When are apicoectomy stitches removed?
Cited to 4 sources. Reviewed 2026-08-25.
Non-dissolving apicoectomy stitches are typically removed at a short follow-up visit within the first week, often between 2 and 7 days after surgery. Some endodontists remove them as early as 48 hours because the gum flap seals quickly. Dissolving sutures are left alone and usually break down and fall out within one to two weeks. Removal itself takes a minute or two and rarely needs anesthetic.
- Non-dissolving sutures
- Removed in about 2 to 7 days
- Dissolving sutures
- Fall out on their own, 1 to 2 weeks
- Removal appointment
- A few minutes, usually no numbing
- Gum incision closed
- About 2 weeks
Why the window is so short compared with other surgery
After an apicoectomy the endodontist places a few stitches in the gum to hold the flap back against the bone while it reattaches. The mouth has an unusually rich blood supply, so gum tissue seals faster than skin does. That is why oral sutures often come out in days rather than the one to two weeks common for surgical wounds elsewhere on the body.
General surgical guidance puts non-dissolving suture removal anywhere from three to fourteen days depending on the wound. Oral surgical sites sit at the fast end of that range, and many endodontists book the suture visit for two to four days after the procedure.
Your exact date is the one your endodontist gave you. If nobody told you, call and ask rather than assuming yours are dissolvable.
Dissolving versus non-dissolving: how to tell
There are two kinds and they are handled completely differently.
- Do not try to remove or trim any suture yourself, of either type
- A loose or dangling stitch that is irritating your cheek is worth a phone call, not scissors
- If a stitch comes out in the first day or two, call and let the office decide whether the flap needs checking
| Non-dissolving (non-absorbable) | Dissolving (absorbable) | |
|---|---|---|
| What happens | Removed by your endodontist at a follow-up visit | Break down on their own and fall out |
| Typical timing | About 2 to 7 days after surgery | Usually 1 to 2 weeks, sometimes longer |
| Do you need an appointment | Yes, a short one | Not for the sutures, though a healing check is still useful |
| What if one comes loose early | Call the office, do not pull it | Normal, they often loosen before they go |
What the removal appointment is like
It is short. The endodontist looks at the incision line to confirm the flap has reattached, lifts each suture knot with tweezers, snips it and slides it out. Most people describe a light tugging sensation rather than pain, and local anesthetic is usually not needed.
The visit doubles as your first healing check. This is the moment to mention anything odd: persistent numbness, a taste of drainage, swelling that has not gone down, or a bite that feels off. It is also usually when you get the go ahead to resume normal brushing over the area and, often, normal exercise.
Keep the appointment even if you feel fine. Sutures left in too long can collect plaque and irritate the tissue they are meant to protect.
Caring for the site while stitches are in
The single most common mistake in this window is inspecting the surgery. Pulling your lip or cheek outward to look at the stitches stretches the incision line and can tear the flap loose from the bone. Resist it, and use a mirror only with your mouth relaxed.
- Do not pull your lip or cheek out to look at the site
- Brush your other teeth normally and go very gently near the incision
- Rinse with warm salt water or the antimicrobial rinse you were given, letting the liquid fall out rather than spitting forcefully
- Stay on soft foods and chew on the opposite side
- Avoid sticky foods and chewing gum, which pull at the knots
- Skip strenuous exercise for the first 48 to 72 hours
Call your dentist or oral surgeon if
- The gum flap looks like it has pulled away from the tooth or bone, or the incision line has gaped open
- Thick cloudy or white discharge, or a bad odor from the incision
- Redness spreading well beyond the incision line, with warmth
- Fever of 100.4 F or higher, or chills
- Swelling increasing after day 3 instead of decreasing
- Pain that is worsening rather than fading over the first week
- Bleeding from the incision that will not stop with gentle gauze pressure
Related questions
Does apicoectomy stitch removal hurt?
Usually not. Most people feel a light tug as each knot is lifted and snipped. Anesthetic is rarely needed, and the whole thing takes a couple of minutes.
What if my apicoectomy stitch falls out early?
Call the office. It is often harmless, especially after the first few days, but the endodontist should decide whether the flap still needs support. Do not try to replace or remove anything yourself.
How do I know if my stitches are dissolvable?
Ask. It is not reliably obvious by looking. If your discharge instructions did not book a removal appointment, that usually means dissolving sutures, but confirming by phone takes a minute.
Can I brush over the stitches?
Brush the neighboring teeth normally and stay gentle right at the incision line until the sutures are out. Rinsing gently after meals does more good than scrubbing the site.
Sources
- Endodontic Surgery Explained (American Association of Endodontists)
- Incision and Surgical Wound Care: Sutures, Stitches, Steri-Strips and Staples (Cleveland Clinic)
- Endodontic Surgery (American Association of Endodontists)
- Tooth extraction (MedlinePlus (National Library of Medicine))
Reviewed against the sources above on 2026-08-25. General information only, not dental advice. Your own provider's aftercare instructions come first.
Keep reading
Most people are back to normal activities the day after an apicoectomy. Swelling peaks around 48 to 72 hours, stitches usually come out within the first week, and the gum incision has closed over by about 2 weeks. The bone around the trimmed root end heals much more slowly, filling in over several months, which is why your endodontist checks it with follow-up X-rays rather than asking how you feel.
For the first 48 hours after an apicoectomy: ice the outside of your cheek 20 minutes on and 20 minutes off, keep your head elevated, eat cool soft foods, and do not lift your lip or cheek to inspect the stitches. Skip strenuous exercise, smoking and straws. Do not chew, drink hot or cold liquids, or smoke for the first hour. Start gentle salt water rinses only when your endodontist tells you to, and never spit forcefully.
Swelling after an apicoectomy builds for the first two days, peaks somewhere around 48 to 72 hours, and then comes down over the rest of the week. Most people look close to normal by day 5 to 7. Bruising on the cheek or under the eye often shows up on day 2 or 3, after the swelling has already started, and can take one to two weeks to fade through the usual purple to yellow color change.
Stick to cool, soft foods for the first 24 hours after an apicoectomy, then soft foods you barely have to chew for about a week. Chew on the opposite side of your mouth the entire time. Avoid hard, crunchy, seedy or sticky foods, anything very hot, and drinking through a straw in the first days. Do not chew, drink hot or cold liquids, or smoke for the first hour after the procedure.