MAKERERE UNIVERSITY

COLLEGE OF HEALTH SCIENCES

SCHOOL OF DENTISTRY

ELECTIVES REPORT

AUTHOR: KISAKYE SAMUEL

PROGRAM: BACHELOR OF DENTAL SURGERY

REGISTRATION NUMBER: 19/U/0402

YEAR OF STUDY: FOUR

SITE: VINE DENTAL SERVICES Inc BETHESDA MEDICAL CENTER

SITE SUPERVISOR: DR. BAMWESIGYE BRUCE MUSIIME

PERIOD: 26th JUNE – 04TH AUGUST 2023

1
 TABLE OF CONTENTS
TABLE OF CONTENTS.........................................................................................................2
ACKNOWLEDGEMENT.......................................................................................................3
INTRODUCTION....................................................................................................................4
ELECTIVE SITE DESCRIPTION ………………………………………………………..5

OBJECTIVES..........................................................................................................................7
ACTIVITIES............................................................................................................................7
LESSONS LEARNT................................................................................................................7
CONSTRAINTS.....................................................................................................................10
RECOMMENDATIONS.......................................................................................................10
CONCLUSION........................................................................................................................10

2
ACKNOWLEDGEMENT
I would like extend my sincere and heart-felt gratitude to;
1. Almighty God for his grace, love, guidance, provision, care and support to pass
throughout the electives period successfully.
2. The College of Health Sciences, Makerere University for giving medical students a
chance to officially mark a transition from pre-clinical to clinical studies through
electives and for having given me a chance to make a choice for electives placement site.
3. Dr. Luke Hyunsuk Lim the hospital director, Bethesda Medical Center for honoring my
application thus giving me an opportunity to train from the facility.
4. Dr. Bamwesigye Bruce Musiime, Director of vine Dental services incorporation with
Bethesda medical center for giving me an opportunity to practice and transform my
theoretical knowledge into clinical experience and for the mentorship throughout the
elective period.
5. The entire staff of Vine Dental Services for their relentless guidance rendered towards
my learning and wellbeing at the facility and most importantly for making me feel
welcomed. May the Almighty God bless you more?

3
INTRODUCTION
Electives is a period where fourth year Dental and Medicine students of College of Health
sciences move to different health facilities of their choice to improve on their clinical skills
through supervised active participation in order to understand and experience health care in a
national setting.
The following were the course objectives;
1. Actively participate in the health care system (service, administration or research) of the
nation.
2. Develop knowledge and respect for other cultures, language and health practices.
3. Develop awareness of social, economic and political factors in health and disease.
The following were the expected outcomes and acquired;
 Knowledge of health care system (service, administration and research)
 Communication, teamwork and interpersonal skills.
 Leadership and management skills.
 Population health.
 Clinical skills for patients care.
Having been given an opportunity to choose an elective site, I chose Vine Dental Services
incorporation with Bethesda medical center for the following reasons;
 First and fore-most the site is suitably located thus allowing high chances of encountering
referral cases such as failed root canal, orthodontic treatment, to mention but a few.
 The surgeon being very friendly, innovative, knowledgeable and also his affection and
passion to share knowledge freely
 The site is equipped with good dental materials, dental instruments and equipments
which I needed to have hands-on.

I was a devoted student to elective activities at the facility of my choice offering services,
gaining practical experience and understanding its operations.

4
DESCRIPTION OF ELECTIVE SITE.
BESTHESDA MEDICAL CENTRE WANDEGEYA

Bethesda Medical Centre Wandegeya is a private not for profit Korean missionary facility
founded in 2002 as a clinic that was later upgraded into a hospital.

It is located opposite Makerere University main gate. As for now it provides outpatient services
and comprises various departments; pediatrics, ophthalmology, internal medicine, surgery, vine
dental clinic, obstetrics and gynecology, pain clinic.

Vision

To be the leading reliable quality medical service provider in Uganda and Africa with God’s
compassionate heart and love.

Mission

 To heal the sick by providing reliable quality medical service with God’s compassionate
heart and love.

 To educate people with proper medical knowledge and skill.

 To reach out to community who needs our service and care.

VINE DENTAL CLINIC

Vine dental clinic was previously located on Bombo road Wandegeya as a standalone clinic in
2005 but was later relocated and incorporated among services offered at Bethesda Medical
Centre Wandegeya.

I chose Vine dental clinic because of the high volume of patients with different oral health needs
and having to work with a good and knowledgeable senior dental surgeon and who is willing to
share knowledge and skills.

The Team
The vine dental clinical team consists of the founder and resident dentist, Dr. Bamwesigye Bruce
Musiime who is assisted by two chair side assistants and an administrator.

5
Dr. Bamwesigye Bruce Musiime has practiced clinical dentistry for over 20 years. He acquired
his Bachelor’s Degree in Dental Surgery from Makerere University in 1993.
He has served under experienced dentists including Dr. Kasiiku, Dr. James Magara of Jubilee
dental and Dr. Ken Chapman of Mengo Hospital. He has also served as the acting head of dental
department at Mengo hospital.

Services Offered

The clinic offers;

 Oral health education
 Endodontic treatment
 Orthodontic treatment
 Implantology and periodontal treament
 Restorative dentistry
 Minor oral surgery
 Conservative dentistry

 Peadiatric dentistry

 Dental consultation

6
OBJECTIVES
The main objectives for my placement at Bethesda medical center were:
1. To learn how to perform a full dental examination and charting
2. To learn how to diagnose patients’ conditions by proper history taking.
3. To gain the ability to perform patient centered care in dentistry.
4. To learn the proper way of handling children as a dentist especially during administration
of local anesthesia and other procedures.
5. To observe and assist during dental procedures
6. To develop more knowledge regarding different techniques of performing certain dental
procedures and the different instruments, materials, and equipment used in each case.
7. To enhance my interpersonal skills by interacting with the patients, dental staff and gain
awareness of social, economic and political factors affecting the dental and medical field
at large.

ACTIVITIES
During my elective placement, I participated in a number of activities including;
 Clerking of patients.
 Oral Health Education/ sensitization of patients
 Assisting and performed different dental procedures like fillings, extractions, endodontic
treatment, scaling and polishing
 Examination of patients and dental charting, and recording of relevant findings.
 Performing periodontal treatment procedures such as scaling and polishing.

LESSONS LEARNT
 Managing patient’s expectations

 Appointment based patient management

 Interpersonal relationship and communication skills. This was mainly during patients’
clerkship, management and education i.e. Oral Health Education.

7
 Proper history taking and examination are essential in diagnosis and treatment planning,
especially the importance of underlying medical conditions and drug allergies. This is
very important to avoid causing harm to patients.
 The importance of patient referral and consultation with different specialists as well as
team work with fellow dentists and other medical workers, this enabled me to learn that if
you don’t know it’s better to ask another colleague or refer, to avoid mistakes and doing
harm plus loss of patients’ trust.
 Proper technique and principles to be followed in extraction of teeth and retained roots.
Here I learnt how to position myself when performing extractions (Ergonomics). I also
learnt the different types of elevators and forceps/instruments used during extraction of
teeth.
 The use of different burs in a hand piece when preparing a tooth for conservation and
when to change or switch them at different levels of the procedure.
 I appreciated the importance of moisture control during restorative procedures especially
composite restoration as well as endodontic treatment. For endodontic treatment, rubber
dam is a must to be sure of a successful treatment and the solution to pollution is dilution
so the canals have to be irrigated largely.
 The use of articulating paper to verify occlusion after a filling.
 Proper management of diabetic patients who come to visit the dentist.
Here precautions have to be taken regarding as a prophylactic dose of antibiotics is taken
for procedures such as extraction.
 Proper handling and management of children. I learnt that with children the dentist has to
be as patient as possible with the child and friendly to them. I was taught the different
options for totally uncooperative children; one new one was the use of conscious sedation
which should only be an option when all efforts to get the child treated have failed due to
its unpleasant side effects. The dentist should interact with the children and try to make
them comfortable with the environment for example by showing them how the dental
chair can go up and down and letting them touch some of the equipment making sure that
there is no damage caused or hurting themselves.
Children also easily get scared and so before doing any procedures it should be explained
to the child and for a first visit if possible, less invasive procedures should be performed
to encourage the child to come back next time without fear.

8
  Management of complications of dental procedures: for example, management of dry
sockets following tooth extractions.
Under local anaesthesia, copious irrigation of the wound site with dilute hydrogen
peroxide, stimulate bleeding at the wound site to enable faster healing, clean the site, then
prepare a dry socket dressing. However, some are made by pharmaceutical companies in
form of cones, one can also be made by mixing zinc oxide base with eugenol oil making
a sticky thick paste that is mixed using a spatula on a glass slab with a few pieces of thin
cotton, which is then placed into the socket and covered with dry cotton wool.
 Patience and politeness. My supervisor taught me how to be really polite and patient with
dental patients as most of them come when they are very anxious in the way that they
need attention and kind handling.
 Professionalism. This involved being smart on duty, conduct, character and respect of
principles of medical ethics and putting them in practice.
 Respect of teammates. I learnt from my supervisor that it’s really a good practice to
always respect colleagues regardless of their status. This makes the working environment
lovely and friendly to every one hence no stress.
 Use of antibiotics; I learnt that the use of antibiotics should be avoided as much as
possible and only prescribed when there is visible evidence of mucosal swelling due to
abscess.
 Orthodontic treatment; I was exposed to a variety of orthodontic cases where I
appreciated the art in including problem list generation, treatment planning and then the
the various procedures and follow ups.
 Infection techniques. I have learnt that infection control in dental surgery is so crucial in
the way that failure to observe asepsis is the major cause of post-operative complications.

CONSTRAINTS EXPERIENCED

9
During my electives placement I had no major constraints however, here were a few setbacks;
 The few patients who missed their appointments

RECOMMENDATIONS
My recommendations to Vine dental clinic are;

1. To adapt insurances system for easy facilitation and coverage of all individuals who work
government, non-governmental organization or private companies.
2. To add more dental units and dental surgeons to cater for patients not on appointments
due to increasing demand for dental services and referrals.

CONCLUSION
It was really a great and unforgettable experience having my electives at Vine Dental clinic and I
regard it as a perfect clinical exposure training Centre for students since it has knowledgeable
and skilled staff, a good turn up of patients and the basic equipment required in the training of
students.
I am and will forever be grateful for this experience.

SUPERVISOR’S NAME ……………………..

SUPERVISOR’S SIGNATURE.......................

10