How Marketing Impacts Education

Quite directly, as in the case of teaching endodontic instrumentation techniques, the students are exposed to not only one technique, but to one brand of that technique based on the company most generous in financially sponsoring their products. In short, the prize of exclusive access to the student body goes to the corporation that pays the largest bribes. The schools adopting the same goals of maximizing profits have a mutually rewarding relationship. Now, obviously for a school to admit to to the effectiveness of such incentives goes against the traditional goals of education, namely, the development of critical thinking skills. From a public relations point of view, more accurately described as propaganda the schools take efforts to justify their decisions on what to teach with a purposeful distancing of the corporate relationships that drive such actions. These justifications include:

. The practicality of the need for the students to learn at least one system

. The schools’ claims that the technique being taught was thoroughly reviewed from a clinical and literature research point of view and deemed the best fit for the students.

. Support from the academic endodontists tasked with teaching the students.

From the sponsoring corporations perspective, they thoroughly support the claims hiding the monetary incentives that determined the schools’ decisions. It’s bad public relations to tie the mandating of what is taught to corporate bribery, a hard, but accurate description of the actions taken by the corporations and accepted by the schools.

Unfortunately for the students having no choice but to bow to the corporate/academic combine, results in a compromised educational process that denies the wider spectrum of solutions that can be applied to the shortcomings of the instrumentation techniques being taught. Let’s start with the fact that most dental students are being taught one rotary NiTi system or another simply because the major rotary companies are also the strongest financially and have the most ability to sponsor their products in the dental schools. Now, the reality of rotary NiTi is that it is subject to instrument separation as the canal anatomy becomes more complex.

This is an undesirable fact and it calls for steps to reduce the problem. In an academic environment free of corporate influence, one of the solutions would be to educate the students to the fact that stainless steel instruments confined to short arcs of motion eliminate instrument separation. However, in an educational environment where corporate/academic influence rules, a solution that is outside the sponsored system can never be taught or adopted. Rather, the schools devise solutions that work within the sponsored system. In the case of rotary NiTi that includes centered shaping with little deviation from the path of least resistance, a technique that reduces, but does not eliminate instrument separation.

This particular partial solution introduces an approach that compromises the cleansing of the canals as they become increasingly oval in cross-section including thin elongated flat isthmuses. This is a solution that in the process of mitigating one problem introduces another, but is acceptable as an answer because the “solution” is found within the system, a solution that is a product of a biased marketing (educational) system that is based on sales and not the most effective way to overcome the most pronounced drawback of rotary NiTi. Those approaches offering solutions outside the sponsored product will never see the light of day within the schools.

Schools today will tout the advantages of the miracle material NiTi in its most recent stages of development giving the students the ability to negotiate curved canals without distortion using an engine-driven rotary motor that reduces hand fatigue and shortens procedural time requirements making the students more productive and profitable once they graduate. This paradigm improvement when discussed in such a light is one that both the schools and the sponsoring corporations take delight in further advertising, the schools taking credit for adopting the latest most effective technology and the sponsoring companies stating their acceptance by these prestigious universities as proof of their superior brand.

The last thing the universities or or the sponsoring corporations will bring up is that nasty side effect of instrument separation and when confronted with it claim that that is a problem associated with all systems, it is a rare event, it has little impact on outcomes and many of these separated instruments can be removed or negotiated around. The use of these arguments is an inaccurate defense of an iatrogenic event that can be eliminated by employing other means of instrumentation that deliver all the positive benefits of rotary NiTi while eliminating all their downsides.

At least one solution is the use of stainless steel relieved twisted reamers. Confined to 30o arcs of motion generated by a 30o oscillating handpiece at a frequency of 3000-4000 cycles per minute, the instruments are invulnerable to breakage solving the major shortcoming of rotary NiTi. Such invulnerability gives the dentists the freedom to solve the second shortcoming of rotary NiTi. No longer needing to stay centered the 30o high frequency oscillating reamers are applied vigorously to all the canal walls while activating the irrigants and driving them into intimate contact with the canal walls.

In accordance with the balance force technique, confined to short arcs of motion they faithfully follow cured anatomy without inducing distortions. Used from the very beginning of instrumentation, they eliminate hand fatigue throughout the entire instrumentation procedure. It has also been shown that instruments confined to short arcs of motion produce fewer dentinal micro-cracks, a reflection of the fact that they are invulnerable to breakage and in accordance with Newton’s Third Law of Motion states that two interactive bodies, the instruments and the canal walls, have an equal and opposite impact on each other. These are not trivial facts, but they will never receive an airing in an academic environment that is ruled by commercial interests.

It is important for us to appreciate the impact commercial interests have in the supposed hallowed grounds of a university in prohibiting an open-ended discussion of solutions to problems that arise from the sponsored products. The university goal here is to stick to the terms of an agreement between the corporations and themselves that encourage further sponsorship going forward.

Interestingly, when I write about these insights, my critic states that the points I bring up have no validity because I have a company that also seeks profits. I see no reason to apologize for being a practicing endodontist that over the course of 55 years and still practicing has sought solutions to the documented weaknesses of rotary NiTi. Nor do I find it germane whether or not as an innovator of alternative systems that it lessens the importance of what I hope I am emphasizing, namely, the distortion of education due to commercial sponsorship, a corrupting process afforded by the corporations that are already most powerful financially and are best situated under the present guidelines to further establish their dominant positions.

It may be a fairly tale today, but critical thinking skills were once considered the highest goal to be obtained in a well-devised educational program. Evidently, that criteria has been overwhelmed by the power of the dollar. Until enough of us awaken to actively oppose this form of “education” we will be stuck with a system that treats us more as consumers employing all the psychological tools developed over the years to encourage us to by the products of these corporate behemoths.

Ironically, those most touting the “free” market are the ones most responsible for the present state of education and dominance by concentrated corporate power. For these financial behemoths a free market means their freedom to do whatever they want with no regulations in place to level the playing field. The only entity that can level that playing field is the government that is not already bought by the major corporations. For that to happen, we need to elect politicians who truly represent the majority of people who elected them and then hold their feet to the fire to stay true. That means enough unbiased public funding to replace corporate funding that precludes the need to seek corporate support. It means the strict enforcement of the elimination of industrial payments to academics as documented by the Rhodes study stating 80% of academic endodontists are the recipients of such industrial payments. It means the end of corporate ghost writers touting the benefits of the products they are paid to write about.

If you simply think of corporate behavior as just another example of lobbying, something only affordable by the most wealthy of corporations, we realize that it is all part of the same system where for the most part money rules. It took the Great Depression and an inspired Franklin Roosevelt to create an environment that more than any preexisting administration successfully challenged corporate supremacy creating a fairer economic environment for the majority of American citizens. And then starting in the late 1970’s perhaps due to collective amnesia we lost it and are now now living in an economic environment equivalent to the pre-Roosevelt era. Until we establish an economic and political environment that represents all of us, not just the 1% or less, these conditions will not change.

Regards, Barry