The rare HOT chief complaint.
Happens maybe twice a year in my practice.
Early on, I boiled/microwaved hot water.
I got smarter, and then did that but used a syringe to “test” each tooth.
I got smarter, and worked my way backwards to forwards – especially important on the lower molars/premolars due to the shared information back to the brain relayed along the IAN.
But, the water still would get everywhere.
And, it takes several mins to get VERY hot water
And, there’s still some potential confounding if the water hits more than 1 tooth.
Hence, the Warm GP test, which, IMHO, I feel is BEST, quick and really reliable. And, so far, duplicates the pt’s CC – EACH and EVERY time!
On down time, my #dentalassistant will make a few GP balls by heating up and “welding” GP into a ball. Once heated and warmed, roll into a ball on a glass slab until it’s to your liking 🙂
When a pt comes in with a CC of HEAT sensitivity, it is usually across several teeth and most of the time it’s a bit tricky to isolate.
I start with my usual #pulpvitalitytests and then, last, I do the hot test – see video.
With a CC of hot, most of the time, the heat is going to onset a bit delayed, so please be patient and wait for it. And, it will usually linger, and the pt will be in a bit of discomfort; warn them. But, this definitively will reproduce their CC.
#protips
have an extra set of eyes (your DA, etc) and also a cotton roll to ensure the pt’s soft tissue won’t feel too much heat or get burned
https://www.instagram.com/reel/Cmb47MCt-u4/
https://www.instagram.com/reel/CmPyVIVps8n/ Part 1
https://www.instagram.com/reel/CmP2oZQJ1kN/ Part 2