Page 128 - Demo

Chapter 7126could give away four implants for free to their patients (ACTA 2012) while patients had to pay for other treatments. This might have influenced the decision making in the undergraduate clinic. Patients may have decided to choose for extraction and an implant instead of saving the tooth by root canal treatment. Apart from the financial benefits, the new course in Implantology might have influenced decision making also in another way. Regarding the handling of endodontic pathology, the decision making by undergraduate students is influenced not only by the education in Endodontology but also by the education in Implantology (Pineda et al. 2018). Implant treatment is found to be indicated more often when the education in Implantology is scheduled after the education in Endodontology in the dental curriculum (Pineda et al. 2018), which is the case in ACTA’s undergraduate curriculum. When developing an undergraduate dental curriculum, it is important to realize that certain treatments may be favoured over others due to the way the curriculum is structured. If one treatment is favoured over another, the attitude of patients – and hence the general attitude of people towards those treatments in general – may change. Both teaching staff and students should be aware of this mechanism and their role in it. Following the implementation of curricular changes, it would be good practice not only to evaluate whether the educational goals aimed for are reached, but also to explore whether the changes had any secondary consequences (e.g. changes in patient care). Although our work suggests that little clinical experience in performing root canal treatment during undergraduate training might be enough (chapter 5), a reduction in the number of root canal treatments performed on patients can be considered as problematic. Root canal treatment is not obsolete and students should gain experience in performing uncomplicated root canal treatments on patients during their undergraduate training (chapters 1 and 4). To increase the number of root canal treatments available for the students, uncomplicated root canal treatments were performed free of charge at the undergraduate clinic of ACTA since 2020, which seems to be an effective measure. Apparently, the treatment costs can influence patients’ decision making. It is in the patient’s interest when this allows them to receive the indicated treatment that they could otherwise not afford. However, the fact that the treatment is – temporarily – free of charge might be an incentive to choose for this treatment even if it is not the recommended option. Performing root canal treatments free of charge cannot endure because it is not financially sustainable, at least not in the Netherlands. Annemarie Baaij.indd 126 28-06-2023 12:26