Exchange report - incoming students
Home university: Makerere University
Study programme: Dentistry
Exchange programme: Linnaeus-Palme
Semester: Spring semester 2014/2015
Name: Ronald Mulwana
Email address: mulwanaronnie@gmail.com

Arrival and registration

The flight time from Uganda to Stockholm is 11 hours. We were two students from Uganda and we arrived on Saturday morning, welcomed by temperature of 4 degrees far different from our usual 25 degrees in Kampala. It was extremely cold for us so we had to immediately make use of our heavy jackets, gloves and head gears to keep warm. Having been used to light clothes back home, switching to heavy clothes was a process which the cold forced you to get used. We were welcomed by a student from the KI pickup service who really helped us find our way to our interim accommodation at Interhostel. We spent 2 days there but I cannot forget the strong dry cold winds that almost lifted in air. We set off for KI Huddinge on Monday morning where we were warmly received by the international coordinator, together with 5 other exchange students from Iceland, Finland and Holland. The coordinator gave us credit cards, important information concerning our stay at KI, SIM cards and helped us process student KI key cards. She then took us to the administrators who warmly welcomed us and showed us around the dental clinic. The huge dental clinic is divided into different departments namely: VUX (Adult) clinic, Orthodontic clinic, Oral Physiology clinic, Endodontic clinic, Paediatric clinic and phantom. I was so excited and could not wait for the clinical sessions.

Acommendation

We were lucky both of us from Uganda got accommodation in one of the best residential areas in Stockholm as per statistics, Jagargatan 20. We were made home to a fully furnished single room and shared bathrooms, kitchen and laundry. I personally had a great view of the city from my window. Jagargatan houses mainly international students so I met people from different walks of life namely people from China, Ethiopia, Italy, Portugal, USA, Belgium, Germany to mention but a few. Several parties were organized by different countries in the kitchen say Ugandan party, Portuguese party and so on. Such were opportunities to mingle in different cultures. There were some Ugandans already on our floor so fitting in was quite easy for us and beside, most of the residents were willing to help when asked. I enjoyed most of my time in the kitchen as I improved my cooking skills, and was also exposed to different dishes such as meat soup and Ethiopian sauce. The chicken wings were very delicious and always tempting. There was a nearby sports facility where we would go and play basket ball when the weather was good. There we would sweat, laugh and shake off all the stress.

Jagargatan was just one train stop from Stockholm Central making it easy to access the city centre.

Leisure time and social activities

We were lucky to have come after the scary winter as we were told Swedish people are usually very sad during that season. Everyone in the clinic was happy to work or help us around. I am so grateful to some of the dental students we rotated with. We used to interact over coffee and lunch. Some of them have become really great friends. One of them was like a brother from another mother. He showed us around the great eating places; we swum together and also went for a one day crooze to Finland with him. We had such a great time on the Viking line.

I also went to some of the International Christian fellowship meetings and they were so spirit refreshing. On Sundays, I would fellowship at Immanuel Church which became home church away from home. Folks there were so loving. I was honored to have been part of the church band playing, acoustic guitar on the team. I cherish every moment I played with the team and I got a chance to lead a song. I am forever humbled and grateful that I was part of the ministry at Immanuel Church.

We also visited the vasa museum were taken back to life on a ship about 300 years ago that only sailed for 25 minutes. Not forgetting the fire at Skansen museum to scare off the winter and welcome the summer.

Pre-departure

I am so glad and grateful to the department of dentistry Makerere University for having chosen me to take part in the student exchange program at Karolinska Institute (KI). I was very excited since I had never travelled out of my country and also was looking forward to the European dental experience as a student. KI being one of the world’s best universities, I knew this was an opportunity to expose me to high tech dentistry. The department briefed us about: latest dental techniques at KI, Ice cold Stockholm and the great transport system in Sweden. I also could not wait to taste the Swedish food and Stockholm lifestyle and culture.

Courses during the exchange period

ETL002 : Child and Adolescent Dentistry - Odontology
• Paedodontic clinic: this involved treament of children ages 2-19 years. Treatment included in-schooling and here the child would come to only be introduced to dental instruments and equipment. History, examination and therapy plan were the other aspects. I did glass ionomer and composite cements, scaling and polishing and fluoride application. • Orthodontic clinic: Here we had patients already in treatment; we discussed the different cases and participated in adjusting and delivering removable appliances such as expansion plates. We also had lectures on the need and criteria followed for one to get free orthodontic treatment in Sweden and a session on clefts looking into early treatment Vs late treatment bearing in mind their effects on speech and growth.
ETL001 : Comprehensive Care - with subject specific courses
• VUX Clinic: this involved treatment of adult patients and here we would thoroughly clerk patients taking their medical and dental history and then do the dental examination which entailed caries examination and cariology risk assessment where we would asses caries risk factors and resistant factors through a cariogram and determine the patient chance to avoid caries. This would encourage the patient to reduce the risk factors. Taking routine dental x-rays, periodontal charting and therapy plan constituted the rest of the examination. Some of the procedures I did were: scaling and polishing, composite and glass ionomer fillings, root canal on a molar and one cerec crown. Such exposure has greatly improved my clinical skills. • Oral physiology clinic: this involved treatment of patients with Temporal Mandibular Joint (TMJ) anomalies especially myalgias. Here we would thoroughly asses the TMJ and muscles involved. Night splints were the major form of treatment. I learnt how to deliver a night splint. In Paedodontic, orthodontic and Oral Physiology clinic we always worked in pairs and each exchange student would work with a KI student and this helped us work faster, share different ideas from different universities and simplified the communication for example some notices in the clinic were in Swedish and a few patients had difficult in speaking English so the Swedish student would help you translate.

Summary

I am thankful to everyone involved in the collaboration and partnership between KI and Makerere University. The exchange period at KI was such a massive opportunity in terms of carrier building for a young dental surgeon in the making. This exposed me to high tech dentistry and also the European lifestyle. Freely sharing of knowledge and experiences between students and lecturers provide a fertile learning environment. I am so grateful to all our teachers at KI and more so to our clinical supervisor who met us every week to share any challenges and how to overcome them. Not forgetting the reception team and the international student coordinator, you made our stay in Stockholm memorable and worthwhile. 

Language and Culture

·         Oral physiology clinic: this involved treatment of patients with Temporal Mandibular Joint (TMJ) anomalies especially myalgias. Here we would thoroughly asses the TMJ and muscles involved. Night splints were the major form of treatment. I learnt how to deliver a night splint.

In  Paedodontic, orthodontic and Oral Physiology clinic we always worked in pairs and each exchange student would work with a KI student and this helped us work faster, share different ideas from different universities and simplified the communication for example some notices in the clinic were in Swedish and a few patients had difficult in speaking English so the Swedish student would help you translate. 

Studies in general

We started off with preclinical sessions which included:

·         Opus Dental which is a software system where all patient history and examination notes are made contrary to the paper system back home. With such a system one can easily access patient records anywhere on a KI computer and plan treatment, book appointments and follow up a case. We would use the same system to call in the teachers to supervise and follow up different dental procedures in the clinic.

·         Preclinical Endo: Here we were guided through the way root canals are done in Sweden and the different material used and techniques such as use of rotary instruments to prepare the coronal 2/3 of the canal. Each one of us was required to do an access cavity, clean and shape and obturate an anterior tooth to complete the course.

·         Preclinical Prosthetics: Here we had sessions in crown preparations for ceramic crown, metal crown and porcelain fused to metal crowns. We also made temporary crowns using luxatemp for anterior teeth and aluminium for posterior teeth. The most interesting of all was the cerec crown technique where we made the crown preparation, scanned it using a special camera and computer, designed the crown on the computer, made the crown within 15 minutes and fitted it on the tooth. This was high tech dentistry.

·         Digital x-rays: Here we guided through the technique of taking digital x-rays slightly different from the analogue system back home. The digital system is faster and clearer since one can change the contrast on the image