanted more information on what dissolvable stitches look like, we've got you covered.
Stitches vs No Stitches
After an extraction, getting stitches when you need them can help expedite your healing. However, there is very little benefit to getting sutures if you don't need them.
We will go over all of the advantages and disadvantages to getting stitches after having a tooth removed.
Stitches - Pros & Cons
Expedites wound healing
Minimizes scar tissue
Can heal via primary intention
Traps plaque and food
Difficult to clean
Can irritate your cheeks or tongue
May require suture removal
No stitches - Pros & Cons
No foreign body in the mouth
Easier to keep tooth socket clean
No cheek or tongue irritation
No suture removal appointment
Healing via secondary intention only
More scar tissue formation
Purpose of stitches after an extraction
The main reason for placing stitches after having a tooth extracted is to help expedite wound closure whenever it's needed. The key point here is "when it's needed".
If your dentist had to make an incision during the procedure to take out the tooth, the soft tissue that they cut will need to be stitched.
Consequences of leaving an incised area unstitched:
More scar tissue formation.
All of the disadvantages above can be minimized if you receive sutures at the surgical site. Without any, you'll experience delayed healing and an increase in scarring of the gingiva.
Can I get stitches if I don't need them?
You can always choose to get stitches for an extraction even if you don't need them. However, the benefits to doing so may not outweigh the inconvenience of having them.
Disadvantages of stitches when you don't need them:
Body recognizes sutures as a foreign body so it may delay healing.
Makes it more difficult to keep surgical site clean since it can trap food and plaque.
Ends of the suture can irritate soft tissue in the mouth. You may feel them poking your cheek and tongue if they're too long.
Last but not least, if an incision was not required, there won't actually be anything to stitch up. In other words, there is very little benefit to getting sutures placed and it may even slow down recovery.
Our recommendation is to not get any if you don't need them. As a matter of fact, that is what we do for our patients. For about 95% of routine extractions that we do at our dental practice, we do not give our patients stitches. They will leave our office with their mouth suture-free.
You may not always get stitches after a tooth extraction. It all comes down to whether or not it was a surgical extraction vs a routine one because the former involves making an incision.
If an incision needed to be made, the edges of the incision line will need to be re-approximated with sutures.
However, if no incision was made, there is actually nothing for your dentist to stitch.
In our opinion, if you don't need it you shouldn't get it. There is no benefit to doing so since it won't really expedite your wound closure by any means. Just breathe a sigh of relief that you don't have to deal with stitches hanging in your mouth. That's everything our dentists in Long Island City have to say about this matter.