HOT TOOTH is not an uncommon phenomenon

Firstly,
The landmark of IDn block may have been missed . The overlying tissues can be pretty deceptive for eg in falbby people/ thin& frail/ old persons, even though one may feel that there r enough subjective & objective symptoms of IDN block.
So, check for reasons of failure of this block.

Secondly, ( assuming that ur block was effective)
HOT TOOTH is not an uncommon phenomenon. There is a special class of SODIUM CHANNELS ON C- FIBRES called as TETRODOXIN-RESISTANT Na channels. These channels sensitize the C -fibres. These channels have been found to be 5 TIMES MORE RESISTANT to anaesthetic than tetradoxin-sensitive channels. So , the moment u touch the pulp, the pt either jumps or maybe thinks that Doc is a quack!!!

T/T OPTIONS :-
1) use more anaesthetic(for idn block) & give pulpal(u tried but prob cud not give on account of pain)
2) use Bupivacaine(more potent than lignocaine in blocking that channel)

3)Supplement with Intraligamentary or intraosseous inj.

4) Use devitalizer eg septodont(non-arsenic) & close the cavity for 3-4 days, they recommend for 7 days but i do it for 3 days or even more depending on other factors. Just make sure that the tooth is not tender. If u can excavate coronal pulp, very good. Even if u can not touch the pulp, try to de-roof or if not possible on account of pain, just place a scoop of it on the pulp chamber or the floor if not opened). When u reopen it, pain ll be either vanished or lessened considerably.

Even if the tooth is tender (source being the carious tooth) & the pulp is necrosed , the pulp can pain due to C-fibres, being more resistant to A-fibres to such compromised/hypoxic state.

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