Hot tooth syndrome (Wikipedia wiped it).

Overview
Pulpitis is inflammation of dental pulp tissue, mainly caused by bacteria infection which itself is a secondary development of dental caries (tooth decay). It manifests itself in the form of a common toothache, but it may be come so severe dental amnestic fails to work on the tooth. When it becomes extremely painful and decayed the tooth may become a "hot tooth" and local anasethtic may not fully work.

It is not to be confused with Hypokalemic sensory overstimulation.

Cause
It is a painful periodontal (“peri” – around; “odont” – tooth) condition caused when tooth decay reaches the root and causes extreme pulpitis and acute apical periodontitis.

This is the condition where the pulp is irreversibly damaged and can not recover from the thermal insult, infection and\or physical damage and it will ultimately result in necrosis (the death), of the pulp tissue. . It will become painful      and local anaesthetic may not fully work.

Symptoms
Symptoms of regular toothache is moderatly painfull and includes transient pain or sensitivity resulting from many stimuli, notably hot, cold, sweet, chewing, water, carbonated drinks and touch. When it becomes extremely painful and decayed the tooth may become a "hot tooth"    and local anaesthetic may not fully work. It will look rotten, taste of pus and may smell. There will be toothache and lingering pain after heat, cold, pressure or tapping.

Anastasia problems
Local anaesthetic may not fully work. Sodium-channel blocker lidocaine will not works during dental work and the amide-type local anesthetic, articaine is used on patients instead with limited success.

A hot tooth with a very inflamed nerve will need more anesthetic and will take longer to become numbed up.

Diagnosis
When it becomes extremely painful and decayed the tooth may become a "hot tooth"    and local anaesthetic may not fully work. It will look rotten, taste of puss and may smell. There will be toothache and lingering pain after heat, cold, pressure or tapping.

Tests for a necrotic pulp and pulpitis include: tapping with a dental probe to test for pain or vitality testing using a thermal test or an electric pulp tester.

Treatment
The tooth may be root canalled, endodontics or extracted under local anesthetic if the patient can stand the pain or under general anaesthetic if they can't take the pain.

As samples for microbiologic culture and sensitivity are hardly ever carried out in general dental practice and bacteria are involved, broad-spectrum antibiotics such as amoxicillin (or Metronidazole and Erythromycin may also be used in some cases) are typically used for a short course of about three to seven days and are for the most part successful in curing it.

Also see

 * Pulpitis