If your wisdom teeth stitches came out after 3 days, you should contact your dentist because they're expected to fall out after 10-14 days. That means your sutures fell out a lot sooner than anticipated and intended.
You may have a complication.
However, there is a chance where it may be okay to leave it as is but it's still safer to ask your dentist first. We'll explain when the stitches for wisdom teeth are necessary and when they may not be as important.
Table of contents:
When wisdom teeth stitches come out
Regardless of whether your wisdom teeth stitches are dissolvable or non-dissolvable, they should come out 14 days after your third molar extraction.
Non-absorbable sutures should be removed after 14 days.
Absorbable sutures should fall out within 10-14 days on average.
Non-dissolvable
Silk is the most commonly used non-dissolving suture for wisdom teeth. Since they don't fall out on their own, they will need to be removed. (Although technically they can dissolve but they're so slow that it's more practical to classify them as if they didn't.)
On average, most patients have healed enough after 2 weeks and the sutures can be removed. At that point, the surgical wound is no longer relying on the threads for healing. It can finish the recovering process on its own.
Dissolvable
Dissolvable sutures such as chromic gut are used much more frequently than the non-dissolving silk for wisdom teeth removal. These self-dissolving third molar stitches are expected to "fall out" within 10-14 days.
That 2 week time frame is what we typically see in clinical practice for our patients.
As with the non-dissolvable stitches, the same rule applies. Usually around the 2 week mark is when the extraction socket has healed enough where it no longer needs the stitches for further recovery. That means having them dissolve in 10-14 days is an ideal time frame.
Dissolving times for other suture materials
For the sake of completeness, there ARE other types of dissolvable materials and they all breakdown at different rates. Below is a table documenting all of the dissolution times for various materials.
Absorbable Sutures | Dissolution Time |
|---|---|
Fast gut | |
Plain gut | |
Chromic gut | |
Polyglycolic acid (PGA) | |
Polydioxanone (PDS) | |
Polytrimethylene carbonate (Maxon) | |
Polyglactin 910 (Vicryl rapide) | |
Glycomer 631 | |
Polyglytone 6211 | |
Poliglecaprone (Monocryl) |
Note: You may have astutely noticed that the chromic gut is listed as 90 days in the table but we told you they would fall out after 10-14 days. The reason is because the 90 days is when it completely dissolves. However, it usually dissolves enough after 2 weeks to "fall out".
Reasons for shorter time of chromic gut sutures:
One study reported that the chromic gut sutures mostly lost its strength after a week.
Another study found that in moist environments such as the oral cavity, the strength of chromic gut is reduced by 20-30%.
According to one of the manufacturers, this suture material maintains its strength for 14-21 days.
In summary, you can expect this material to pretty much fall out on their own in about 2 weeks. However, when the sutures are absolutely necessary, it is usually for the impacted teeth where the gums have to be cut away and the bone drilled away. Those situations definitively require wound approximation!
In summary, it comes down to whether or not your third molar was impacted or not. If it was, the sutures are crucial but if it wasn't, it may not really be necessary! If it is the latter, it could be okay to not replace the fallen out stitches.
Early stitches loss is a complication
If your wisdom teeth stitches come out after a mere 3 days, you've a complication because they're supposed to stay in for 2 weeks. It is very likely that your wisdom tooth hole has not healed enough and still needs to rely on the stitches for efficient healing.
The purpose of the sutures is to assist with the socket closure and reduce secondary intention healing.
Assist with socket closure. The stitches approximates the wound so the body doesn't have to work as hard to close up the hole. Therefore, having stitches can reduce healing time. If you didn't have them, it would increase healing time.
Reduce secondary intention healing. Having the wound edges closely approximated will encourage primary intention healing rather than secondary. In layman's terms, there will be less scar tissue formation.
Typically, when stitches are needed after wisdom tooth extraction, the most crucial period would be the first 1-2 weeks of healing. During this time, the socket relies heavily on the sutures to expedite the healing. However, after that time period, the body no longer needs the sutures and can heal just fine on its own.
Consequences of healing without stitches
Delayed healing. Body has to work harder if the wound edges aren't approximated closely. This results in a longer healing time. In other words it will take the wisdom tooth hole a lot longer to close.
More scar tissue formation. Due to increased secondary intention healing, you can expect more scar tissue.
Therefore, we highly recommend that you contact your dentist if the sutures come out early. There is a good chance that your dentist may want to put back in new ones to replace the fallen out old ones so that you can heal as quickly as possible.
Exception - When it may not be a complication
Despite early suture loss being a complication, there is an exception where it may not be a complication. There are situations where stitches aren't needed for wisdom teeth removal but your dentist places them because it may help speed up healing a little bit.
You may be surprised to know but for the vast majority of fully erupted wisdom teeth that we take out, we don't put stitches in the socket. The reason is because there isn't anything to stitch up, at least for teeth that are fully erupted.
However, when the sutures are absolutely necessary, it is usually for the impacted teeth where the gums have to be cut away and the bone drilled away. Those situations definitively require wound approximation!
In summary, it comes down to whether or not your third molar was impacted or not. If it was, the sutures are crucial but if it wasn't, it may not really be necessary! If it is the latter, it could be okay to not replace the fallen out stitches. If you're concerned, you should contact your dentist but if you're in the Long Island City area, we can give you a dental consultation as well.
