Dental implants are a common and effective way to replace missing teeth. During the implant placement procedure, the oral surgeon will make incisions in the gums to insert the implant into the jawbone. These incisions are closed with stitches or sutures at the end of surgery.
The type of sutures used, as well as each individual’s healing ability, determine how long it takes for these stitches to dissolve. On average, dental implant stitches take between 7-14 days to dissolve.
What are dental implants?
Dental implants are small titanium screws that are surgically inserted into the jawbone to replace missing tooth roots. They provide a stable foundation for fixed or removable replacement teeth. Dental implants may be used to replace a single tooth or multiple teeth.
The main advantages of dental implants over other tooth replacement options include:
- Dental implants look and feel like natural teeth
- They do not require altering adjacent healthy teeth like dental bridges do
- Dental implants are sturdy and stable, allowing proper chewing and speaking
- They help prevent bone loss in the jaw that occurs after losing teeth
- The success rate of dental implant procedures is over 95%
The dental implant procedure involves several steps over the course of a few months. First, the implant is surgically placed into the jawbone during an outpatient procedure. The gums and bone tissue are given about 3-6 months to heal and securely integrate with the implant. Finally, an abutment and crown are placed on the implant to complete the restoration.
Why are stitches needed after dental implant surgery?
During the initial implant placement surgery, the oral surgeon makes small incisions in the gums to expose the underlying bone. The implant is then inserted into precisely prepared channels in the jawbone. Once the implant is in the ideal position, the surgeon sutures the gum tissue incisions closed.
Stitches are necessary after this procedure for the following reasons:
- To properly align the edges of the incised gum tissue so optimal healing can occur
- To minimize bleeding and prevent complications
- To promote quick and proper healing of the incisions
- To reduce the risk of infection
If the incisions were left open after the surgery, the gums could heal in a way that negatively impacts the implants. Suturing the flaps of gum tissue back into their original position helps ensure successful implantation and an aesthetically pleasing gingival contour after healing.
Types of sutures used for dental implant procedures
The stitches used to close the incisions after dental implant placement procedures typically consist of absorbable sutures that the body naturally breaks down over time. Common options include:
- Polyglactin 910 (Vicryl): These synthetic absorbable sutures provide up to 2 weeks of tensile strength retention in tissue. Full absorption occurs between 60-90 days.
- Poliglecaprone 25 (Monocryl): This monofilament absorbable stitch maintains strength for about 2 weeks and is fully absorbed in 60-90 days.
- Chromic gut suture: Derived from purified connective tissue (animal collagen), it lasts 10-14 days before absorption.
- Polydioxanone (PDS): These synthetic polymeric sutures keep 50% of their strength at 3 weeks post-op and are fully absorbed in 6 months.
In some cases, the surgeon may opt for non-absorbable sutures like nylon or polypropylene. However, these require removal after a certain period of time. Absorbable sutures are more convenient as they gradually dissolve on their own without need for removal.
Factors that determine how long implant stitches take to dissolve
While absorbable sutures used for dental implant procedures generally take 1-2 weeks to dissolve, several factors affect the exact time frame:
Type of suture material
As covered above, the specific suture material used impacts how long the stitches will remain intact before degrading. Chromic gut dissolves more rapidly than materials like PDS or Monocryl.
Location of incisions
Areas of the mouth with greater blood flow and warmer temperatures tend to facilitate faster absorption of sutures. Stitches placed in palatal incisions or under the tongue may dissolve quicker than those in mandibular labial flaps.
Oral hygiene
Proper oral hygiene is essential after dental implant placement. Food debris and plaque accumulation around sutures can delay healing and dissolution. Brushing carefully after eating and using chlorhexidine mouthwash helps keep the area clean.
Individual healing ability
The body’s natural ability to heal varies from person to person. Factors like age, malnutrition, smoking, and certain medical conditions can interfere with wound healing and tissue regeneration. For people who heal slower, sutures may take a little longer to be absorbed.
Medications
Certain prescription drugs like oral steroids or chemotherapy medications can impair healing. People taking these types of drugs may need to keep stitches longer before full absorption.
How long do non-absorbable sutures need to stay in?
While absorbable sutures are preferred for most dental implant procedures, non-absorbable materials like silk, polyester, or nylon may be used in some cases. These types of sutures do not degrade and have to be manually removed by the dentist or surgeon.
Non-absorbable sutures usually need to stay in place for:
- 5 to 7 days for the lower jaw
- 7 to 10 days for upper jaw incisions
The oral surgeon will schedule a follow-up appointment during this time frame to gently remove the stitches once adequate healing has occurred. Leaving non-absorbable sutures in for too long can increase scarring.
What to expect as sutures dissolve
The dissolution process occurs gradually over the course of several days to weeks. Here’s what to expect:
- 1 to 3 days after surgery: Swelling and inflammation peaks. Stitches are intact.
- 3 to 5 days after: Swelling improves. Early stages of suture absorption begins.
- 1 week after: Stitches begin degrading but are still moderately supportive. Some may fall out.
- 2 weeks after: Most or all of suture material is absorbed by the body.
As sutures dissolve, the incision lines will progressively look less distinct. This is normal and indicates the tissue is healing. There may be some redness around the area that also improves over time.
Let your oral surgeon know if you experience any increased pain, bleeding, or discharge during the healing process, as these could signify potential complications.
Tips for managing pain and discomfort from sutures
It is common to have some soreness or pain around the surgery site as the stitches dissolve. Here are some tips to help manage discomfort:
- Take any prescribed pain medication as directed by your oral surgeon.
- Apply ice packs to the outside of your face for 10-minute intervals to reduce swelling.
- Rinse your mouth gently with warm salt water to keep the area clean.
- Stick to soft, bland foods and avoid very hot or spicy items.
- Sleep with your head elevated on an extra pillow to minimize swelling.
- Use over-the-counter pain relievers like acetaminophen or ibuprofen as needed.
- Avoid vigorously brushing, flossing, or touching the sutured area.
The discomfort typically peaks on days 3-5 before gradually improving by the end of the first week. Contact your oral surgeon if pain seems excessive or gets worse rather than better.
Signs of problems with suture healing
For the most part, absorbable sutures heal without issue as they dissolve. However, it’s important to watch for any concerning signs of impaired healing or infection:
- Increased swelling or bruising at the surgery site
- Moderate to severe pain that persists or worsens
- Bleeding from the incisions
- Bad breath or foul taste in your mouth
- Pus drainage or red streaking from the wound
- Fever of 101°F (38°C) or higher
Notify your oral surgeon promptly if you notice any of these problems, as antibiotics or other treatment may be needed.
When can sutures be removed after dental implant surgery?
Most oral surgeons use absorbable sutures that do not require removal. However, if non-absorbable materials like silk are used, they will need to be taken out once the tissue has closed adequately.
Typically, non-absorbable dental implant sutures can be removed:
- 5 to 7 days after surgery for the mandibular jaw
- 7 to 10 days after surgery for the maxillary jaw
Your oral surgeon will have you come back during this timeframe so they can snip and gently take out the remaining stitches. Trying to remove them too early can disrupt the healing. Leaving them in too long increases scarring.
Are there any special instructions for after suture removal?
Once any non-absorbable sutures have been removed, your oral surgeon may recommend:
- Rinsing with warm salt water after meals
- Continuing to gently brush around the area with a soft toothbrush
- Avoiding very hot, spicy, crunchy, or acidic foods temporarily
- Use of antiseptic chlorhexidine mouth rinse for a few more days
Most of the incision sites should be healed within 24 hours of stitch removal. Avoid probing the area with your tongue or fingers. Report any increased bleeding, pain, or swelling after suture removal to your oral surgeon.
When can I resume normal activity after dental implant surgery?
Your oral surgeon will provide detailed instructions on recovering after dental implant placement surgery while sutures heal and dissolve. Here are some general timelines on when you can resume activity:
- Next day: Return to light desk work or remote employment.
- 3 days after: Resume light activity like short walks around the house.
- 5 to 7 days after: Go back to work, school, or normal routines with modifications as needed.
- 2 weeks after: Slowly resume exercise, vigorous activity, and sports.
- 6 to 8 weeks after: Fully back to normal activity and lifestyle.
However, adjust this timeline based on your individual healing. Go slow with activity in the first 1-2 weeks and avoid excessive chewing on the implant site while it mends.
Conclusion
Dental implant surgery requires suturing the gums so the incision sites can heal optimally. For most procedures, absorbable suture materials are used that take around 1-2 weeks to gradually dissolve on their own.
Factors like oral hygiene, health status, suture type, and location impact the precise time frame. While waiting for sutures to absorb, keep the area clean and gently rinse with warm saltwater to facilitate proper healing.
Also, limit vigorous activity for the first couple weeks after surgery. With good wound care and proper oral hygiene, dental implant sutures typically heal and absorb on schedule without complications.
Consult your oral surgeon about what types of stitches were used, expected healing timeline, and recommendations for care as the incisions mend and sutures dissolve.