UNIT III.

ROOT CANAL THERAPY (RCT)

DISCUSSION POINTS

1. Read the quote. Do you agree or disagree with the authors’ messages.
Response: As you can see, time is of the essence when it comes to tooth loss. The sooner you get a handle on
the situation, the easier it is to solve. The longer you wait to get your tooth loss issue fixed, the more damage
is done. Afterwards you'll have to get different implants, bridges and dental prosthesis which are expensive
and sometimes painful. This is why you have to always take care of your teeth and mouth hygiene.

1. Work in groups. Read the statements. Share your ideas.

Pain subsiding does not mean you do not need root canal treatment. There are many people who
try to tolerate a toothache and delay going to the dentist for various reasons. You experience pain
when bacteria attack the tooth’s pulp where the nerves and blood vessels are located. If you wait too
long, the pulp may die and the pain can disappear, but the next stage is an infection that travels to the
roots. Therefore, see your dentist as soon as you experience pain and discomfort before your
infection spreads.
Taking antibiotics does not cure tooth infections. When you first experience a toothache due to an
infection, one of the first thoughts that most people have is to try and treat it with antibiotics.
However, the working mechanism of antibiotics includes reaching the infected site through the
bloodstream. Due to the location of this tooth infection, antibiotic medicine cannot effectively reach
the infection in order to treat it.
The procedure does not cause pain. Even though root canal treatments have a bad reputation for
causing pain, from the beginning of the procedure to the end, it has multiple steps to reduce any kind
of pain that you may have. You will be given a local anesthetic to fully numb the affected area. Most
patients claim that root canal therapy is not any more painful than getting a cavity filled.
It has a healing period. While the treatment itself does not cause pain, you are likely to feel sore
and uncomfortable afterward until it fully heals. Dentists often recommend regular painkillers and
sometimes recommend medication to accelerate the healing process. It is important to rest well and
consume soft foods to allow your body to heal faster. After a few days, many people are able to
return to their regular lifestyle.
Aftercare is important. A root canal treatment may save your tooth, but it also weakens it.
Therefore, it is important to take extra care of that particular tooth to ensure it does not eventually
break or fall off.
It is not an invincible treatment. Root canal treatment and crowns often last over 15 years with
good care and maintenance. However, it does not make your tooth fully invincible from future
damage caused by cavities or gum disease. Therefore, you will need to take extra care of your teeth
and keep the oral cavity clean at all times. Always be sure to visit your dentist at least once every 6
months to prevent any further damage.
 ROOT CANAL THERAPY
Root canal treatment (also known as endodontic therapy, endodontic treatment, or root canal therapy)
is a treatment
It savessequence
you from forpulling
the infected pulp of
your tooth. With a tooth which is intended
all that said, receivingto result in thetreatment
root canal elimination of infection
helps you
and the protection of the decontaminated tooth from future microbial invasion. Root canals, and their
save your tooth and smile. The only other option to treat infected or inflamed pulp is through
associated pulp chamber, are the physical hollows within a tooth that are naturally inhabited by nerve
extraction.
tissue, blood Root canals
vessels and are a highly effective
other cellular entities. and minimally
Together, these itemsinvasive treatment.
constitute the dental pulp.
Endodontic therapy involves the removal of these structures, disinfection and the subsequent shaping,
cleaning, and decontamination of the hollows with small files and irrigating solutions, and
the obturation (filling) of the decontaminated canals. Filling of the cleaned and decontaminated canals is done
with an inert filling such as gutta-percha and typically a Zinc oxide eugenol-based cement.  Endodontics
includes both primary and secondary endodontic treatments as well as periradicular surgery which is generally
used for teeth that still have potential for salvage before endodontic therapy is carried out, a correct diagnosis of
Vocabulary
the dental pulp and the surrounding periapical tissues is required. This allows the endodontist to choose the most
decontaminate /ˌdiːkənˈtæmɪneɪt/- to remove harmful substances from a place or thing
appropriate treatment option, allowing preservation and longevity of the tooth and surrounding tissues.
hollow /ˈhɒləʊ/-
Treatment optionshaving a hole or empty
for an irreversibly spacepulp
inflamed inside(irreversible pulpitis) include either extraction of the tooth or
removal
inhabit of the pulp.  to live in a particular place
/ɪnˈhæbɪt/-
Removing the infected/inflamed pulpal tissue enables the endodontist to help preserve the longevity and
entity /ˈentəti/- something that exists separately from other things and has its own identity
function of the tooth. The treatment option chosen involves taking into account the expected prognosis of the
inert as
tooth, /ɪˈnɜːt/-
well without power towishes.
as the patient's move orAact, fullwithout
historyactive chemical
is required or other
(which properties
includes the patient's symptoms and
medical history), a along
filling /ˈfɪlɪŋ/- small with
amount a clinical
of metal examination (both inside
or other material and
used to filloutside
a hole the
in amouth),
tooth and the use of diagnostic
tests. 
gutta-percha /ˌɡʌtə ˈpɜːrtʃə/-a natural substance that can be shaped when it is heated and is hard when
There are several diagnostic tests that can aid in the diagnosis of the dental pulp and the surrounding tissues.
cool include:
These
·salvage /ˈsælvɪdʒ/-
Palpation theisthings
(this wherethatthe are
tip ofsaved fromisa felt
the root disaster
fromortheanoverlying
accident tissues to see if there is any swelling
or tenderness
swelling /ˈswelɪŋ/-present)
 a place on your body that has become larger or rounder than normal as the result of an
· Mobility (this is assessing if there is more than normal movement of the tooth in the socket)
illness or injury
· Percussion (tender to percussion; the tooth is tapped to see if there is any tenderness)
· tenderness /ˈtendənəs/- the
Transillumination fact ofa alight
(shining partthrough
of the body beingtopainful
the tooth whenare
see if there youany
touch it (soreness)
noticeable fractures)
·mobility Tooth/məʊˈbɪləti/-
Slooth (thisthe is
ability
where to move easilyisfrom
the patient askedonetoplace, social upon
bite down class or job to another
a plastic instrument; useful if the
patient complains
palpation /pælˈpeɪʃn/- ofthepainactonofbiting
examiningas thispartcanof bethe
used
bodyto localise the tooth)
by touching it
· Radiographs
over-the-counter /ˌəʊvər ðə ˈkaʊntər/- medicines that can be obtained without a prescription 
· Dental pulp tests
painkiller
Root canal/ˈpeɪnkɪlər/-
treatment isa only
drug required
that reduces pain
when dental X-rays show that the pulp has been damaged by a bacterial
infection. The pulpawill
pimple /ˈpɪmpl/- small begin to red
raised die if it's infected
spot on the skin by bacteria, allowing the bacteria to multiply and spread.
The symptoms
cracked /krækt/-of a pulp infection
damaged with linesinclude: pain when
in its surface eating
but not or drinking
completely hot or cold food and drink, pain when
broken
biting or chewing, a loose tooth. As the infection progresses, these symptoms often disappear as the pulp dies.
linger
Your /ˈlɪŋɡər/-
tooth  to stay to
then appears alive
havebuthealed,
becomebut weaker
the infection has in fact spread through the root canal system. You
numb /nʌm/-
eventually unable to
get further feel, think
symptoms or react
such in the normal
as: pain when way
biting or chewing returning, swelling of the gum near the
affected tooth, facial swelling, the tooth becoming a darker colour
To treat the infection in the root canal, the bacteria need to be removed. This can be  done by either: removing
the3.bacteria
Match fromthethe
words
root canalwithsystem
their definitions
(root canal treatment), removing the tooth (extraction). But removing
the tooth is not usually recommended a. a drug as that
it's better
reduces topain
keep as many of your natural teeth as possible. After the
1. Over-the-counter- d
bacteria have been removed, the root canal is filled and the tooth sealed with a filling or crown. In most cases the
2. painkiller b. a natural substance that can be shaped when it is heated and is hard
inflamed tissue -anear the tooth will heal naturally. Before having root canal treatment, you'll usually be given
a local anaesthetic. -b
3. gutta-percha This means when cool
the procedure should be painless and no more unpleasant than having a filling.
Root canal treatment is usually successful. c. a small amount of metal or other material used to fill a hole in a tooth
4. filling -c
d. medicines that can be obtained without a prescription
READING/WRITING
4. Give the synonyms for the following words and word combinations.

✓ Tooth extraction - tooth removal

✓ Root canal treatment - root canal therapy
✓ Pulpitis - inflamed pulp (pulp inflammation )
✓ Obturation - obstruction/occlusion
✓ Pain - discomfort/ache

5. Tell whether the following statements are true or false according to the texts. Correct
those that are false.

1. You can take over-the-counter painkillers, such as paracetamol or ibuprofen, to relieve any discomfort,
return to your dentist if you still have pain or swelling after using painkillers. False
2. In most cases it's possible to prevent the need for further root canal treatment by: keeping your teeth
clean, not eating too much sugary food, giving up smoking if you smoke. True
3. Root canal treatment is designed to eliminate bacteria from the infected root canal, prevent reinfection of
the tooth and save the natural tooth. True
4. There’s no need to be worried if your dentist or endodontist prescribes a root canal procedure to treat a
damaged or diseased tooth. This tissue contains blood vessels, nerves and connective tissue, which help
grow the root of your tooth during its development. A fully developed tooth can survive without the pulp
because the tooth continues to be nourished by the tissues surrounding it. False
5. Saving the natural tooth with root canal treatment has many advantages: efficient chewing, normal biting
force and sensation, natural appearance, protects other teeth from excessive wear. True

6. Paraphrase the underlined words and word combinations

A root canal is a serious procedure, but one that specialists handle __________every day, before engaging
in any type of dental work, it’s important __________to know the facts about root canals. Since patients
are given_________ anesthesia, a root canal isn’t more painful than a regular dental procedure, such as a
filling or getting a wisdom tooth removed__________. However, a root canal is generally a bit sore or
numb after the procedure, and can even cause mild discomfort ___________for a few days. Root canals are
needed for a cracked tooth from injury or genetics, a deep cavity, or issues from a previous
filling_____________. Patients generally need a root canal when they notice____________ their teeth are
sensitive, particularly to hot and cold sensations. 
7. Fill in the blanks with the appropriate words from the box.
dental, filling, gutta-percha, pulp, abscess, damage, tooth, decay, treatment

Endodontic treatment helps you maintain your natural smile, continue eating the foods you love and limits
the need for ongoing ___dental_________work. With proper care, most teeth that have had root canal ___
treatment________can last a lifetime. It’s necessary to have endodontic or root canal treatment when the
inside of your tooth (the pulp) becomes inflamed or infected as a result of deep__decay________, repeated
dental procedures, faulty crowns or a crack or chip in the__tooth_______. Trauma to your tooth may also
cause pulp _damage__________even if the tooth has no visible chips or cracks. If pulp inflammation or
infection is left untreated, in can cause pain or lead to an_abscess__________.
When you undergo a root canal or other endodontic treatment, the inflamed or infected _pulp_______is
removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-
like material called_filling________. Afterwards, the tooth is restored with a crown or _gutta-
percha________for protection and will continue to function like any other tooth.
8. Answer the questions.
1. How does endodontic treatment save the tooth? -Endodontic therapy involves the removal of the
damaged structures, disinfection and the subsequent shaping, cleaning, and decontamination of the
hollows with small files and irrigating solutions, and the obturation (filling) of the decontaminated
canals. This allows the endodontist to choose the most appropriate treatment option, allowing
preservation and longevity of the tooth and surrounding tissues.
2. How do you know if you need a root canal? - The treatment option chosen involves taking into account
the expected prognosis of the tooth, as well as the patient's wishes. A full history is required (which includes
the patient's symptoms and medical history), along with a clinical examination (both inside and outside the
mouth), and the use of diagnostic tests. 
There are several diagnostic tests that can aid in the diagnosis of the dental pulp and the surrounding tissues.
These include:
· Palpation (this is where the tip of the root is felt from the overlying tissues to see if there is any
swelling or tenderness present)
· Mobility (this is assessing if there is more than normal movement of the tooth in the socket)
· Percussion (tender to percussion; the tooth is tapped to see if there is any tenderness)
· Transillumination (shining a light through the tooth to see if there are any noticeable fractures)
· Tooth Slooth (this is where the patient is asked to bite down upon a plastic instrument; useful if the
patient complains of pain on biting as this can be used to localise the tooth)
· Radiographs
· Dental pulp tests

3. What happens during root canal treatment? - To treat the infection in the root canal, the bacteria need
to be removed. This can be done by either: removing the bacteria from the root canal system (root canal
treatment), removing the tooth (extraction). But removing the tooth is not usually recommended as it's better
to keep as many of your natural teeth as possible. After the bacteria have been removed, the root canal is
filled and the tooth sealed with a filling or crown. In most cases the inflamed tissue near the tooth will heal
naturally. Before having root canal treatment, you'll usually be given a local anaesthetic. This means the
procedure should be painless and no more unpleasant than having a filling.
4. What are the symptoms of pulp infection?- The symptoms of a pulp infection include: pain when
eating or drinking hot or cold food and drink, pain when biting or chewing, a loose tooth. You
eventually get further symptoms such as: pain when biting or chewing returning, swelling of the gum
near the affected tooth, facial swelling, the tooth becoming a darker colour.
5. When is the root canal treatment required?- Root canal treatment is only required when dental X-
rays show that the pulp has been damaged by a bacterial infection.

9. Unscramble the letters to make a word.

1. Root canal treatment is a dental procedure used to treat infection at the centre of a
__tooth_________(othot)
2. Root canal treatment is not painful and can save a tooth that might otherwise have to be removed
_____________(mopclelyet)
3. The infection at the centre of a tooth is caused by __bacteria_______(catibaer) that live in the mouth and
invade the tooth.
4. This can happen after: tooth decay, leaky fillings, damage to teeth as a result
of __trauma________(trauma)
5. There are a few symptoms that mean you might need a root canal therapy: severe pain while chewing or
biting: pimples on the gums, chipped or cracked tooth, lingering sensitivity to hot or cold, even after the
sensation has been removed, swollen or tender gums, deep decay or darkening of the
__gums_______(gums)

LISTENING

1. Warm-up: Think-Pair-Share
What do you know about Root Canal Treatment Step by Step?

Video: Root Canal Treatment Step by Step

https://youtu.be/AATnG9BdIMg

2. Give the definition

1. It is a specialized area of dentistry focused on treating diseases or injury to the dental pulp.
2. Dental specialists with advanced training in root canal treatment they are experts in saving your natural
teeth using state of the art technologies like microscopes and digital imaging to treat patients quickly and
comfortably.

Pre-listening: 
Reflect and Discuss: Importance of correct RCT.

Listening: 
3. Listening for the Main Idea: 
What is the talk mainly about?
_______________________________________________________________________________________
_______________________________________________________________

Listening for Details: Take notes of the ideas about Root Canal Treatment Step by Step

4. Be ready to answer the questions.

1. What problems can threaten teeth and ruin smiles?
2. What is the way a tooth can be saved?
3. When is the pulp removed?
4. Why is the pulp removed?
5. What is the first step in RCT?

5. Listen and write the right derivative for the words in brackets

1. An opening is made through the crown of the tooth into the pulp chamber.
2. The pulp is (to remove) _________ using small instruments. The endodontist (to clean) and shapes the
canals.
3. The filling (to protect) ____________ the tooth and ensures the success of RCT.

Post-listening

6. State the sentences as true or false. Correct the false ones.

1. Many teeth can be saved thanks to advances in treatment and technology. T/F
2. The endodontist numbs the area so that the patient does not feel the pain during the procedure. T/F
3. The tooth must be kept dry and clean during the procedure. T/F

8. Discussion
Share your notes and discuss the main idea/details. 
Write one critical thinking question and discuss it in your group. 
_______________________________________________________________________________________
_______________________________________________________________
9. Project: 
Review and reflect on RCT Steps. Point out 5 key points.

https://www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/
https://www.nhs.uk/conditions/root-canal-treatment/
https://allseasonsdentalclinic.com/7-facts-everyone-should-know-about-root-canal-therapy/
https://youtu.be/AATnG9BdIMg