In oral diagnosis and treatment, wisdom tooth extraction is a common surgical procedure. To help the wound heal better, doctors usually perform suturing after tooth extraction. However, sometimes the stitches may come off. This seemingly minor change may trigger a series of chain reactions. So, what exactly happens when the wisdom tooth suture falls out? Next, we will conduct a detailed analysis from multiple aspects.
Initial changes of the wound
The moment the wisdom tooth suture falls off, the wound that was originally drawn in and closed by the suture will be exposed again. Just like pulling the curtain to cover the wound, the tooth extraction socket (the depression formed at the wound site) comes into direct contact with the oral environment. Under normal circumstances, the suture plays a role in fixing the edge of the wound and reducing bleeding. After the suture falls off, the wound loses this layer of restraint. The blood clot that has initially coagulate may shift or even fall off due to changes in oral pressure, swallowing actions, or muscle movements during speaking.
At this point, the blood at the wound site will seep out again. At the beginning, there might just be a few blood streaks mixed in the saliva. This is because the tiny blood vessels on the surface of the wound are stimulated and start bleeding again. If the patient fails to notice it in time and take the correct measures, as the oral activity continues, the amount of bleeding may gradually increase and even form obvious blood clots. When a blood clot breaks off, the fresh wound beneath is exposed. This condition is medically known as the early manifestation of “dry socket syndrome”, which greatly increases the risk of infection.
Furthermore, after the sutures fall off, the edge of the wound is no longer tightly pressed together, and the gingival tissues on both sides will gradually contract towards the center of the wound. This process will make the wound appear larger than when the suture was in place. Moreover, due to the lack of support from the suture, the tissue at the edge of the wound is prone to dislocation, affecting the subsequent healing process. If the originally neat edge of the wound cannot be accurately aligned and grown, it may lead to an unattractive shape of the gum after healing, and even affect the chewing function and oral hygiene.
The influence of the oral internal environment
The oral cavity is a complex environment full of bacteria. Under normal circumstances, the presence of sutures can, to a certain extent, prevent bacteria from invading the wound. However, after the sutures fall off, the wound is directly exposed, providing an opportunity for bacteria in the oral cavity to take advantage. A large number of bacteria will rapidly attach to the surface of the wound and multiply in large numbers with the residual blood and tissue fluid in the wound as nutrients.
The metabolic products of these bacteria can stimulate the tissues around the wound and trigger an inflammatory response. Patients will feel an intensification of pain at the wound site, which is different from the normal pain after tooth extraction. It is often a persistent distending or throbbing pain, and may even radiate to the ear, temples and other areas, seriously affecting the patient’s daily life and sleep quality. At the same time, inflammation can also cause the gingival tissue around the wound to become red and swollen, and a distinct tenderness can be felt when touched gently by hand.
As the inflammation progresses, the wound may become suppurated. Pus is a product of the body’s fight against bacterial infection, mainly composed of dead white blood cells, bacteria and tissue fragments. When pus accumulates in the wound, it will increase the pressure at the wound site, further aggravating the pain symptoms. Moreover, the special smell of the pus will cause patients to have obvious bad breath, affecting their social life. If not treated in time, the infection may spread to the surrounding tissues, causing an infection in the maxillofacial space, leading to serious consequences such as facial swelling and restricted mouth opening, and even threatening life and health.
The patient’s physical reaction
In addition to the local changes of the wound and the influence of the oral environment, the detachment of the suture can also cause a series of physical reactions in the patient. The first is the discomfort caused by pain. Persistent pain can make patients mentally tense and anxious, affecting their appetite and sleep. Because they dare not chew food normally, patients may choose to eat some soft food or liquid food. In the long run, this may lead to an imbalance in nutrient intake.
Pain can also stimulate the body’s stress response, causing fluctuations in the patient’s body temperature. A mild inflammatory response may cause low fever, with body temperature generally ranging from 37.3℃ to 38℃. If the infection is not controlled, the body temperature will rise further, exceeding 38℃ or even higher, accompanied by systemic symptoms such as chills and fatigue. In addition, the release of inflammatory mediators may also cause discomfort such as headache and dizziness, affecting the patient’s work and study efficiency.
Psychologically, the additional distress caused by the detachment of sutures can make patients worry and distrust the treatment effect. Especially when the pain and infection symptoms are more severe, patients may fall into panic, worrying about more serious complications. This negative emotion, in turn, will affect the body’s recovery, creating a vicious cycle.
Different handling methods for various situations
If the wisdom tooth suture is found to have fallen off, the patient should not panic at first. Different treatment measures should be taken according to the specific situation. If the suture falls off within a short period of time (1-2 days) after tooth extraction and there are no obvious symptoms such as bleeding or increased pain at the wound site, you can observe it by yourself first. During this period, special attention should be paid to oral hygiene to prevent food residues from entering the wound. After meals, gently rinse your mouth with clean water or mouthwash prescribed by a doctor to wash away any food residues in your mouth. However, be careful not to rinse your mouth forcefully to avoid causing bleeding again.
If there is a small amount of bleeding at the wound site after the suture falls off, you can try biting a clean piece of gauze or cotton ball and stop the bleeding by applying pressure to stop the bleeding. Generally, after biting for about 30 minutes, the bleeding condition will improve. If the bleeding does not stop, or if the pain at the wound site significantly intensifies, and symptoms such as redness, swelling, and pus appear, one should immediately go to the hospital for a follow-up visit. The doctor will handle it according to the specific situation of the wound.
For cases where there is no obvious infection at the wound site, the doctor may re-apply sutures to bring the edge of the wound closer together again, creating favorable conditions for wound healing. If the wound has become infected, the doctor will first perform debridement treatment on the wound, alternately rinsing it with normal saline and hydrogen peroxide to thoroughly remove pus, bacteria and necrotic tissue. After debridement, a drainage strip will be placed inside the wound to help drain the remaining pus. At the same time, antibiotic drugs will be prescribed based on the severity of the infection to control the development of inflammation.
During the subsequent recovery process, patients should strictly follow the doctor’s instructions for care. Take antibiotics on time, keep your mouth clean, avoid spicy and irritating foods, and quit smoking and drinking. Generally speaking, with correct treatment and meticulous care, the wound will gradually heal. However, the entire healing process may be prolonged compared to when the sutures are in normal position. Patients need to have sufficient patience and confidence.
Measures to prevent the stitches from falling off
Although suture detachment is a possible situation after tooth extraction, we can take some measures to reduce the probability of its occurrence. During the recovery period after tooth extraction, patients should avoid opening their mouths too much. For instance, when yawning, they can support their chins with their hands and try to minimize the extent of mouth opening to prevent the stitches from falling off due to excessive stretching of the muscles in the mouth. At the same time, avoid eating hard and large pieces of food to prevent accidentally pulling the stitches during chewing.
When brushing your teeth, be gentle. Do not brush the wound directly. You can avoid the wound first and clean the other teeth. Wait until the wound has healed to a certain extent before brushing your teeth normally. In addition, patients should avoid spitting frequently, as it creates negative pressure in the mouth, which can easily lead to the detachment of blood clots and the loosening of sutures. If there is saliva in the mouth, it can be swallowed gently.
When performing suture operations, doctors will also select appropriate suture materials and methods based on the specific conditions of the patients. Different suture materials vary in strength, absorbency and irritation to tissues. Doctors will comprehensively consider factors such as the size and location of the wound and the patient’s physical condition to select the most suitable suture. Meanwhile, proficient and meticulous suturing techniques are also the key to ensuring the stability of the sutures, which requires doctors to have rich clinical experience and professional skills.
Conclusion
The detachment of wisdom tooth sutures may seem like a minor issue, but it can lead to a series of complex situations and have many impacts on wound healing and the patient’s physical health. Understanding the changes after the stitches fall off and mastering the correct handling and preventive measures are crucial for patients to smoothly get through the recovery period after tooth extraction. If any abnormal situation occurs during the recovery process, it is essential to communicate with the doctor in a timely manner and seek professional assistance. Only in this way can the wound heal as soon as possible and oral health be restored.
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