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22 ENDO TRENDS Endo Tribune United Kingdom Edition | 9/2017 “The immense variability of human tooth anatomy” An interview with Dr Craig Barrington about his technique for capturing high-definition endodontic images With his high-definition photogra- phy of complex root canal systems, Dr Craig Barrington, who practices dentistry in Waxahachie, Texas, is developing quite a name for him- self. Just check out his presence on Facebook, at craiggbarringtondds. In an interview with DT America, Barrington talks about how he cap- tures these high-definition endo- dontic images and how he uses them to increase his knowledge and help improve the level of care he provides to his patients. Please tell our readers a little bit about yourself and your dental practice. Dr Craig Barrington I graduated Summa Cum Laude from the University of Texas Health Science Center in San Antonio in 1996. I am a general dentist in Waxahachie, Texas. I have been in my current location for 20 years. What do you like best about prac- ticing dentistry? I most enjoy the science, the bi- ology and having a front-row seat in and around the ability to inter- act with, affect and watch the hu- man body function and heal. I ap- preciate the ability to solve prob- lems and the ability to work on problems that are yet to be solved. I like being a part of a “past, present and future” continuum that is the overall profession of dentistry. I enjoy having the ability to affect an individual person, from patient to fellow practitioner to dental stu- dent, all the way up to having the ability to have a positive effect on humanity across the globe. Who influenced you most in your career? First, I would thank Dr Joel B. Alexander. He was an endodontic professor when I was in dental school who encouraged and taught the value of recalling your cases in order to assess your treat- ment outcomes. Secondly, I would thank Dr Terry Pannkuk. After much aware- ness, pursuit of and concentration on the topic of mentorship, I cer- tainly believe he is the best doctor alive today. He has done much for our profession from a philosophi- cal standpoint to the actualities of clinical healthcare. He sees the value in this tooth clearing and di- aphonization project I am in- volved in and consistently has pro- vided more support and encour- agement than anyone else. He has kept me motivated even if it is just by simply saying “wow, that result is amazing”. I can’t say enough about what he has done for me personally or in my career as my friend and mentor. I con- tinue to learn from him daily and I hope that some- where along the way, I recip- rocate some of the support he has given me over the years. You have become known for your high-definition pho- tography of the root canal anatomy. How did you be- come interested in this area? That too goes back to Dr Alexander and Dr Pannkuk. Both of these doctors influ- enced me to recall my work in endodontics and truly take a scientific approach to the question of whether endodon- tics actually works and whether it actually works in my hands. After recalling many of my own cases, I started to see failures and prob- lems that I was not satisfied with. I started to postoperatively evalu- ate my work and found that there were clinical aspects I could change to improve my outcomes. It was via the internet that I met Dr Ar- naldo Casteallucci. After the inter- actions we had, I saw the cover of his textbook. The tooth on the cover put me in awe. This was the first “cleared tooth” I had ever seen. It is from there that my interest in clearing teeth originated. I just had to fig- ure out what was going on and how and why it worked. Fifteen years later, I am still manipulating processes in the diaphonization of human teeth in search of the “an- swers”. I have a patent pending in the clearing process, and the knowledge it has provided has be- come one of the most valuable tools in pre-operative and postop- erative evaluation of the internal anatomy of human teeth. Can you tell our readers a little bit about how you go about capturing these images? It must take some technical skill. The photography is actually not difficult. It is oil immersion oblique illumination light micros- copy, which has been done in his- tology labs for years. It is, however, a new realisation in this area for dentistry. In dentistry, we are fa- miliar with the study of micro- scopic histologic sections. Teeth, on the other hand, are gross histo- logic specimens that can under- standably be seen via the naked eye; however, viewing of the inter- nal anatomic structures is greatly enhanced with microscopic evalu- ation. Any photographs of the teeth I work with are simply ob- tained through my “artistic” ar- Today, I see characteristics of the internal anatomy of human teeth that I never thought possible or knew existed. Visualising the immense variability of human tooth anatomy has changed my clinical practices and improved my clinical results, which benefits the patients I treat. Do you perform endodontic ther- apy yourself or do you typically re- fer cases out? I do all of my own endodontic treatments in my office. It has taken me years to identify the area of dentistry that I love. Perhaps one day I will take the necessary we can just take the time to follow our rolls as doctors. Doctor by definition means “to teach”, and proper teaching is not going to take place via advertising. Market- ing is one aspect. Advertising is another. We have to start the movement toward patient-cen- tered treatment, with the true healthcare providers taking the first step away from any notion of what would or could be consid- ered advertising in healthcare. Is there anything you would like to add? I am respectfully honored by this opportunity, your questions Dr Craig Barrington uses oil immersion oblique illumination light microscopy to capture high-resolution images of root canal anatomy. (All images provided by Dr Craig Barrington.) rangement of the specimen in ei- ther a visually interesting position or in what I would consider an educational interpretation that I think would most benefit the viewer of the photograph. What have you learned most by taking these root canal photo- graphs? As Napoleon Hill said: “What- ever your mind can conceive and believe, it can achieve.” Where I sit today in my under- standing of tooth clearing and dia- phonization, I at first thought was never possible. It started as a sim- ple question, then the develop- ment and realisation of a goal. The process has been consistently evolving and delivering informa- tion and results ever since. steps to specialise, but life is cur- rently focused on my family and my children. Is there anything you would like to see changed about the way den- tistry is practiced today? Absolutely! More than you can imagine or can be covered in this session. In short, we need to work on our ethical standards within the profession itself and move back toward being true, real doctors over the business-fo- cused patient treatment we are seeing overwhelm the practice environment today. The actual care of the patient is always in competition with and in direct contrast to the business and profit. We have to get back to pa- tient-centered practices. The prof- its are there in mass quantities if and in you finding significance in this work of mine. Thank you! Editorial note: This interview origi- nally appeared in roots magazine, No. 1/2017. Dr Craig Barrington received his DDS from the University of Texas Health Science Center San Antonio in 1996 and is a member of Omicron Kappa Upsilon. He is also an associate member of the American Academy of Endodontists. He main- tains a practice in Waxahachie, Texas. He has written various articles and publications on the dental operating microscope in general dentistry. For comments, questions or presentation requests, please contact Barrington at cbdds002@yahoo.com.