Enamel pearls, also known as enamel nodules, are small masses of enamel found in unusual locations along tooth roots, most commonly in the trifurcation of maxillary molars. They form due to the activity of Hertwig's epithelial root sheath during tooth development. Radiographically, enamel pearls appear as smooth, well-defined radiopaque nodules along the root surface with density similar to enamel. While usually asymptomatic, they can occasionally lead to periodontal problems if located near the gingiva. Proper oral hygiene and nonsurgical removal may be recommended if causing issues.