Videos Take Lighthearted Look at Digital Dentistry

Richard Gawel


If you think clinical videos are dull, then you haven’t seen Dr. Joel Henriod’s Enamel Pearls series on YouTube. In his practice in Pasadena, Calif, he emphasizes regenerative periodontal therapy, minimally invasive tissue grafting, advanced dental radiology, and proper timing in dental implantology—hardly the stuff of comedy gold.

However, the Enamel Pearls videos have fun with these tricky topics. Henriod uses humor to show dentists how they can use breakthrough technology in providing treatment, often with some silly costumes and jokes at his own expense. Recently, he took a break from his practice and filming to discuss his creative process and how dentists should integrate new tools into their practice.

Q: What inspired you to launch the Enamel Pearls series?

A: I wanted to jazz up how I can teach implantology in seminars and met a video producer, Jay P. Morgan, who has a very successful YouTube channel on photography (The Slanted Lens). We collaborated to create videos with off-the-wall antics but solid information. The Enamel Pearls videos are 2- to 3-minute shorts showing dental tips and how-tos, like mini lessons on the most important aspects of surgical dentistry and dental technologies. Before we started the videos we tried to line up sponsors, and most companies were like “Who are you?” and “Why would we be on YouTube?” So instead of featuring sponsored content, I chose topics that I wanted to detail, like “How do you choose the right implant size?”

Q: How did you partner with Carestream Dental?

A: I’ve used Carestream Dental’s cone beam technology since 2010 when they introduced smaller fields of view to dental CT. After 5 years of daily use of their CT units (CS 9000 3D and CS 9300) and their CS 3500 intraoral scanner, we had created a video showing how to locate the inferior alveolar nerve on CT and other day-to-day CT uses. Carestream Dental saw the videos and we partnered to show how digital dentistry is changing our day-to-day work lives. The videos released in August are the result! I think of these videos as Season 3 of Enamel Pearls.

Q: What technologies should general practitioners be learning about and using now?

A: Proven technologies that each dentist should explore: 3-D interpretation, digital dental workflow, appropriate laser uses, and ways to make dentistry less invasive (The Wand STA [Aseptico], Isolite [Isolite Systems], sedation, etc). All dentists need a working knowledge of 3-D interpretation. It forever changes how dentistry is diagnosed in all disciplines. Cone beam is available wherever we practice, not just in schools and large institutions like in the past. For example, if a tooth has a localized abscess, 3-D images help determine whether an infection is from a fracture, endo, perio, or mixed origin. In implantology, the bone and local anatomy is evaluated and the decision is made to do immediate implant placement versus bone grafting. In implantology, 3-D x-rays reveal the anatomical truth so that a successful implant or bone graft can be planned. The digital restorative workflow is the most recent wave of democratizing technology that’s sweeping dentistry. Once an office commits to the digital workflow and gets over the learning curve, it becomes routine to scan preps, plan digital restorations or ortho treatment, and mill restorations. The marriage of optical scans and CT data offers another layer of planning and executing the best dentistry.

Q: What are the most common problems that you see, and how has new technology started to solve them, or provide better treatment?

A: With regards to 3-D x-rays, I am concerned that the ALARA (as low as reasonably achievable) principle needs extra consideration since radiation doses with CT scans are higher than other dental imaging. Should children be imaged with higher radiation to achieve better orthodontic diagnosis? What about repeat scans to assess growth and development or bone graft healing? The cost/benefit of extra radiation for more diagnostic data has to be weighed. When it comes to digital workflow, it is a confusing space with competing models of open and closed systems. Closed systems like CEREC (Sirona Dental Systems) and E4D (E4D Technologies) integrate the scanning and milling together, but limit how data can be exported and used by out-of-system providers and labs. Open systems like CS 3500 or the TRIOS system (3Shape) are more flexible, but don’t have the in-office track record of the integrated systems like CEREC. So, there is a leap of faith to adopt either philosophy.

The only way to lose out, though, is to sit on the fence and not get involved in digital dentistry. It’s important not to throw the baby out with the bathwater. Traditional impressions and lab workflow are necessary and we still use those for many cases, especially for full-mouth treatments. In full-mouth reconstruction we sometimes go through 2 or 3 rounds of provisionals, implant provisionals, abutment and framework try-ins, etc, that are facilitated by traditional impressions and model work. It’s a great time to be a dentist and to be able to marry tried and true techniques with new technologies

Q: What technologies do you think will have the biggest influence on the future of general practices?

There are so many technologies that can make a contemporary dental practice welcoming to patients: digital radiographs, same-day crowns, electronic assisted anesthesia, hard-tissue lasers…. The hard thing is deciding which technologies to adopt and when. There is only so much space and money in a practice. So many toys!

Q: If you could invent a particular tool that would be very helpful but doesn’t exist yet, what would it be?

A: The sights, smells, and sounds in dentistry are still hard on most patients. If I could numb patients without them feeling anything, treat teeth without scary noises, tastes, etc, that would be amazing. The only way I have to do that now is with IV sedation!

Q: Where do you get your ideas for videos, both in terms of what you will be talking about, and how you will put a fun spin on them?

A: The videos cover what I consider some important principles in implant and surgical dentistry: radiography, implant treatment planning, and basic suturing how-tos. And since I’m a bookworm and love dental textbooks, I review my favorite books on occasion. I don’t mind making fun of myself, so we find every opportunity to bring zombies, finger amputations, water, candy, or a 7-foot tooth into the mix.

Q: What kind of feedback have you gotten from other dentists about the videos?

A: My referrals dropped off precipitously after I showed myself drill through my finger, but things have recovered, and the general consensus is that if anyone should sacrifice the body for dentistry, it’s me. Would the world suffer without one more periodontist?

Q: Have you gotten feedback from patients who have seen them?

A: If you Google my name, the YouTube channel comes up quickly. Many patients have seen them, and although the audience is supposed to be dentists, they enjoy the antics and thought process behind the videos.

Q: What’s next for the Enamel Pearls series? Any plans to take it beyond the short videos you’ve produced so far?

A: After seeing the success of franchises like Alvin and the Chipmunks 2: The Squeakquel, Paul Blart Mall Cop 2, and Dumb and Dumberer, we have no choice but to go for a full feature length film. For now we will continue to build a fan base and produce videos for anyone in the dental industry that wants to feature their products.

Dr. Joel Henriod practices periodontics in Pasadena, Calif. He graduated from UCLA School of Dentistry, then received a periodontics specialty certificate from the Medical University of South Carolina. He is a Diplomate of the American Board of Periodontology. He presents dozens of continuing education courses each year to dentists, hygienists, and dental assistants. He has developed “Dental School in a Day,” an interactive training program for the dental profession. And he is active in the American Academy of Periodontology, the ADA, the American Academy of Oral Maxillofacial Radiology, the California Dental Association, the California Society of Periodontists, and the San Gabriel Valley Dental Society.