Dental Sutures: Application, Care and Removal

Dental Sutures: Application, Care and Removal
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Sutures provide tissue integrity and control bleeding. They are used in surgical procedures to secure open wounds and promote primary healing. For proper healing, it is vital to place sutures. There are many types of sutures mainly classified into monofilament or multifilament and natural or synthetic.

Application of dental sutures

Simple dental procedures do not require sutures, but wisdom tooth extraction, bone grafts, alveoloplasty, etc., need closure by sutures; otherwise, it can lead to open margins and eventually infection. A needle holder, a needle, and suture material are needed for suturing. There are a lot of techniques ranging from interrupted sutures, continuous, horizontal mattresses to figure of eight to approximate specific wound margins. Sometimes a combination of techniques is used. Several sutures are used in dental surgery, for example, chromic gut, silk, propylene, and nylon. Propylene sutures are used primarily because of their minimal tissue drag ability. The knots also matter, a simple knot or a surgical one. In a deep wound, tissues should be closed in layers to avoid dead space.

How and when to remove sutures

Sutures may be absorbable or non absorbable. Non-absorbable ones are usually removed within 7-14 days. The general principle is that sutures are left in place as long as margins are approximated, and wound closure has been achieved. Absorbable sutures resorb on their own when it’s the appropriate time. The suture should be identified, pulled with a hemostat, and taken out with scissors. Leaving a suture may warrant debris collection and infection or abscess.

Look after your sutures 

Sutures should be placed and removed with great care. Apart from that, the patient must maintain adequate oral hygiene. The patient should not miss their suture removal appointment. Moreover, they should also keep an eye on absorbable sutures as some fragments might need removal. Any remaining piece of suture can lead to infection as it is, after all, a foreign body. Dental sutures should not come out before time, and if they do, patients should see their dentist. The sutures generally impart no pain, but if there is, it could be a sign of infection that should not be ignored.

 
 

Dr Rimsha Qasim
Dr Rimsha Qasim

The author is contributing writer at Dental News Pakistan and can be reached at rimsha.qasim@duhs.edu.pk