Title

Management of hot tooth: Clinical challenges and emerging strategies: A narrative review

Authors

Prachod Krishnan^1,*, Heena Shaikh², Aarzoo Sihag³, Fizzah Dadani⁴, Thulasi Atchi⁵ & Sindhu Chavva⁶

Affiliation

¹Department of Oral & Maxillofacial Surgery, Saveetha Dental College & Hospital, Chennai, India; ²Department of Dentistry, Pacific Dental College & Hospital, Udaipur, India; ³Department of Dentistry, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India; ⁴Department of Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, India; ⁵Department of Dentistry, Sree Siddhartha Dental College and Hospital, Tumkur, Karnataka, India; ⁶Department of Dentistry, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India; *Corresponding author

Email

Prachod Krishnan - E-mail: pkrishnanom@gmail.com
Heena Shaikh - E-mail: heenamshaikh.30@gmail.com
Aarzoo Sihag - E-mail: dr.aarzoomalik@gmail.com
Fizzah Dadani - E-mail: fizzahdadani@gmail.com
Thulasi Atchi - E-mail: atchithulasi369@gmail.com
Sindhu Chavva - E-mail: chavva.sindhu2113@gmail.com

Article Type

Review

Date

Received August 1, 2026; Revised August 31, 2026; Accepted August 31, 2026, Published August 31, 2026

Abstract

Symptomatic irreversible pulpitis (hot tooth) is a common endodontic problem characterized by severe spontaneous pain and difficulty in achieving profound local anesthesia. Accurate diagnosis and effective pain control remain major clinical challenges because intense pulpal inflammation lowers the pain threshold and increases nociceptive activity. These inflammatory changes reduce the success of conventional anesthetic techniques and may compromise endodontic treatment outcomes. Adjunctive approaches including supplemental anesthetic techniques, preoperative inflammation control and anxiety management can enhance anesthetic efficacy and patient comfort. Thus, data shows that integrating the mechanisms underlying anesthetic failure in hot teeth with evidence-based strategies for improving pain management and treatment success.

Keywords

Hot tooth, irreversible pulpitis, anesthesia, inferior alveolar nerve block failure, pulp inflammation, intrapulpal anesthesia

Citation

Krishnan et al. Bioinformation 22(8): 4732-4736 (2026)

Edited by

Ritik Kashwani

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.