Root canal treatment known also as pulp removal is needed for two main reasons. The first one is infection. An untreated cavity is a common cause of pulp infection. The pulp is found in the center of each tooth. Pulp includes connective tissue, nerves and blood vessels. Pulp nourishes the tooth, but once the tooth matures, the pulp can be removed without destroying the tooth. During pulp infection bacteria infect the pulp and reduce the blood supply to the tooth. The reduced blood supply also keeps the pulp from healing.

The second reason for a root canal is damage to the pulp that can't be fixed.Trauma, a fractured tooth and even a lot of restoration, such as several fillings placed in the same tooth over a period of time can damage the pulp.

When the pulp is inflamed but not infected, it may heal on its own. If the pulpremains inflamed, it can be painful and may lead to infection. An infection in the pulp can affect the bone around the tooth. This can cause an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty root canals with a material calledgutta percha. 
If root canal treatment is not done, an infected tooth may have to be extracted. Also, if an infected or injured tooth is ignored the infection can spread to other body parts.

Root canal procedure involves the following steps. First the area around the tooth isnumbed. Sometimes sedation, such as nitrous oxide is recommended. A hole in the top or back of the tooth is drilled to get to the pulp chamber and some of the diseased pulp may be removed. Then the root canals have to be measured to make sure the entire canal is cleaned. To measure the root canals, X-rays or an electric device called an apex locator are used. After the canals have been measured all of the diseased pulp may be removed. Then the canal is cleaned with antiseptic. This helps treat and prevent infection. All the canals within a tooth must be cleaned. Once this is done the roots are filled with gutta percha. A temporary filling is placed over the tooth. The top of the tooth should then be covered with a permanent filling or crown. In most cases, the tooth will need a crown. A crown will help to restore the tooth's strength and protect it from cracking.

After the procedure the tooth in which pulp has been removed will no longer be sensitive to hot or cold.

GLOSSARY
antiseptic – antyseptyk 
apex lokator – endometr 
blood vessel – naczynie krwionośne 
connective tissue – tkanka łączna 
damage – uszkodzenie 
to destroy – zniszczyć 
to drill – wiercić 
empty – pusty 
entire – cały 
to fix – naprawić, usunąć 
gutta percha – gutaperka 
to mature – dojrzeć 
to measure – mierzyć 
to numb – znieczulić 
to nourish – odżywiać
over a period of time – z upływem czasu 
permanent filling – wypełnienie stałe 
pulp – miazga
to remain – pozostawać
removal – usunięcie
root canal treatment – leczenie kanałowe
step – krok
supply – dostarczanie, zasób
temporary filling – wypełnienie tymczasowe
trauma – uraz
x-rays – zdjęcie RTG
_________________________________________________________________________

Match words from GLOSSARY section with their definitions

1. ______________- a rubbery substance used in dentistry as a filling material.
2. _______________- it connects, supports, binds, or encloses the structures of the body. These structures include bones, cartilage, mucous membranes, fat, and blood.
3. _______________- the soft innermost part of a tooth, containing nerves and blood vessels.
4. _______________- an electronic device used to determine the length of the root canal space.
5. _______________- to cause lose of physical sensation. 
6. _______________- rays which can pass through many substances impossible for light to pass through, and which produce a picture of the object through which they have passed.
7. _______________- having reached full natural growth or development.
8. _______________- a restoration which is used until permanent one is carried out. It is used to cover the prepared part of the tooth.

Match patient’s questions with dentist’s answers:

1. Are antibiotics necessary to treat root canal infections? 
2. Is root canal treatment painful?
3. What is an apicectomy?
4. How can I know if I have a root canal problem?
5. Are there any problems associated with a root canal treated tooth?

A. It is the "removal of the apex of the root." It may be necessary after a root canal treatment has not been successful. After an unsuccessful root canal treatment, when some infection has remained at the end of a root and in the surrounding area. This can happen. The purpose of this procedure is to make sure that there is no remaining infection in the area.

B. Although the pulp has been removed, an endodontically treated tooth can still be used for biting and chewing just like any other normal tooth. However, the treated tooth may be slightly more brittle than a normal tooth. A proper restoration like a Crown ,for example, and good oral care are essential to ensure that the tooth will be able to serve you

C. Sometimes the infection is so severe that it can spread through the end of the roots and into the bone that surrounds the tooth. This is the way an abscess forms at the end of a root. The endodontist or dentist may decide to use this way of treatment to clear the infection before he/she continues with the root canal procedure.

D. Pain is the most common symptom. The pain can be in response to temperature changes, especially hot drinks, or can be spontaneous, very severe, and even throbbing in nature. The tooth may be tender on chewing.

E. Local anesthetic is used during the procedure so the procedure itself is not painful. If the patient is in pain after the anesthetic wears off, pain relievers can be used.

Write instructions for aftercare following a root canal or endodontic treatment. Use the hints in brackets.

1. (local anesthesia >> numbness in lips, teeth or tongue>> chewing >> anesthesia worn off) _________________________________________________________________
2. (temporary filling may wore off >> chewing or eating hard or sticky foods) _________________________________________________________________
3. ( proper oral hygiene continued >> flossing and brushing) _________________________________________________________________
4. (prescribed antibiotics >> complete the entire course) _________________________________________________________________
5. (pain and discomfort after the procedure >> over-the-counter painkillers >> warm salty water helpful) __________________________________________________________________
6. (persistent pain or bite feels uneven >> your dentist immediately) __________________________________________________________________
7. ( temporary filling >> permanent restoration as soon as possible) __________________________________________________________________


Lesson 14 answers