Do your research and communicate with your oral surgeon before getting your wisdom teeth extracte...
Credit: Julia Freeman-Woolpert | ©sxc.hu/juliaf
Why You Should Demand Stitches When Having Wisdom Teeth Removed
I'm not an oral surgeon, but I've heard enough horror stories about wisdom teeth extraction in the last week that I feel just about qualified to yank a tooth or two. I had all four (two impacted) pulled last week, and my pain strangely compels everyone around me to share their own experience. Power in numbers, perhaps.
My oral surgeon, thankfully, stitched all my tooth holes up with stitches that are slowly dissolving. I've avoided straws and cigarettes as instructed (though I'm not addicted to either anyway) and am healing pretty well.
Several friends of mine, however, weren't quite as lucky. My sister had hers yanked all at the same time and the surgeon decided to forego the stitches in favor of leaving gaping holes in her mouth. Clots are naturally supposed to develop in those holes. If the clots don't form properly or get dislodged from the holes, dry sockets form. The hole left from your tooth leaves the bone beneath exposed and susceptible to infection. This is what happened in her case, and she was as miserable as I've ever seen her. The area where her teeth had been were throbbing and the pain extended into her ears and lymph nodes.
Stitches, Plugs and Other Options
My sister and I represent extreme ends of the stitches/no stitches issue. Some surgeons choose non-disolving stitches, which need to be removed a few days after surgery. Some choose to fill the holes with dissolvable plugs, such as the Collagplug or Gelfoam. The advantage of these plugs is that they do keep the area clean and dry - if they stay in place. Some surgeons mix tetracycline in the the Gelfoam, which is supposed to further reduce the chances of dry socket. Some surgeons also opt to keep those plugs in with a few stitches, which may be an effective option. The problem with the plugs is that they can fall out the same way as the blood clot.
Causes and Likelihood of Dry Sockets
My oral surgeon, thankfully, stitched all my tooth holes up with stitches that are slowly dissolving. I've avoided straws and cigarettes as instructed (though I'm not addicted to either anyway) and am healing pretty well.
Several friends of mine, however, weren't quite as lucky. My sister had hers yanked all at the same time and the surgeon decided to forego the stitches in favor of leaving gaping holes in her mouth. Clots are naturally supposed to develop in those holes. If the clots don't form properly or get dislodged from the holes, dry sockets form. The hole left from your tooth leaves the bone beneath exposed and susceptible to infection. This is what happened in her case, and she was as miserable as I've ever seen her. The area where her teeth had been were throbbing and the pain extended into her ears and lymph nodes.
Stitches, Plugs and Other Options
My sister and I represent extreme ends of the stitches/no stitches issue. Some surgeons choose non-disolving stitches, which need to be removed a few days after surgery. Some choose to fill the holes with dissolvable plugs, such as the Collagplug or Gelfoam. The advantage of these plugs is that they do keep the area clean and dry - if they stay in place. Some surgeons mix tetracycline in the the Gelfoam, which is supposed to further reduce the chances of dry socket. Some surgeons also opt to keep those plugs in with a few stitches, which may be an effective option. The problem with the plugs is that they can fall out the same way as the blood clot.
Causes and Likelihood of Dry Sockets
- Holes left from extraction can be left open, stitched, or filled with a plug.
- Dry sockets are more common in lower extractions than upper ones.
- Impacted extractions are at greater risk of getting a dry socket.
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