REPUBLIC OF CAMEROON REPUBLIQUE DU CAMEROUN

Peace - Work - Fatherland Paix - Travail - Patrie

ST LOUIS HIGHER INSTITUTE OF MEDICAL STUDIES

DOUALA

DEPARTMENT OF DENTAL THERAPY

COMMUNITY INTERNSHIP REPORT DONE AT

INTERNSHIP REPORT DONE AT BONASSAMA DISTRICT HOSPITAL IN THE DENTAL UNIT,
DSCHANG
EMERGENCY DISTRICT
UNIT AND HOSPITAL IN THE DENTAL
NURSING UNIT
UNIT
From 1st August to 30th August 2019
From 13th July to 7th August 2020

By BEASSO FOZOCK AIME WILFRIED

MATRICULE: DEN/18/0020

LEVEL 200

Supervisor

Professional; Mme. TAAFO Blandine (GS)

Dr. CHIMY Herna (DS)

Mme. KANA Sandrine Leonie (Major)

Academic; Dr. Derrick NGWA AWAMBENG

2019/2020
 Dedication

I dedicate this piece of work to my lovely BEASSO family

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 Acknowledgement

I would like to give thanks in the first place to The Almighty God, who is so beneficial and
merciful. He guided me throughout the period I was in the hospital and provided me with confidence,
strength and stability to complete this internship report on time.

I’ll thank my family for the unconditional love and support that they never cease to provide.

I’ll thank the ATSONFACK family here in Dschang who sheltered me throughout the period I
did my internship. For their comprehension and understanding towards me and for the way they
created an environment suitable for my studies.

I’ll thank the dental team of the of the DDH who made my practical learning less stressful and
was very opened to involve themselves in the training. For the respect they showed and the
collaboration we all experienced as colleagues. To Dr. CHIMY Herna, a dental surgeon who holds
her title with expertise and good knowledge of the theoretical and practical skills on her domain. To
Mme KANA Sandrine, a woman who was not only full of good advices as she instructed and
directed me throughout the internship. To GUENANG Armandine and DONFACK Irene, 2 DTs that
treated us as colleagues that practice the same activities.

To the entire medical team who were all ready to share their knowledge of medecine to us as
new medical professionals. To Mr. ALEMAFACK Etienne, the main person that transformed the
hospital into a hospitable environment for my training. To all the majors in the Dental, Antenatal,
Hypertensive/Diabetic and HIV/treatment units who did not only permit me to show them what I
know but also taught me the functioning of the units in particular and that of the hospital at large.

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 TABLE OF CONTENT

Table of Contents
Dedication...........................................................................................................................................................I

Acknowledgement..............................................................................................................................................II

TABLE OF CONTENT.....................................................................................................................................III

List of Tables.....................................................................................................................................................V

List of Figures...................................................................................................................................................VI

List of Abbreviations and Acronyms................................................................................................................VII

CHAPTER 1.......................................................................................................................................................1

1.1. Introduction.................................................................................................................................................1

1.2. Internship period.........................................................................................................................................1

1.3. Internship objectives...................................................................................................................................1

1.4. Significance of internship.............................................................................................................................2

CHAPTER 2..........................................................................................................................................................3

2.1. Literature Review........................................................................................................................................3

2.1.1. History......................................................................................................................................................8

2.1.2. Geolocalisation.........................................................................................................................................9

2.1.3. Health manpower of the hospital............................................................................................................10

2.2 Organizational chart...................................................................................................................................10

CHAPTER 3........................................................................................................................................................13

A. Hospital base................................................................................................................................................13

B. Community base...........................................................................................................................................13

3.1. Activities observed....................................................................................................................................14

3.2. Instruments used........................................................................................................................................14

3.3. Activities done under supervision..............................................................................................................14

3.3.1. Hypertensive/Diabetic unit.....................................................................................................................15

3.3.2 Antenatal Unit.........................................................................................................................................15

3.3.3. HIV/ treatment unit.................................................................................................................................16

3.3.4. HIV testing and screening.......................................................................................................................16

3.3.5. Dental consultation.................................................................................................................................17

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3.3.6. Scaling and polishing..............................................................................................................................17

3.3.7. Tooth Extraction.....................................................................................................................................17

3.3.8. GIC filling..............................................................................................................................................18

3.3.9. Composite filling....................................................................................................................................18

3.3.10. Infection control methods.....................................................................................................................19

3.3.11. Sterilisation of instruments...................................................................................................................19

3.3.12. Cavity preparation................................................................................................................................19

3.3.13. Root canal treatment.............................................................................................................................19

3.3.14. Pulp capping.........................................................................................................................................20

3.3.15. ZOE filling as a temporal restoration....................................................................................................20

CHAPTER 4........................................................................................................................................................21

4.1. Conclusion.................................................................................................................................................21

4.2. SWOT Analysis.........................................................................................................................................21

4.3. Recommendation.......................................................................................................................................22

4.2.1 Recommendations for organization.........................................................................................................22

4.2.2 Recommendation for University..............................................................................................................23

4.4. References.................................................................................................................................................23

4.5. Appendix...................................................................................................................................................23

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 List of Tables

Table 1: Population of autoctones living in Dschang under the health coverage of the district of Dschang.......4

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 List of Figures

Fig 1: The district area of health of Dschang......................................................................................................3

Fig 2: Picture taken at the district of health of Dschang.....................................................................................4

Fig 3: Hospital’s patients pathway......................................................................................................................7

Fig 4: Date of inauguration of the hospital.........................................................................................................8

Fig 5: Organigram of the hospital.....................................................................................................................11

Fig 6: electronic sphygmomanometer or BP machine......................................................................................14

Fig 7: Pregnancy menstrual calender circle......................................................................................................15

Fig 8: Consultation tray. Composed of mirror, tweezer and dental prop..........................................................16

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 List of Abbreviations and Acronyms

AIDS: Acquired Immunodeficiency syndrome

ATV: anti-tetanus vaccin

Ca: Calcium

CHC: Community health center

CMA: Centre medical d’arrondissement

D: district

DDH: Dschang district hospital

DS: Dental surgeon

DT: Dental therapist

Fe: Iron

GS: General supervisor

HC: health center

HIV: human immune deficiency virus

HSVP: L’Hopital St Vincent de Paul/St Vincent de Paul Hospital

IHC: Integrated health center

NGO: Non-governmental organizations

PHC: private health center

PPE: personal protective equipment

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 CHAPTER 1

1.1. Introduction
A community internship is a work experience that permits medical students to learn how to
encounter the community. The various procedures followed will help the medical team to know what
the community lacks in, sensitize them on the numerous services the the hospital offers at large and
dental department in particular.
This community internship tried to teach me on how to approach the public, educate them on
what can help them and to increase their awareness on the advantages and disadvantages of the
various activities they practice which are different from the standards.
This community internship session was simultaneously carried-out together withe clinical
internship at the Dschang District Hospital (DDH). it was done in both the hospital and the
community. So together with the programme scheduled by GS (General supervisor), the 4 weeks
allocated for that internship was organised to suit the well completion of our objectives.

1.2. Internship period.

This community internship was programmed by the school for a duration of 4 weeks. Precisely from
the 13th July to 7th August 2020. by prioritising the hospital base and community base community
internship session, the rest of the days were to be spent in the dental unit.
According to the objectives goals, in the hospital we were to carryout our activities in the Diabetic
unit, HIV/treatment center unit, Hypertensive unit and Antenatal unit. Meanwhile the activities in the
community were to be carried out in church houses, market places, schools and door-to-door
sensitizations.

1.3. Internship objectives.

The objectives of this community internship to be completed were as follows:
- Hand washing
- Tooth brushing
- Community fluoridated water
- Diet
- Medication (auto-medication)
- Accessibility to health facilities
- Importance of regular dental/medical checkups
These talks were done in the various facilities listed earlier both in the community and the hospital

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1.4. Significance of internship
This internship done in the community which consist of health talks carried out in the various
situations helped us:
- Gain confidence on how to exercise public speaking
- Know the various administrative steps that will permit us do at the level of the health district to
carryout a field activity in the community
- To teach the population/community concerning the good aspects of a good oral hygiene and the
consequences attached to it when not well respected.
-

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 CHAPTER 2

2.1. Literature Review

DDH is the central hospital in the town of Dschang. It is the main public institution and is the
representative of the ministry of public health at the peripheral level. This hospital is found in the
former German district capital after Fontem in 1909.

Dschang is located in the Menoua subdivision in the West region of Cameroon. It is the second
largest town of the region after Bafoussam and followed by Foumban, Mbouda, Bagangte. It is
occupied by the ethnic group called the Bamilekes who commonly speak the Yemba Language. It is
found at an altitude of about 1500m and has a population of about 120000 inhabitants (National
institute of statistics, 2020). it covers a surface of 262km2 spread into 20 communities in urban side
and 96 rural communities. The 5 groupements are as follows: Foto(99km 2), Foreke-Dschang(86km2),
Fongo-Ndeng(31km2),

Fig 1: The district area of health of Dschang

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 The health district of Dschang is headed by the District hospital who which directed by the
DMO (District medical officer) which is at the same time a medical doctor. The district hospital is
assisted by many other private hospitals and also by many, IHC (Integrated health centers), HCs
(Health centers), ambulatory cases/houses. They are being spread into the following health areas of
Dschang as shown in the picture below.

Fig 2: Picture taken at the district of health of Dschang

The district of health of Dschang covers 24 health areas which are all incharge of the health of
Cameroonians living there. They are represented with their respective population data of people
naturally living there as follows:

Table 1: Population of autoctones living in Dschang under the health coverage of the district of

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Dschang

Health area Health center Total population

BALEVENG CMA NKONG-NI 732

BALEVENG IHC BANZA 368

BALEVENG IHC MEBOU 233

BALEVENG HC ST KISITO 294

BELEVONI IHC BALEVONI 146

DOUMBOUO IHC DOUMBOUO 518

DOUMBOUO PHC BATSINGLA 159

DOUMBOUO AD LUCEM DOUMBOUO 110

DOUMBOUO CNDS 359

DOUMBOUO IHCSAAH BATSING 24

FIALA-FOREKE DDH 2135

FIALA-FOREKE ST CONSTANCE CLINIC 959

FIALA-FOREKE ST DANIEL HC 39

FOKOUE CMA FOKOUE 243

FOKOUE FOTOMENA IHC 134

FOKOUE LA COLOMBE HC 120

FOMETA AD LUCEM FOTO 233

FOMETA FOMETA IHC 794

FOMETA HC PASTEUR DE FOTO 163

FOMETA HC LA REFERENCE 124

FOMETA FIANGUEP POLYCLINIC 79

FOMOPEA FOMOPEA IHC 174

FONAKEUKEU FONAKEUKEU CHC 378

FONDONERA FONDONERA IHC 484

FONDONERA NKA IHC 155

FONGO-NDENG FONGO-NDENG IHC 373

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FONGO-NDENG FOSSONG-WENCHENG IHC 215

FONTSA TOULA FONSTA-TOULA IHC 214

FOTETSA FOTETSA IHC 303

LATCHOUET LATCHOUET IHC 315

LEPOH LEPOH IHC 604

LEPOH KEKANG IHC 148

LINGANG-FOTO LINGANG-FOTO IHC 350

MAKA MAKA IHC 438

MAKA LIKONG IHC 156

MAKA BANKI IHC 246

MBENG BAFOU CHEFFERIE IHC 592

MBENG ST LAURENT IHC 448

MBENG BALEFE IHC 125

MBENG MBIH IIFOLO IHC 131

MBENG TSINFOU IHC 57

MBENG POUR TOUS IHC 133

MBENG LA GRACE BASSES IHC 227

MBOUA CMA FONFO-TONGO 437

MBOUA PASTEUR DE ZIFOD HC 131

MBOUA MEGUEU IHC 74

MEKOUALE MEKOUALE IHC 359

MEKOUALE APOUH IHC 314

NDOH DJUTTITSA CMA DJUTTUTSA 922

NDOH DJUTTITSA CTE IHC 78

NDOH DJUTTITSA MAA MEDJIO YIM PHC 84

NDOH DJUTTITSA ST BERNARD HC 78

NKEUU NKEUU IHC 186

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SITEU HSVP St Vincent de Paul 1999
Hospital

TOTAL 18994

When a patient comes into the hospital, s/he follows this scheme or pathway below.

Fig 3: Hospital’s patients pathway

2.1.1. History

The hospital inherited the colonial type of infrastructure in which the first buildings were first
built in 1924 and was commonly known as the Dispensary. In 1957, the main building was
inaugurated by Mr Amadou Ahidjo and remained as the regional hospital of the grassfield west
colonial and post colonial till 1962. from 1962 to 1995, it was a departmental hospital and directed
by the military doctors till 1984. and its just as from 1995 that the hospital was named as the district
hospital till now.

One of the legacies left till now of the colonial marks till now of the hospital are the good

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standing buildings and the picture below which indicated the administrative authorities at that time
present for the inauguration.

Fig 4: Date of inauguration of the hospital

2.1.2. Geolocalisation

Dschang is located 45 mins from Bafoussam (60km), 4hrs from Douala (300km) and 5hrs from
Yaounde (400km). it occupies a surface area of about 5655ha and is found between the territories of
the Foto chiefdoms and of Foreke-Dschang. The council of Dschang is bouded to the nord by the
council of Nkong-Zem, to the south by the council of Santchou, to the west by the council of Fongo-
Tongo, to the east by the council of Fokoue and to the southwest by the concil of Fontem. Dschang
town is crossed by the national highway N5 which is at 46km from Bafoussam, 54km from Mbouda,
46km from Melong, 84 km from Nkongsamba in Moungo division and 26km from the boundary
with southwest region. The town is located at 1400m up in the mountains.

The district of Dschang is one of the large health districts of the west region. It spreads on about

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1060km2. its is bounded to the east by the D of Penka Michel, to the Nord East by by D of Batcham,
to the South East by D of Bandja and to the South by D of Santchou.

Upon the 6 subdivisions of the Menoua division, the Dschang D covers which are as follows:

- Dschang subdivision

- Fokoue subdivision

- Nkong-ni subdivision

- Fongo-Tongo subdivision

- Fondonera groupement from Santchou subdivision.

DDH is found on a 4ha partially secured by a fence in construction blocks uncemented.

This hospital is located at Fiala-Foreke at the center of the town. Its is bothered by the university
of Dschang to the north, District of Dschang to its west, climatic center to its east and the main
Market A to its south. Its found 150m from the 50th Century monument.

The dental unit is precisely located in the hospital directly behind the surgical unit building and
before the laboratory. It shares its building with the vaccination unit on the right.

Its buildings are well spread out to facilitate good circulation of patients and personnel.

2.1.3. Health manpower of the hospital

DDH is the main public hospital at the head of the district health area of Dschang. It’s headed by
a medical doctor specialist, Dr. FONDOP Joseph (Heptologist neurosurgeon).

The hospital is composed of a variety of qualified personnel which all together make up a total
of more than 150 workers. And also the number of beds in the hospital are 165.

2.2 Organizational chart

The hospital in all its occupied surface area, has 11 buildings which were all built since its
creation till now. We have all the following units organised into them:

a. Administrative block b. Reception and cashier unit

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c. Pharmacy unit l. Emergency unit

d. Maternity unit m. Minor surgery unit

e. Dental unit n. Major surgery unit

f. Laboratory o. Theater unit

g. Physiotherapy lab p. Haut-standing and mini-standing units

h. Vaccination unit q. Diabetic and hypertensive unit

i. Prenatal consultation unit/ antenatal unit r. Ophthalmologic unit

j. Pediatric unit s. Psychiatric and mental disorder unit

k. Biochemistry unit

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The hospital is administrative body and manpower is organized as shown in the figure below.

Fig 5: Organigram of the hospital

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 CHAPTER 3
This chapter will discuss about the various activities been done for the community dentistry
internship. It was composed of community base and hospital base activities. Regarding upon the fact
that it has to be simultaneously clinical and community, the internship period of 4 weeks was
partitioned mainly to suit the community internship. At the beginning of the community internship,
we saw the GS who programmed us into the various units at the hospital. Meanwhile the community
base session was to be programmed by the Health District of Dschang.
The hospital base community session has been well programmed by the GS but the community
session hasn’t been programmed because since our application written and deposited at their office,
no response was given for us to start activities.
Our community internship mainly included health talks which was more centered to the dental
field. The topics to be discussed were as follows:
- Hand washing techniques
- Tooth brushing techniques
- Community fluoridated water
- Diet
- Medication (auto-medication)
- Accessibility to health facilities
- Importance of regular dental dental/medical checkups

All the above listed activities were discussed in the following units as follows
A. Hospital base
I) Diabetic Unit :31st July - 2nd August 2020
II) HIV/treatment unit : 3rd - 4th August 2020
III) Hypertension Unit : 17th - 19 th July 2020
IV) Antenatal clinics : 24th - 26th July 2020
B. Community base
I) Church houses
II) Market places
III) Schools/orphanages/prisons
IV) Door to door sensitizations

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3.1. Activities observed
The clinical part of this internship was not too observatory since it was just the continuation of
the previous clinical internship. The following activities done there were more of doing and
assisting and less observing. They include:

- scaling and polishing - anaesthetic techniques of infiltration and

- extraction nerve block
- RCT - Sterilisation of instruments
- cavity preparation - HIV test screening
- filling with GIC, Amalgam, Composite - Infection control methods
and ZOE - Dental consultation

3.2. Instruments used

The dental unit was filled with instruments here and there. Here ill alist a series of them with
their uses. The instruments can be either hand-held or rotary and others can be of fiber optic
light and ultrasonic equipment.
The types of hand instruments can be categorized based on their functions:
- examining the mouth and teeth
- scaling or professional cleaning of mouth
- cutting teeth and removing cavities
- Placing and condensing filling materials
- caring and finishing dental fillings
- Miscellaneous types
Concerning the Community session, I used the following:
- prepared notes that I discussed with the patients I encountered.
- depending on the various units I was assigned to give health talks, the content of
information I was to share with the patients

3.3. Activities done under supervision

In the various hospital unit I went, I initially talked to them about the following on a general
basis:
- Hand washing techniques
- Tooth brushing techniques
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- Informed them about community fluoridated water established by the government
- Diet. Here we are talking of the impact of sugary food on the teeth
- Accessibility to health facilities depending on their localisation
- Importance of a regular dental/medical check-up
Meanwhile specifically which means in the various units assigned, I discussed about the
following:

3.3.1. Hypertensive/Diabetic unit

At the Hypertensive/ Diabetic unit unit, I was to give health talk that was mostly centered
on their nutrition I.e. their diet.
Since this unit takes care of the hypertensive and diabetic patients, I appeared there
twice.
The patients hospitalised in this unit had were all put under a specific health diet
program. They were mostly associated with patients suffering from Diabetes. So the had a
very low glucose intake to consume, little salt to consume and lipids and proteins were all
screened so that their treatment can be very effective. This is because their treatment is
mostly dependent and highly influenced on the food they eat.
I taught them on the impact of their diet on their teach. Also on how to take good care of
their mouth. That eating more sugary food can increase the occurrence of dental caries. Also
that brushing their teeth with any substance other than tooth paste is agressive to the teeth and
the mouth tissues in general.

Fig 6: electronic sphygmomanometer or BP machine

3.3.2 Antenatal Unit

At the antenatal unit, I first tried to learn on how the unit works and the way it takes care
of their patients. It mainly does consultations on pregnant women, give them their first

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vaccinations like ATV (anti-tetanus vaccin), calculates the number of weeks of pregnancy,
record the number of times the patient was pregnant, assess the development of the upcoming
baby, etc
I also did my health talk, on the relationship of the dentistry with pregnancy. A
developing foetus can easily be affected by the drugs the mother takes at a certain stage of the
pregnancy. Drugs like tetracyclines can affect the bones and teeth of the baby in terms of
colour and shape. That is leading to amelogenesis or dentinogenesis imperfecta. The pregnant
woman should take scrupulously her Fe and Ca supplements as prescribed by the doctor,
since it can lead to a baby coming with underdeveloped bones and soft teeth.

Fig 7: Pregnancy menstrual calender circle

3.3.3. HIV/ treatment unit

In this unit I learnt many things related to HIV management. The unit takes care of HIV
positive patients, counsels them, provides them with their drugs, tells them about the impact
of their status in their day-to-day activities and also the side effects of the drugs to their teeth
and nails for as they change colours. As seropositive patients if they take well their
medications, they will be able to live a very long period of their life free in health and being
safe from complications like occurrence of opportunistic material.
As a dental personnel, I came in to give them a health talk on general hygiene in the first
place, the importance of a good oral hygiene and the relationship that exists between both
dentistry and AIDS. Since AIDS is a disease that results to a reduced number of CD4 cells
which are the defence mechanism of the body, thereby causing a a weak immune system.
This immunosuppressivity will permit the manifestation of diseases that were normally
unshown because of the patient’s previous seronegative status. These diseases are best known
as opportunistic diseases and can now become life threatening if the ARV drugs are not
taken.

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3.3.4. HIV testing and screening
Here the patient is been asked firstly if he/she ever did the test and when last that was
done. The test is done when the patient previously did it most than 3 months in the past or
when he wants to do it. The patient must have a negative status before been consulted by
the dental surgeon.
The test goes thus. With the help of an alcohol wet cotton, the patients finger is cleaned or
swapped. Then with the help of a sterile lancet, the finger is pricked and the when blood
comes out, it is put on the HIV test strip. Then the reagent is added immediately and then
allowed for it to show the results.
If one band appears at the control space then the patient is negative. If 2 bands appear on the
control and test spaces, then the patient is positive.

3.3.5. Dental consultation

Acquiring a diagnostic database. Which includes: medical history, past dental
history, clinical examination, diagnostic testing, extra-oral and intra-oral examination,
treatment plan.
Instruments used include: Consultation tray, composed of dental mirror, prop/explorer and
tweezer.

Fig 8: Consultation tray. Composed of mirror, tweezer and dental prop

3.3.6. Scaling and polishing

This is a procedure used by a dental practitioner to completely clean the mouth. This
procedure is done with the help of the either the manual scaler or an ultrasonic scaler
machine. Its main principle is to remove calculus found on all surfaces of the anatomical
crown of all teeth present in the mouth. It removes calculus on in the embrassure,
subgingivally, supragingivally, occlusally, lingually, buccally, labially, interproximally,
incisally and with the help of the polishing bur, plaque on the tongue are also removed.

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Instruments used include: PPE(personal protective equipments), consultation tray, polishing
paste ultrasonic scaler machine, cotton and hypochloride solution for disinfection of
material.

3.3.7. Tooth Extraction

This is one of the last procedures to be done on a tooth. It is implemented if and only
if the can’t be restored. The dentist chooses this as treatment plan because of the
following: tooth mobility, tooth necrosis, tooth fracture, esthetic purposes, when tooth
impairs in the normal development of the other tooth of same kind, etc.
The instruments used include: consultation tray, extraction forceps, cotton balls, dental
syringe, anesthetic drugs, elevator, syndesmotome, alveolar curette, powder amoxycilline.
When the patient has a toot be extracted, we said up the tray for extraction. Before the
procedure begins, we first administer the medications prescribed by the doctor. After the
patient is been well set on the chair, we carry out a nerve block and infiltrations in the
patients mouth. After noticing a change in coloration which is a clair sign of numbness,
then the dentist can begin. With the help of the syndesmotome, the periodontal ligaments
are being separated from the tooth. Then the elevator is used to elevate the tooth. Then
the dental forcep is used to grip the tooth firmly and with gentle movement of sideways
and circular then upward the tooth is removed from the alveolar socket. The mouth is
rinsed with clean water. Then using the curette to check for any debris found beneath the
socket. After the whole, dried and closed, the amoxycillin is poured inside and closed
with dry cotton. This is used to ensure fast healing of the wound

3.3.8. GIC filling

GIC is a filling material which helps to protect the teeth against further caries in the
mouth after placement on a tooth. Its mostly used as a pit and fissure sealant.
The process of putting GIC is as follows.
- firstly assembling the material used for the procedure, then prepare the cavity by removing
all carious lesions using the hand piece and bur.
- rinse and dry the cavity then isolate it from saliva.
- put the GIC that has already been mixed on the paper just after the cavity has been prepared.
- after the cavity is filled with GIC, apply vaseline on it then use then finger press technique
to condense it. And the curve it to its natural form and structures.then patient is allowed
to go.
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3.3.9. Composite filling
- Preparing the instruments to be used for the procedure such as; UV lamp, etchant solution,
composite with shades adapted to the patient’s teeth, bonding solution, mouth spatula,
mouth mirror, prop and tweezers.
- Cavity preparation was done with help of hand piece and bur to remove carious lesions.
- When the cavity was cleaned then the etchant was added and allowed for 30s. This will
ensure opening surface for bonding of composite to tooth.
- The etchant was rinsed and bonding was applied to together with composite, then the lamp
was fleshed on the site for polymerisation. The composite was added bit by bit till it was
all fillinh the cavity as initially as the normal tooth.
- If it was on the occlusal surface, all the natural pits and fissures were to be carved to make it
look normal.

3.3.10. Infection control methods

These are the various methods or procedures put in practice by the dental personnel to
avoid contamination and spreading of pathogens in between the patients and then personnel.
Its is done by, firstly, wearing a pair of gloves in between patients and before every
procedure and immediately washing hands after. Cleaning dental chair as soon as a patient
leaves it.
The personnel should always safety lab goggles before attempting any procedure. The unit is
been cleaned everyday with detergent and cleaned water and a disinfectant is prayed
every Wednesday and Thursdays to avoid further disease contaminations during this
period of COVID-19 pandemic.

3.3.11. Sterilisation of instruments.

Every instrument used is been sterilised and decontaminated.
After any procedure, a used tray is destroyed. This is done by separating the used instruments
from the soiled materials. Sharp needles are discarded into a safety box, metallic
instruments are placed into a decontamination solution and allowed for 15mins, while the
rest of the soiled materials like cotton and gloves are thrown into hospital disposable
container.
After 15mins, the metallic instruments are placed into an autoclave or sterilizer and allowed
for 30mins at 100oC.
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3.3.12. Cavity preparation
Cavity preparation is a procedure done whenever a tooth is disease. So it’s the act of
using a rotatory material to remove all the carious lesions on the tooth. This is to obtain
the outline form, convenient form, retentive form, etc which will ensure that the
restorative material put on it stays firm on is well attached to the toot

3.3.13. Root canal treatment

It is an endodontic treatment done on the teeth at the level of the root canals. It
consist of gaining access to the root canals from the crown, removing the pulp completely
or incompletely, cleaning with files and filling with an obturating material.
With the help of a lentulo, the obturating material such as fluid ZOE and granulotec
are put into the canals for filling all the space of the canals. Then gutta percha is
introduced into that same canal. This serves as the artificial nerve. NB: the gutta percha
isn’t put on deciduous teeth.
3.3.14. Pulp capping
This is an endodontic treatment that helps to protect the vitality of the tooth of
interest. The product used here is Dycal. This product is being inserted into the prepared
cavity and placed before the pulp cavity.

3.3.15. ZOE filling as a temporal restoration

ZOE is a paste made of zinc-oxide + eugenol. When mixed in various consistencies
or textures, it can be used to do a series of activities.
Fluid ZOE is used to filled root canals definitely especially on deciduous teeth without gutta
percha.
Hard ZOE is used to fill a cavity at the level of the crown. Its especially used as a wound
dressing material. It’s used to closed pulp chamber immediately as the the root canals
have been sealed with another root canal obturating material.

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 CHAPTER 4
4.1. Conclusion
This community internship helped me to exercise public speaking with confidence. It
permitted me to transfer knowledge to a large group of people by teaching a targeted group
certain aspects of my field and how they can benefit from them. Participants actively asked
questions and appropriate answers were shared to their best understand.
I also helped to demystify what people had in mind concerning dentistry which is not
only renown for a medicine of removing of teeth, but instead a medical science that treats
pathologies found in the teeth and mouth in particular to buccal cavity and head at large.

4.2. SWOT Analysis

Strength

- Good quality of dental care is provided

- Good infrastructure which are well spaced out and organized

- Well clean and spacious rooms

- A secondary power generator in case of power shortage

- Good system of waste management

- A working manpower of specialists, physicians, nurses and interns of various fields

- Cost of services are very affordable.

- Well spacious available area for health talks in the hospital

- Oftenly organises outreaches and sensitisations into the community.

Weaknesses

- There is no availability of good materials.

- Light shortages are very frequent and can destroy connected devices

- The dental radiograph is nonfunctional hence all radiographic examinations are been done

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in the main regional capital of Bafoussam.

- There is no availability of clean potable tap water. Water is provided once a week making
activities difficult there at the unit.

- Also due the present health pandemic, prices of materials became very expensive due to
their limited numbers in the market.

Opportunities

- The hospital is a teaching hospital to be so it has a very good collaboration with the
University of Dschang and other state professional school.

- Organises outreaches and sensitizations campaigns in partnerships with NGOs like those in
charge of HIV/AIDS prevention thereby receiving funding and consumables for their
activities.

- Through such processes, the population get more acquainted with the hospital services.

Threats

- The hospital is surrounded by many private hospitals which has dental services there. Some
do send or refer their patients to DDH due to incompetence, and the hospital notices bad
practices being done on the patient. Hence the patients suffers more pain and trauma.

4.3. Recommendation

4.2.1 Recommendations for organization

The hospital’s personnel should try to work more in collaboration with one another. The
qualified personnel should well supervise the activities of the internees. They should stop
blaming the students on procedures these students didn’t perform well instead of punishing
them uselessly which may in turn hinder their learning process. The hospital’s should at least
look into the working conditions of the personnel well increasing their salary and providing
them with necessary equipments for the proper functioning of the unit and better satisfaction

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of the patients.

4.2.2 Recommendation for University

Due to my personal observations, I will recommend the university to insist more on the
practical of their students on campus before sending them to various health institutions. This
may put a good image on the school and also render the various practises of the students
unquestionable on field. It will also help the students to be versed with administrative
procedures on how to well plan and organise outreaches.

4.4. References

- www.wikipedia.org

- www.minsante-dschangdistrict.com

- L’historique de l’HDD

- papers pasted at the health district of Dschang offices concerning population data

4.5. Appendix

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Signatures
Head of Dental Unit Major of Dental Unit
Dr. CHIMY Herna Mme KANA Sandrine Leonie

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