College of Dental Surgery, BPKIHS has come into existence on August 1999 as a pioneer of Dental Education in Nepal. The College is committed to contribute towards providing dental surgeons who are knowledgeable, skilled and compassionate, and at the same time equipped with leadership and teaching abilities. This College is also providing quality oral health service to the people of Nepal considering health statistics and national health policy of Nepal. The College was started at previously existed old buildings located at south point of campus with 74 dental chairs with all minimum requirements. The College shifted to its new building on 7th February 2004. Area allotted for the College is 6.77 hectares and total build up area is 120000 Sq. ft. The building has all infrastructures which are required for smooth functioning of a dental college and hospital. We believe this hospital is a model dental college and hospital of this country. At present the college has 131 dental colleges with all other major equipments like OPG, RVG, IOPA, Phantom heads, Central Air Compressors, LP Gas supply unit etc.

1.1 BDS PROGRAMME

BDS course at BPKIHS is landmark for Dental Education in Nepal and is the first course in the country. The Dental Education at BPKIHS started on August 1999 with the intake of first batch of 40 BDS students.

1.2 Duration of the Course

The course of studies leading to the Bachelor of Dental Surgery (BDS) degree of the BPKIHS consists of 5½ academic years including 1-year Community Oriented Compulsory Residential Rotatory Internship.

1.3 Admission Requirement

Selection purely by merit on the basis of Entrance Examination students having twelve years of schooling with science, such as I. Sc., CBSE board etc. or GCE Advanced Level are eligible to appear in Entrance examination.

1.4 Curriculum
The Bachelor of Dental Surgery (BDS) curriculum of BPKIHS is committed to producing health manpower needed and deemed appropriate for the twenty-first century. The curriculum is an integrated one, incorporating the organ-system and need based approach. It is community oriented and uses problem-based learning as a supplementary tool in the teaching-learning process. During the first two years of the course, designated as Phase-I, the emphasis has been laid on the applied basic sciences along with community medicine and professional skills. In the next two and a half years, designated as Phase-II, the emphasis is on clinical sciences with a high degree of integration between clinical and community medicine and applied basic sciences. The curriculum incorporates early patient contact and emphasizes the importance of study of community medicine and behavioral sciences from the beginning. Teaching through lectures has been restricted to a bare minimum while problem-based learning and other unconventional learning experiences (UNCLE) are encouraged. In their own interest, students should attend all classes organized for them. Attending at least 80% of the classes is essential for being eligible to take the Annual Examinations conducted during the course.

1.5 CONCEPTUAL FRAMEWORK OF BDS PROGRAMME

2. Departments:
1. Department of Oral Medicine & Radiology
2. Department of Oral & Maxillofacial Surgery
3. Department of Prosthodontics
4. Department of Pedodontics & Preventive Dentistry
5. Department of Orthodontics
6. Department of Community Dentistry
7. Department of Periodontics
8. Department of Conservative Dentistry
9. Department of Oral Pathology

2.1 Department of Oral Medicine & Radiology

The Department of Oral Medicine & Radiology deals with diagnosis and treatment of oral diseases of all patients and radiographic investigations as on routine basis. Cases such as sub-mucous fibrosis, Leukoplakia, Lichen planus are being treated in the department independently. The major cases like malignant lesions are also diagnosed and forwarded to Cancer Hospitals for further management.
At present, the department is running efficiently for providing patient cure and undergraduate teaching/learning with One faculty, one Dental Surgeon, Regular visiting Faculties and adequate support staffs. Almost all equipment like twelve dental chairs, RVG, OPG, IPOA X-Ray units etc. are available in the department.

2.2 Department of Oral & Maxillofacial Surgery

Minor Oral Surgical procedures such as teeth extraction, removal of impacted teeth, cyst enucleation, biopsies etc are routinely carried out in this department. In addition, in-patient services are provided with 10 beds. Major surgical procedures under general anesthesia for maxillofacial trauma etc are being carried out with the help of Senior Short term faculties.

Two ANM are posted in the department. The role of Tutor, dental surgeons, & chair side assistants were defined and explained to each member. Case record maintenance system was started in the department (OPD).
In-patient services are being provided with the help of bed allotted in the Hospital ward. Major surgical procedures under general anesthesia are being done usually once a week on the allotted day (Friday) whenever faculty available.
OPD services include minor surgical procedures such as extraction, removal of impacted teeth, cyst enucleation, biopsies etc, which are carried out under local anesthesia with the help of 10 modern dental chairs and surgical instruments, equipment.
This department provides and manages Emergency service in an integrated manner from the Emergency building of Medical College. Dental Surgeons and Senior Consultants are available on duty as on call basis around the clock.

2.3 Department of Prosthodontics

This department provides new artificial tooth for those persons who lose their teeth. This Department carried out replacement of missing teeth. Complete dentures, removable partial dentures, fixed bridges and maxillofacial prosthesis of congenital defects resultant of carcinoma & trauma are routinely fabricated in this department. The clinical procedures are carried out by the Tutor and Dental Surgeons posted in the department on a rotatory basis with the supervision of Short term Faculties, technical and nursing staff members are there for support in clinic and lab work. At present, there are two faculties and one Dental Surgeon to look after the department activities with technical and nursing staff and one helper in the department. Number of dental chairs has been increased up to 18 including other necessary equipment, instrument and materials.

Academic responsibilities include teaching I year to V year BDS students, in the form of SIS, for coverage of theoretical back-ground, LABEX for imparting laboratory skill and CLIP & CBL for imparting clinical skills approximately 1200 hrs in total.
LABEX is conducted in the pre-clinical Prosthodontics laboratory which has a capacity to accommodate 40 students at a time.

2.4 Department of Pedodontics and Preventive Dentistry

A separate branch is devoted to the needs of children. The importance of child's dentition is explained to parents and necessary procedures are carried out in restoring them.

Procedures like (a) Amalgam Restorations (b) Glass Inomer Restorations (c) Anterior & Posterior Composite Restoration are routinely done.
Extensive Procedures like: (a) Root Canal Treatment (b) Apicoectomy (c) Crown & Bridge Preparation are carried out with the guidance of MDS staff.
Procedures like: (a) Pulpotomy (b) Removable Orthodontic Therapy (c) Serial extractions (d) Pulpectomy are carried out on child patients at present. Management of handicapped patients is also being done.
With respect to preventive Dentistry –school health programme has been scheduled / recommended from the public health dept.
Most of the required equipments & instruments including eighteen dental chairs all facilities are available for the department.
All full fledged phantom head lab having 40 phantom heads for pre clinical training of students before they start work on patient in devices.

2.5 Department of Orthodontics

The Department of Orthodontics and Dentofacial Orthopedics is the area of dentistry concerned with the supervision, guidance and correction of the growing and mature dentofacial structures, including those conditions that require movement of teeth or correction of mal-relationships and malformations of related structures by the adjustment of the relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of the functional forces within the craniofacial complex. The ultimate aim of Orthodontic treatment is to achieve functional efficiency, structural balance and esthetic harmony of face and the dentofacial structures.

Presently, various treatment procedures such as: fixed orthodontics, removable orthodontics, dentofacial orthopedics procedures are being carried out.

At present the department is developed with adequate equipments, instruments including fourteen dental chairs with all facilities. A team of an Associate Professor, an Assistant Professor, a Dental surgeon and support staff is running department smoothly.

2.6 Department of Community Dentistry

This department is involved in the community based academic & clinical activities. Research & Oral Health Awareness Programme also are carrying out from the department. This department has its own importance, as the curriculum of BDS is community oriented.

This department is conducting dental camps, school health programmes, Mother-child dental health awareness programes etc. individually according to the plan of action in accordance with the academic curriculum of BDS programme.

Initially, the role-played by the Community Dental Service was mostly at a curative level, gradually, department started to consider the aspects of prevention methods, health promotion and health education as well as community activities.

At present department have twelve dental chairs and other essential equipment, instrument and materials. A team of an Assistant Professor, a Dental surgeon and support staff is running department smoothly.

2.7 Department of Periodontics

The department of Periodontics deals with the diagnosis, treatment and prevention of diseases and conditions of gums, periodontal ligament, cementum and alveolar bone which are very important parts of oral health. Oral prophylaxis/scaling, polishing and periodontal surgeries are carried out in this dept. It consists of ultra-modern ultrasonic scalers.

A Professor is heading the department with an Associate Professor, Dental Surgeons and adequate Nursing & Technical Staffs. Specialized treatment procedures being carried out in the department. Teaching-learning activities are smoothly carrying out based on the academic curriculum.

The department is equipped with twelve dental chairs, eight ultrasonic scaling units and adequate surgical periodontal instruments.

2.8 Department of Conservative Dentistry & Endodontics

All types of restorative dentistry as well as Endodontic treatments are carried out in this department. Cosmetic dentistry works carried out in this department is gaining popularity in the recent times.

The department is now fully supported with a Professor, 2 more Faculties, Dental Surgeons and adequate Technical and Nursing staff. Latest instruments and materials including seventeen dental chairs with all accessories are available in the department to provide efficient treatment to the patients and to provide thorough clinical learning to the students. Equipment like Electronic Apex Locator, Profile and Protapers system with gear reduction hand pieces Thermafil oven and Thermafil R.C Filling material, Auto matrix. Paleodent matrix system and Rubber Damkits and LED Curing units along with regular QTH curing units, Endosonic unit is there to deliver the quality dental care to patients as well as to look after the learning needs of the students.
List of Procedures carried out in this department:

2 .9 Department of Oral Pathology
Conformed diagnoses of the oral diseases under microscope are carried out in this department. Students are being taught Morphology, Anatomy of tooth, histology of tooth.

Oral Pathology is a major subject included in the 3rd Year BDS curriculum. A branch of the subject is taught for the students of 2nd year BDS, as Oral Biology, comprising of 4 main topics under the headings of Tooth Morphology, Oral Embryology, Oral Histology, and Oral Physiology.
At the academic level, Oral Biology theory classes and LABEX are being taken with full effect, for the BDS 2nd Year students and Oral Pathology theory and LABEX are being taken as per the curriculum
At present department have 49 microscopes including 2 binocular Microscopes and adequate numbers of pathological slides to help the students study the oral tissues. Due to unavailability of microscopic tissue slides earlier some slides of normal tissue were borrowed from the Depts. Of General Anatomy/Pathology, while some were prepared for the Department. At the Dept. level, the Oral Histology /Pathology Lab is being set up gradually. As of now, since the lab is not well developed, in the Dental Section, biopsy tissue specimens are being sent to the General Pathology Lab where they are being processed, sectioned, stained, & diagnosed. The biopsies most commonly obtained are from patients presenting with lichen planus, leukoplakia, erythroplakia, squamous cell carcinoma of the floor of the mouth / tongue, cysts / tumors of the jaw bones etc. An attempt is also being made to prepare sections of the tooth.

3. Under Graduate Teaching:
Teaching learning activities for BDS programme is going on smoothly as per the curriculum and teaching programme. Teaching and learning activities comprise Structured Interactive Session (SIS), Clinical Posting (CLIP) Small Group Discussion (SGD), Case Based Learning (CBL), Laboratory Exercise (LABEX), Objective Structured Practical Examination (OSPE), Objective Structured Clinical Examination (OSCE), learning in Field (LIF) etc.
At present there are five batches of BDS students in the College of Dental Surgery and three batches has already awarded graduate degree.

3.1 BDS Programme Phase- I

The Phase I BDS Programme (the first two years) consisted of – learning activities of both basic medical sciences and dental sciences curriculum is with organ system framework, community oriented and is partly problem based with emphasis on early clinical exposure and community exposure.

3.2 BDS Programme Phase- II

In accordance with the prescribed BPKIHS document, i.e., The Bachelor of Dental Surgery Curriculum, The First Version, 1999, appropriate steps are being taken to fulfill the requirements and suitable actions implemented to execute the relevant teaching and learning activates.

An “Organization, Assessment and Evaluation Plan of BDS Phase -II Programme” was developed [as this was lacking in the Curriculum document] with consultations and inputs from concerned departments.

The BDS Phase II program is covered in 5 semesters with 2 ½ years and later 1 year of internship.

All 9 departments in dental college regularly participate in T/L activities.

''Teaching Program Implementation Committee' monitors the program. The Committee meets regularly on every Wednesday. All faculty members of the departments from dental college attend the meeting to discuss matters pertaining to the study program and evaluation of the student's performances.

The Study Program:

The BDS Phase II study program consists of 5 semesters [From V to IX] each of 20 weeks duration. The T-L activities include SIS, CBL, out patient Treatments in the Dental clinics, LABEX, Seminars, LIF and Residential Field Postings consisting of 2 weeks.

5. Internship Programme

5.1 Introduction:

Community Oriented Compulsory Residential Rotatory paid Internship Programme for BDS final year passed out students was started for its first batch of 40 students from 15th March 2004 and completed by 14th March 2005. At present 5th batch is doing their Internship. COCRRIP was initiated and implemented as per the COCRRIP-BDS Program Development workshop held from 12-14th February 2004 and BDS internship program development subcommittee report. To provide opportunity to acquire a general professional skills and knowledge about various subjects of dentistry and adequate opportunity to work with the community under the able guidance of Dental Faculties, Residential Dental Supervisors and Hospital Superintendent the BDS Internship Program at BPKIHS consists of twelve months, of which six months posting is at Teaching Hospital, i.e. College of Dental Surgery and six months is at the District and Zonal Hospitals.

At its early stages, the peripheral part of COCRRIP had to face several challenges at few centers like logistics, improper working conditions, security and political situations. There were mixed feelings at the beginning both by the local people and local administration at few places. However, with time and resources, adjustments and improvements were made and at the end the year, this innovative COCRRIP program is running smoothly. Within a short span of twelve months our program has had a tremendous impact on the health resource map of Nepal. Today, our interns and dental supervisors and faculty are working upon the Basic Oral Health Needs as per the National Oral Health Plan, and thus today COCRRIP is a Flag mark of BPKIHS.

The dental clinics at peripheral centers began with basic supply of equipments and materials. For basic oral health care (BOHC) and Oral Urgent Treatment (OUT) could be provided to the public. Dental awareness gradually increased among the public and among hospital authorities as well. As a result, the working conditions improved, resources improved; dental treatment ranged from oral health promotion to difficult extractions, restorations of carious teeth and minor surgeries. Such is the impact of our program and dedication of involved authorities and people that some hospitals even purchased their own sets of sophisticated dental equipments like ultrasonic scalar units and air compressors.

As this program was community oriented the oral health care was not only limited to individuals attending hospital OPD’s. Community programs like School Oral Health Programs, Maternity Child Oral Health Program, and Community Field Oral Health Programs were also regularly organized and implemented by the interns under the able guidance of supervisors. While doing so, the dental interns have developed communication skills, planning and implementation skills and organization skills, apart from their normal clinical skills. They have had an inerasable impression of the true Nepali Communities. Peripheral postings, although in a small way, have created a major positive impact not only on the interns and patients but also on the institution as a whole.

The central teaching hospital, College of Dental Surgery, too tasted the success of COCRRIP. Here, the dental interns were not only able to sharpen their clinical skills but were also involved in major learning areas under the direct supervision of faculty members. They were involved in Major and minor oral surgeries, precision requiring periodontal surgeries, emergency care and management, orthodontic appliances, and Endodontic therapy etc. They also had ample opportunity to participate in seminars, Continuing Medical Education sessions and various other presentations. Above all, they acquired patient management skills and opportunity to utilize their knowledge and skills in providing precise, affordable, genuine treatment to patients by all ethical means.
To sum up, COCRRIP provided an opportunity for dental interns as a podium to perform their best and prove ability to be good doctors and community planners/partners and moreover, better human beings.
5.4 Consumable Dental Materials to the each Internship Peripheral Training centers at District & Zonal Hospitals:
To start the Internship programme all the consumable dental materials including General Medical Consumables and emergency Drugs were supplied by the BPKIHS.
5.5 Logistics support:
Hostels for Interns, Dental Surgeon and Dental Clinic setups in Hospital are developed by the institute with co-operation with DHO, DPHO, Medical Superintendent and local bodies. Public Health Section of B.P Koirala Institute of Health Sciences is looking after the logistic support.

5.6 Supervision of Internship Peripheral Training Centers:
The Internship Program is being carried out under the strict supervision of Faculty Members and Dental Surgeons of Dental College. Peripheral Centers activities are mainly emphasized upon community based preventive and educative programs as well as basic oral health care under the strict supervision of DHO, Hospital Superintendents, Dental Faculties and Dental Surgeons. Dental surgeons are posted in each centers on regular residential basis (monthly rotation basis). Clear job descriptions have been given to them for supervision of Interns during residential field posting at Teaching Districts/Zonal Hospital. Faculty visits the center on a weekly basis and supervises the centre and provides specialized care as necessary. (See annexure 5). Faculty and supervisors report on a weekly and monthly basis respectively and the recommendations and suggestions for the improvement of the program have been considered after thorough examination and discussion with the authorities and many modifications have been carried out as and when necessary during this period. Other than this a monitoring team has been constituted regularly consisting of dental, medical faculties, public health supervisor and when feasible, an executive member of the BPKIHS family to monitor and supervise the program on a timely basis.

5.7 Assessment and Evaluation of Interns:
Head of the Department or DHO/DPDO/Medical Superintendent is certifying the work done under concerned Department of College or District/Zonal Hospital. Interns must repeat those department or Hospital which are certified unsatisfactory. While certifying the work of Interns the HOD or the Supervisor must consider the following components:
1. Clinical Skills
2. Laboratory Skills
3. Behavioral Skills
4. Process Skills
5. Administrative & Managerial Skills
6. Ability to work indifferent settings

To record and certify the assessment of the above components each interns is provided with a logbook.

Component of Log Book are as under:
• Objective of each Posting
• Clinical Requirements for successful completion in the Department or Internship Hospital
• Daily Record of activities
• End Posting assessment in the department or Hospital

The progress of Interns is regularly monitored through the Log Book considering the above facts. The Log Book should be updated by the Dental Intern on a daily basis and entries verified by the HOD/Faculty /Supervisor.

During the postings at Zonal/District Hospitals Dental Interns are supervised by the Medical Superintendent/DHO/Medical Officer or the supervisor deputed from the BPKIHS. After satisfactory completion of twelve months (52 weeks) of COCRRIP the Dental Intern will be awarded the Internship Completion Certificate.

6. Community Activities:
College of Dental Surgery is being actively involved in Community Services with co-ordination of Department of Community Medicine, Community Nursing and Public Health Section. Institute has 4 District Hospital in Dhankutta, Sunsari, Morang and Ilam, 2 Zonal Hospitals in Mechi and Sagarmatha, 5 Primary Health Care Center as Teaching District Centers. Faculties, Dental Surgeons, Technicians from Dental College are regularly attending patients at the following Hospitals:

1. Sunsari District Hospital, Inaruwa
2. Dhankutta District Hospital, Dhankuta
3. Rangeli District Hospital, Rangeli, Morang
4. Ilam District Hospital, Ilam
5. Mechi Zonal Hospital, Bhadrapur
6. Sagarmatha Zonal Hospital, Rajbiraj
Department of Community Dentistry is not only involved in above community activities but also actively being conducting School Dental Health Programme, Mother Child Dental Health Education Programme and Dental Health Camp in and around peripheral centers of teaching districts. Hospital is providing technical support to field based clinical activities in accordance with the teaching programme co-coordinators of the BDS/MBBS/B. Sc Nursing etc.

Support services for community Oral Health Activities:
Oral Health Camps, School Oral Health Camps and other community activities have been conducted successfully with the help of additional manpower, resources and materials from BPKIHS. As and when required upon recommendation of the dental supervisor and DHO/MS from various centers, College of dental surgery and especially dept. of Community Dentistry has supported the Community Oral Health Activities regularly.

7. RESEARCH

As one of the promotion criteria demands standard research with paper publication, all faculty members are encouraged to conduct research activities in their departments. Institute invites research proposals from all the faculty members periodically. All these activities are monitored by Research Committee which has members drawn from eminent medical scientists from India & Nepal. After the approval from the Ethical Committee and the Research Committee proposals can be implemented. The amount of a research grant is ordinarily Rs. 25,000/- for one year.
BPKIHS research grants are intended to provide seed money to encourage quick translation of ideas into projects. It is expected that projects so initiated will grow into major projects for which the investigator will be able to attract bigger grants from national and international agencies.
A separate support team consisting of Statistician, Demographer, Sociologist, Psychologist Nutritionist and Computer Operators is available to get services required for implementing research activities.

SOME EXAMPLES OF RESEARCH PROJECTS COMPLETED LAST YEARS
1. Epidemiological Survey of Dental Caries in small children in Sunsari District.
2. Estimation of FLUORIDE Levels in drinking water (Sunsari District)
3. Effectiveness of digital analysis of bite mark evidence – a pilot study
4. Emergence Pattern of Permanent teeth in Children of Sunsari District of Eastern Nepal. (Self supported study)

8. CONTINUING DENTAL EDUCATION (CDE):
BPKIHS attaches great value to continued upgrading of the knowledge and skill of its faculty, staff & students. Continuing Dental Education Programme is aimed at interaction between faculties, with the intention of sharing & earning knowledge. The overall vision of Continuing Dental Education Programme would be to also involve the Medical /Dental Faculty who would actively participate in areas of mutual interest to benefit in raising the academic standards of the institution. As a part of CDE programme College of Dental Surgery is organizing series of guest lectures by senior faculty members from different prestigious dental colleges of Nepal, India and abroad.

9. DENTAL TEACHING HOSPITAL

Dental Teaching Hospital is running with 131 dental chairs and an inpatients ward of 10 beds, state of the art material and an enthusiastically energetic team of faculty, dental surgeons and supporting staff. Patient inflow is about 150 per day in aggregate to all departments (calculated as per the records maintained by each department). Treatment includes out patient as well as in patient surgery inclusive of aesthetic, restorative, oral rehabilitation & maxillofacial reconstruction respectively. Not only in Hospital, it has spread its services to the peripheral/rural population over eastern region.

Dental OPDs, Minor OT and Radiology are in the Dental College premises, In-patient Ward, Major OTs, ICU and Clinical Laboratories (Microbiology, Pathology & Biochemistry) are located in the Medical College buildings.
Emergency service:
The Dental College provides Emergency service in an integrated manner in the Emergency building of Medical College. Dental Surgeons and Senior Consultants are available on duty as on call basis around the clock.
Working hrs 8.00am to 5.00pm - Dental Surgeons & faculty from Dept. of Oral & Maxillofacial Surgery.
5.00pm to 8.00am - Duty on call on rotation basis by Dental Surgeons and Faculties
- 1st on call - Dental Surgeons
- 2nd on call - Faculties from department of Oral & Maxillofacial Surgery
Emergency patient inflow – 1-2 calls/day on an average
Cases handled in Emergency are:
Major-RTAs with polytrauma
Minor-Bleeding socket, Infection, Pain, Dento alveolar trauma

Out Patient Service:
OPD Clinics:
The Dental College provides OPD service on following specialty: