What does it mean to have a “Hot” Tooth?
The term a “Hot Tooth” is generally used for patients who have had a very painful tooth, and upon treatment is persistently stubborn to fully anesthetize. In some cases despite the area being profoundly “numb”, on commencement of treatment (root treatment) some residual sensation is still present. It is clear that anesthesia is not profound and additional anesthetic is required; but why is the sore tooth taking longer to “numb” up than normal? This can be very distressing for patients!
There are many different reasons experts believe that can cause a sore tooth to be more difficult to numb than other times.
Theories of Hot Tooth Causes
- Location, Location, Location – Not only just used in real estate, but if the area where the aesthetic is to be administered is off target, this can lead to partial numbness or an ineffective injection.
- Local tissue changes because of inflammation – This theory states that the area of inflammation around the inflammed tooth is causing the anesthetic to be less effective. This theory does have a limitation, as it does not explain injections that are distant area from the area of inflammation
- Hyperalgesia – This theory states that the inflammation within the tooth has altered the actual nerve, at a point more distant on the nerve itself, making it more difficult to numb.
- The nervous patient – In some cases being nervous, apprehensive or jumpy has the vicious cycle of lowering our pain threshold.
- Time – Is some cases it may just be a time factor, as some patients take more time than others.
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