The Importance and Techniques of Sutures in Mouth Surgery

Sutures, also known as stitches, are used in various medical procedures, including dental care, to close and secure wounds or incisions. In dental care, sutures are commonly employed after oral surgeries or certain operations involving the mouth’s soft tissues. They aid in healing by holding the edges of the incision or wound together, promoting proper tissue alignment, reducing bleeding, and preventing infection. In this article, we will explore the significance of sutures in mouth procedures, their applications in dental care, and their role in promoting successful oral surgery outcomes.

When are they used in dental care?

Here are a few scenarios where sutures may be used in dental care:

Tooth extraction procedure: After tooth extraction, especially for impacted or surgically removed teeth, sutures might be employed to close the surgical site. This helps to control bleeding and facilitate proper healing.
Gum grafting: In cases of gum recession, where the gum tissue has pulled away from the teeth, a gum grafting procedure may be performed. Sutures are used to secure the graft, which may be taken from another area of the mouth or a tissue bank in place.
Oral surgeries: Various oral surgeries, such as dental implant placement, orthognathic surgery, or the removal of cysts or tumors, may require sutures to close the incisions made during the procedure.

The type of sutures used in dental care can vary. They may be absorbable or non-absorbable. Absorbable sutures dissolve over time, eliminating the need for removal, as they are designed to break down naturally within the body. On the other hand, non-absorbable sutures require manual removal by a dental professional after the appropriate healing period.

Benefits of sutures for mouth health and healing

Sutures are crucial in promoting mouth health and facilitating proper healing after dental procedures. Here are some benefits of sutures in terms of mouth health and healing:

Wound closure: For wisdom teeth removal, sutures are used to bring the edges of a wound or incision together, facilitating proper alignment and closure. This reduces the risk of complications, such as infection, by minimizing the exposure of the injury to oral bacteria and debris.
Hemostasis: Sutures help control bleeding by applying pressure on blood vessels, reducing the risk of excessive bleeding during and after dental procedures. This helps maintain a clean surgical field and improves visibility for the dental professional.
Tissue support and stability: Sutures provide support and stability to the soft tissues during the initial healing phase. They hold the tissues in place, preventing excessive movement, which can disrupt the healing process and delay recovery.
Reduced risk of complications: Properly placed sutures help reduce the risk of complications such as wound dehiscence (reopening of the wound), infection, and excessive scarring. By holding the wound edges together, sutures promote healing in a controlled manner, minimizing the chances of complications.
Faster healing: Sutures aid in the healing process by promoting wound closure, reducing bleeding, and providing support to the surrounding tissues. By keeping the wound edges in close proximity, sutures help accelerate the initial stages of healing, allowing the body to repair the tissues more efficiently.
Minimized discomfort: Sutures can help minimize post-operative discomfort and pain by stabilizing the wound and reducing movement that could irritate the area. This allows patients to experience a more comfortable recovery period.

It’s important to note that the choice of suture materials and the technique used for their placement may vary based on the specific procedure, the patient’s condition, and the dentist’s professional judgment. Follow-up care and proper oral hygiene practices, as the dental professional instructs, are essential to ensure optimal healing and mouth health.

Types of sutures used in mouth procedures

In dental procedures, various types of sutures may be used based on the patient’s specific needs and the procedure’s nature. The choice of sutures depends on factors such as the location of the incision, the expected healing time, and the preference of the dental professional. Here are some common types of sutures used in mouth procedures:

Non-absorbable sutures

Non-absorbable sutures are made of materials that do not break down or dissolve within the body. They require manual removal by a dental professional after the appropriate healing period. Common types of non-absorbable sutures used in dental procedures include:

- Silk: Silk sutures are smooth and easy to handle. They are commonly used for soft tissue closure and are typically removed after a week or two.
- Nylon (Ethilon): Nylon sutures have strong knot security. They are often used in oral surgery, periodontal procedures, and closure of deeper incisions. Nylon sutures are usually removed within 5 to 7 days.
- Polyester (Mersilene): Polyester sutures are durable and have good tensile strength. They are commonly used for subcutaneous closure or for long-term wound support. Polyester sutures are typically removed within 7 to 10 days.

Absorbable sutures

Dissolving stitches are made of materials that break down naturally within the body over time, eliminating the need for their removal. The choice of absorbable sutures depends on the expected healing time and the tissue being sutured. Common types of absorbable sutures used in dental procedures include:

- Polyglycolic Acid (PGA): PGA sutures are commonly used for soft tissue closure and resorb within 7 to 14 days.
- Polylactic Acid (PLA): PLA sutures have a slower absorption rate than PGA and can provide longer-lasting support. They typically resorb within 14 to 21 days.
- Vicryl (Polyglactin 910): Vicryl sutures are a blend of PGA and PLA. They offer excellent knot security and have a resorption period of approximately 7 to 14 days.
- Chromic Gut: Chromic Gut sutures are made from sheep or cow intestines. They provide short-term wound support and are absorbed within 7 to 14 days.
- Plain Gut: Plain Gut sutures are also made from sheep or cow intestines but have a faster absorption rate compared to Chromic Gut. They are typically absorbed within 5 to 7 days.

It’s important to consult with your dental professional to determine the most appropriate type of sutures for your specific dental procedure, as they will consider factors such as the location of the incision, the expected healing time, and your individual needs.

How long do sutures stay in the mouth?

The duration for which sutures stay in the mouth can vary depending on the type of suture material used, the specific procedure performed, and the individual’s wound healing process (blood clot formation). Here are general guidelines regarding the typical timeframes for suture removal or absorption in the mouth:

Non-absorbable sutures: Non-absorbable sutures, such as silk, nylon (Ethilon), and polyester (Mersilene), are not designed to dissolve on their own. They need to be manually removed by a dental professional after a specific period, usually within 5 to 14 days, depending on the location and the healing progress. Your dentist or oral surgeon will schedule a follow-up appointment to remove these sutures.
Absorbable sutures: Absorbable sutures are designed to break down naturally within the body over time, eliminating the need for removal. The absorption rate varies depending on the type of absorbable suture material used. Here are some general guidelines:

- Polyglycolic Acid (PGA) sutures: Typically, PGA sutures resorb within 7 to 14 days.
- Polylactic Acid (PLA) sutures: PLA sutures have a longer absorption rate and may take 14 to 21 days to resorb.
- Vicryl (Polyglactin 910) sutures: Vicryl sutures have an absorption period of approximately 7 to 14 days.
- Chromic Gut sutures: Chromic Gut sutures usually dissolve within 7 to 14 days.
- Plain Gut sutures: Plain Gut sutures have a faster absorption rate and may dissolve within 5 to 7 days.

It’s important to note that these timeframes are general estimates, and the actual duration may vary based on individual healing rates and the specific circumstances of the dental procedure.

Risks and side effects associated with having mouth sutures

While sutures are commonly used in dental procedures and are generally safe, there are some potential risks and side effects associated with having sutures in the mouth. These can include:

Infection: Any incision or wound carries a risk of disease. If proper oral hygiene practices are not followed or if there is an underlying oral health issue, bacteria can enter the wound site and cause an infection. Signs of infection may include increased pain, swelling, redness, pus formation, or a fever. It’s important to report any concerning symptoms to your dental professional.
Pain and Discomfort: Some degree of pain or discomfort is common after oral surgeries or procedures requiring sutures. However, if the pain intensifies, becomes severe, or is accompanied by other concerning symptoms, it could indicate a complication, and you should seek prompt dental attention.
Bleeding: Slight bleeding is normal immediately after a dental procedure that requires sutures. However, if bleeding becomes excessive, persists for an extended period, or is difficult to control, it could cause concern. Contact your dental professional if you experience uncontrolled bleeding.
Allergic Reactions: While rare, some individuals may have an allergic reaction to the suture material. Allergy symptoms may include localized swelling, redness, itching, or a rash around the sutured area. If you suspect an allergic reaction, inform your dentist or oral surgeon immediately.
Suture Complications: In certain cases, complications related to sutures may arise. These can include suture dehiscence (opening of the wound), where the sutures fail to hold the wound edges together, or suture granuloma, which forms a localized inflammatory response around the suture material. These complications require professional attention for proper management.

Regular follow-up appointments will allow your dental professional to monitor the healing process, assess the sutures, and address any concerns or complications that may arise. If you experience any unusual or concerning symptoms or have questions about your sutures, it’s best to contact your dental professional for appropriate guidance and care.

Tips for taking proper care of your teeth after having a suture procedure done

Taking proper care of your teeth and the surgical site after a suture procedure is essential to promote healing and reduce the risk of complications. Here are some tips for post-operative oral care:

1. Follow post-operative instructions: Your dental professional will provide specific post-operative instructions tailored to your procedure and situation. Follow these instructions carefully, including guidelines on oral hygiene, diet, medication, and any restrictions or precautions.

2. Oral hygiene practices: Maintain good oral hygiene, but be gentle around the surgical site to avoid disrupting the sutures. Here are some tips:

Brushing: Brush your teeth carefully, avoiding the surgical area. Use a soft-bristled toothbrush and gentle, circular motions. If possible, use an antiseptic mouthwash as recommended by your dentist.
Rinsing: Rinse your mouth gently with a warm saltwater rinse or an antiseptic mouthwash as your dental professional advises. This can help reduce bacteria and promote healing. Avoid vigorous rinsing or spitting, especially in the first 24 hours after the procedure.
Flossing: Avoid flossing around the surgical site until your dental professional gives you the go-ahead. If you need to floss in other areas, be cautious and gentle.

3. Pain management: If you experience discomfort or pain after the procedure, follow your dental professional’s recommended pain management regimen. If advised, take prescribed pain medications as directed and use cold compresses on the outside of your mouth to help reduce swelling.

4. Control bleeding: Some minor bleeding is normal after oral surgery. If bleeding occurs, bite down gently on a clean gauze pad or a moistened tea bag for about 20-30 minutes. If bleeding persists or becomes excessive, contact your dental professional.

5. Diet and eating: Follow any dietary restrictions or recommendations provided by your dental professional. Stick to soft foods and avoid chewing on the side of the surgical site. Maintain good hydration by drinking plenty of water

6. Avoid irritants and trauma: Avoid smoking, using straws, or consuming hot and spicy foods or beverages, as these can irritate the surgical site or potentially dislodge the sutures. Be cautious not to accidentally bite or traumatize the area.

7. Attend follow-up appointments: Keep all scheduled follow-up appointments with your dental professional. They will monitor the healing progress, remove sutures if necessary, and address any concerns or complications.

It’s important to communicate with your dental professional if you have any questions, experience unusual symptoms, or are unsure about any aspect of your post-operative care. They are the best resource to guide you through the recovery process and ensure optimal healing.