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UD PCS Summer Dental Symposium 2015

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If you are a general dentist, dental hygienist, or dental assistant, take advantage of this program in a relaxed, collegial environment. Join us in beautiful Ocean City, Maryland at the Clarion Resort Fontainebleau Hotel for a continuing dental education program co-sponsored by Dodd Dental Laboratories and the University of Delaware’s Division of Professional and Continuing Studies.
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CONTINUING DENTAL EDUCATION July 27–31, 2015 Ocean City, Maryland Clarion Resort Fontainebleau Hotel SUMMER SYMPOSIUM Dodd Dental Laboratories University of Delaware, Professional & Continuing Studies
Transcript

CONTINUING DENTAL EDUCATION

July 27–31, 2015Ocean City, Maryland

Clarion ResortFontainebleau Hotel

SUMMER SYMPOSIUM

Dodd Dental Laboratories

University of Delaware, Professional & Continuing Studies

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The Continuing Dental Education Summer Symposiumcombines quality education with a great location. If youare a general dentist, dental hygienist or dental assistant,take advantage of this continuing education program ina relaxed, collegial environment. Whether you are traveling alone or with family, Ocean City offers the ideal location for our Summer Symposium. Attractionsabound, from the world-famous boardwalk, to the beautiful beaches (including nearby Assateague IslandNational Seashore); great shopping; tennis, golf andother recreational opportunities; arcades and amusements;and a nearly endless variety of restaurants and eateries.For more information on attractions and activities, go to www.ococean.com. Ocean City is approximately a three-hour drive from Baltimore, Philadelphia or Washington, DC. Excellent programs and speakers.Great beach location!

Credit

Participants will be awarded 4.0 credit hours for each seminar(except for the Mid-Atlantic P.A.N.D.A seminar, which awards2.0 credit hours). To receive credit, participants must sign in atthe seminar, attend the seminar in its entirety and complete anevaluation. Certificates of attendance will be awarded at thecompletion of each seminar and must be picked up at thattime. Please contact your state examining board to see if thecourses offered at this symposium are approved for credit.

National Dentex Corporation is designated as anApproved PACE Program Provider by the Academyof General Dentistry. The formal continuing education programs of this program provider areaccepted by AGD for Fellowship, Mastership, andmembership maintenance credits. Approval does

not imply acceptance by a state provincial board of dentistryor AGD endorsement. The current term of approval extendsfrom 10/1/2014 to 9/30/2017. Provider ID# 211838

This continuing educationactivity has been planned

and implemented in accordance with the standards of theADA Continuing Education Recognition Program (ADA CERP)through joint efforts between National Dentex and Universityof Delaware.

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Program Schedule

Monday, July 27 7:30 a.m.Registration and Continental Breakfast

8 a.m.–noonClinical Nutrition in the Dental Practice: A CourseWhich Will Help the Dentist, Dental Staff, Families and Patients Along the Road to Optimal HealthThomas E. Baldwin, DDS, MAGD

Tuesday, July 28 7:30 a.m.Registration and Continental Breakfast

8 a.m.–10 a.m.Mid-Atlantic P.A.N.D.A. – Preventing Abuse and Neglect Through Dental AwarenessSuzanne Kim, DDS

8 a.m.–noonThe Complexities and Complications Associated With Restoring Dental ImplantsCarl F. Driscoll, DMD

Wednesday, July 29 7:30 a.m.Registration and Continental Breakfast

8 a.m.–noonEverything You Wanted to Know About Street DrugsBut Were Afraid to AskHarold L. Crossley, DDS, PhD

Thursday, July 30 7:30 a.m.Registration and Continental Breakfast

8 a.m.–noonInfection Control is Not Optional: Dental Practitioners Need to be InvolvedLouis G. DePaola, DDS, MS

Friday, July 31 7:30 a.m.Registration and Continental Breakfast

8 a.m.–noonThe Rapidly Evolving Field of Dental Sleep MedicineElliott J. Alpher, BS, DDSOliver C. Roberson, DC, CSHEDavid Gergen, CDTCongressman Marty Russo (retired)

Monday, July 27, 8 a.m.–noon

Clinical Nutrition in the Dental Practice: A Course Which Will Help the Dentist,Dental Staff, Families and Patients Alongthe Road to Optimal HealthThomas E. Baldwin, DDS, MAGD

An almost infinite number of sources tell us that optimal health and well-ness are available to all of us. But no matter the source of this information,you have to be totally confused. There is conflicting information abouthow to attain optimal health, slow aging and have abundant energy. Dr. Baldwin will cut through the fog and give you information that you canuse starting tomorrow. Attendees will learn to establish a plan for optimalhealth for themselves, their staff, their families and their patients.

Learning objectives:

• Learn the four pillars of optimal health

• Learn how the four pillars relate to personal health

• Learn how to formulate a plan to optimize personal health

• Learn how to implement a plan for optimization of oral and total bodyhealth for patients

This seminar is appropriate for dentists, dental hygienists and dental assistants.

Dr. Baldwin graduated from the University of Maryland Schoolof Dentistry in 1970. After serving for two years in the U.S.Army, he joined a practice as an associate dentist. He thentaught full-time for two years at the dental school, duringwhich time he opened a private practice in general dentistry

in Towson, Maryland in 1975. He received a master of science in nutritionfrom the Clayton College of Natural Health in 2005. He has been awarded amastership in the Academy of General Dentistry along with fellowship andaccreditation from the International Academy of Oral Medicine and Toxicology. Dr. Baldwin retired from active dentistry in 2008 and now practices nutritional counseling and mentoring in dental practices.

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Tuesday, July 28, 8 a.m.–10 a.m.

Mid-Atlantic P.A.N.D.A.—PreventingAbuse and Neglect Through DentalAwarenessSuzanne Kim, DDS

Mid-Atlantic Preventing Abuse and Neglect through Dental Awareness (P.A.N.D.A.) is a continuing education course designed toeducate dentists, dental hygienists, dental assistants and others aboutthe problems of child abuse and neglect, domestic violence, elder abuseand neglect, and human trafficking. This course aims to teach dental andother health care professionals to recognize the indicators of abuse andneglect and inform them of their legal and ethical responsibilities in reporting and referring victims. Abuse and neglect are an ever-increasingproblem in today’s society. Dental professionals are frequently the firsthealth care professional to render treatment to a maltreated individual,yet make few reports. The more education you receive, the more likelyyou are to recognize and report. Early recognition with timely reportingand referrals to appropriate agencies can help prevent more significanthealth consequences and even death in maltreated individuals.

Upon completion of this continuing education course participants willbe able to:

• Discuss the background of abuse and neglect, events of historical significance, and the effects of maltreatment of children, adults and the elderly.

• Define, identify facts, and discuss child abuse and neglect, domestic violence, vulnerable adults, elder abuse and neglect, and human trafficking.

• Describe the health care provider’s role and ethical and legal responsi-bility in reporting suspicious cases of maltreatment of children and vulnerable adults.

• Identify the problem of abuse and neglect from a dental health perspective.

• Identify local and national agencies to contact to appropriately reportsuspicious cases of maltreatment of children and vulnerable adults.

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• Describe the health care provider’s role in recognizing, reporting andreferring victims of domestic violence, elder abuse and neglect, andhuman trafficking.

• Discuss risk factors, indicators, screening questions, barriers to seekinghelp and education needed regarding abuse and neglect of children,domestic partners, vulnerable adults, elders and victims of human trafficking.

This seminar is appropriate for dentists, dental hygenists and dental assistants.

Dr. Suzanne Kim graduated in 1990 from Columbia School of Dental Medicine with a DDS degree. She has been in private practice since 1995 inBethesda, Maryland. Dr. Kim has been teaching P.A.N.D.A. for about fiveyears and has been involved with the local chamber of commerce, Rotary,churches and different study clubs. She has done pro bono work in Vietnam,Equador and in New Orleans, Louisiana after hurricane Katrina.

Tuesday, July 28, 8 a.m.–noon

The Complexities and Complications Associated with Restoring Dental ImplantsCarl F. Driscoll, DMD

The implant industry continues to grow at an astounding rate. Once reserved only for patients with unlimited financial capabilities, patientsof even moderate means are now receiving implant treatment. This presentation will focus on the complexities and complications that maybe seen during the course of this treatment. These complications mayactually be normal maintenance procedures that need to be identifiedprior to the start date of any proposed treatment and conveyed to thepatient. A clear picture of preventable and non-preventable complica-tions will be discussed. Attendees will be exposed to many differentcomplications involving implant treatment through numerous clinicalexamples. The handling of these complications will be discussed so thatthe attendee can better treat his/her patients when unfortunate eventsdictate immediate reconciliation.

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Learning objectives:

• Learn the complications that you may face with implants in your practice

• Learn methods to differentiate implant complications that are normalmaintenance issues from those that are not predictable

• Learn clinical techniques to make implant treatment less stressful toyou and the patient

• Learn methods to deal with implant complications

This presentation is appropriate for general dentists, prosthodontists, periodontists, oral and maxillofacial surgeons, hygienists and assistants.

Dr. Carl F. Driscoll received his DMD from Tufts University in1977. He completed a general practice residency at Ft. Meade,Maryland in 1978 and received his prosthodontic training atLetterman Army Medical Center in San Francisco in 1986. In1990, he completed a fellowship in maxillofacial prosthetics at

the National Naval Dental School in Bethesda, Maryland. Dr. Driscoll cur-rently serves as a professor at the University of Maryland Dental School andas director of the prosthodontic residency. He previously held the same position with the United States Army at Walter Reed Army Medical Center inWashington, DC from 1994-1997. Dr. Driscoll retired from the U.S. Army in1997 with the rank of colonel. Dr. Driscoll is a diplomate of the AmericanBoard of Prosthodontics and a fellow of the American College of Prostho-dontists. Dr. Driscoll is vice president of the American Board of Prosthodonticsand vice president of the American Academy of Fixed Prosthodontics. Dr. Driscoll has given over 225 presentations nationally and internationally,including in Sweden, Brazil, Germany, Korea, Japan, Singapore, Poland, Israel, Mexico, Canada, Brazil, Uruguay and the Marshall Islands. He has authored over 60 papers, abstracts and book chapters.

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Wednesday, July 29, 8 a.m.–noon

Everything You Wanted to KnowAbout Street Drugs But Were Afraidto AskHarold L. Crossley, DDS, PhD

What questions should I be asking my patients to avoid drug interactionswith street drugs? What are some of the oral manifestations of streetdrug abuse? How will I know if a person is under the influence of streetdrugs? What are the characteristics of and how do I manage the “doctorshopper”? Do I have to take any precautions with the dental patient whois under the influence? Why is it so important that the dental staff beknowledgeable about street drugs? Why am I at risk? What are somecharacteristics of adolescent substance abuse and what do I do about it?What if I know my teenager is abusing drugs?

The dental team is in a unique position providing dental care to a patientpopulation that may be regular users or experimenting with mood altering drugs. This dynamic, brutally honest, and graphic presentationwill provide you with the information to be better prepared to encounterpatients, family members and friends who are abusing street drugs orprescription medications. Discussion includes the origins, types, signsand symptoms of commonly abused prescription and illicit drugs.

Learn:

• The signs and symptoms of commonly abused prescription and illicitdrugs in patients and adolescents

• What medications to avoid with the suspected drug abusing patient

• How to recognize and manage the doctor shopper

• How to manage the recovering chemically-dependent patient

• What are “meth mouth,” “lean,” “whippets,” “parachuting,” “bath salts,”“Spice Diamond,” “Spice Gold” and more?

• How does my kid get intoxicated on hand sanitizer?

This seminar is appropriate for dentists, dental hygienists and dental assistants.

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Harold L. Crossley, DDS, PhD is professor emeritus at the University of Maryland Dental School. A native of Rhode Island,Dr. Crossley received a bachelor of science in pharmacy fromthe University of Rhode Island in 1964. He later was awardedmaster of science (1970) and doctoral degrees (1972) in phar-

macology. The University of Maryland Dental School in Baltimore awardedDr. Crossley his DDS in 1980. His role as liaison between the classroom andhis dental practice produced a practical approach to understanding thepharmacology of drugs used in the dental office.

Dr. Crossley has co-authored a number of articles and four books dealingwith a variety of topics within the field of pharmacology. Other areas of expertise include the pharmacology of street drugs and chemical dependency.Dr. Crossley serves on the Maryland State Dental Association’s Well-BeingCommittee, was a member of the University Interdisciplinary Committee for Drug Abuse Education and served on the Governor’s Commission on Prescription Drug Abuse. He is an active member of Phi Kappa Phi, OmicronKappa Upsilon Honorary Dental Society, the American College of Dentistsand the International College of Dentists. He has been a consultant for theUnited States Drug Enforcement Administration and other law enforcementagencies since 1974.

Drawing on this unique background, Dr. Crossley has become nationallyand internationally recognized as an expert on street drugs and chemicaldependency as well as the clinical pharmacology of dental drugs.

Thursday, July 30, 8 a.m.–noon

Infection Control Is Not Optional:Dental Practitioners Need to be InvolvedLouis G. DePaola, DDS, MS

Learn what’s new in infection control. In May 2011, the CDC reaffirmedthe importance of infection control with the release of the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care, which is an update of the Guideline for Isolation Precautions:Preventing Transmission of Infectious Agents in Healthcare Settings 2007and Guideline for Disinfection and Sterilization in Healthcare Facilities 2008.Included in these documents are recommendations for updating ofstandard precautions and there are significant modifications that impactthe delivery of health care. The alarming increase in antimicrobial resist-ance and health care associated infections (HAIs) compels all health careproviders to be knowledgeable about infection control practices that reduce the risk of disease transmission. A thorough review of these newCDC Guidelines as well as the Guideline for Infection Control in Dentistry,2003 and other current CDC/OSHA infection control recommendationswill be presented. Recent spread of Ebola virus has caused concern forall health care workers. This presentation will review both Ebola andpandemic influenza, and discuss what steps oral health providers shouldtake to reduce the potential of transmission in the dental office, as wellas lessons to be learned from recent infection control breaches in Colorado, Oklahoma and Pennsylvania.

This program will help the oral care provider to:

• Understand the routes of transmission of infectious diseases and howto break the chain of infection.

• Know the updated recommendations for standard precautions.

• Learn the principles of respiratory etiquette to reduce the impact ofcolds and flu.

• Learn how to develop a practical and cost effective infection controlmethodology to safely treat patients infected with resistant and blood

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borne diseases, achieve a safe workplace and comply with the mostcurrent CDC/OSHA recommendations.

• Review the latest on these topics: principles of infection control, hardsurface disinfection, instrument preparation and packaging, disinfec-tion and sterilization, operatory set up and breakdown, personal protective equipment, dental unit waterlines, and post-exposure moni-toring, follow-up and prophylaxis.

This seminar is appropriate for dentists, dental hygienists and dental assistants.

Dr. Louis DePaola is the assistant dean of clinical affairs andprofessor, Department of Oncology and Diagnostic Sciences,School of Dentistry, University of Maryland, Baltimore. He received his DDS in 1975, completed a master’s degree in oralbiology, is a diplomate of the American Board of Oral Medicine

and the American College of Dentists, and has a certificate in prosthodontics.He is the director for dental training for the PA-Mid-Atlantic AIDS Educationand Training Center and served as a member of the ADA Council of ScientificAffairs from 2002-2005. Well known on the lecture circuit, he has presentedat most major national meetings as well as numerous international organi-zations. Active in research, he has authored and co-authored over 130 journalarticles, book chapters and abstracts and serves as a consultant to theAmerican Dental Association and numerous other professional groups andprivate industry. Over the past 20 years, he has been awarded over 75 researchand service grants, many in the field of antiplaque chemotherapeutic agents,HIV/AIDS, management of medically compromised dental patients, rapid salivary diagnostic testing, dental unit waterlines and infection control.

Friday, July 31, 8 a.m.–noon

The Rapidly Evolving Field of DentalSleep MedicineElliott J. Alpher, BS, DDSOliver C. Roberson, DC, CSHEDavid Gergen, CDTCongressman Marty Russo (retired)

The rapidly evolving field of dental sleep medicine can be daunting tothe dentist, given the variety of appliances, techniques and protocolsavailable. A thorough understanding of the causes of sleep disorders,how patients develop their presenting symptoms and the relationshipbetween the temporomandibular joint and the cervical spine is neces-sary for successful treatment. In this lecture, the unique relationship ofthe temporomandibular joint, the cervical spine and the autonomicnervous system will be examined from both a dental sleep medicine andatlas orthogonist perspective. Protocols for examination, diagnosis, fabrication of the appropriate appliance, delivering the appliance andtitrating it for maximum effectiveness and home testing are all individualtechniques honed by applying learned skills. Accepted science and theproper protocols based on a thorough knowledge of temporomandibularjoint disorders, cervical spine anatomy, autonomic nervous system influences on the physiology of sleep and wakefulness and the uniqueproperties of the selected appliance will allow for greater success. Afterthis lecture, you will evaluate your patients more effectively.

Knowing this field is rapidly evolving, you will learn what the federalgovernment is doing about sleep issues and how the community needsto get involved. Dentists need to be part of the solution and not part of the problem and let their voices be heard.

Participants will learn

• The effect of an oral sleep appliance on the biomechanics of the entirebody, the temporomandibular joints, the cervical spine and the bio-chemistry of sleep.

• The connection between the jaw and cervical spine and how misalign-

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ment affects the jaw, neck and outcomes of oral sleep appliance therapy in dental sleep medicine.

• How to create a reasonable treatment protocol and titrate sleep appliances.

• Learn what the federal government is doing about sleep issues andhow you can be part of the solution and not part of the problem.

This seminar is appropriate for dentists, dental hygienists and dental assistants.

Dr. Elliott Alpher, one of Washington, D.C.’s most experiencedspecialists for sleep and jaw disorders, on staff at GeorgeWashington University and Georgetown University Hospitals,has been known as a leader in the treatment of sleep disordersand jaw pain for 25 years. He has pioneered a conservative,

noninvasive approach utilizing computerized and verifiable diagnosticmethods to treat TMJ, snoring and sleep apnea. Alpher was also recently responsible for heading a delegation to the Federal Motor Carrier Safety Administration (FMCSA) and Medical Advisory Board (MAB) to introduce thenew technology of compliance chips in oral appliances to treat and monitorsleep apnea and snoring of truckers and other transportation personnel. In addition, he earned the status of diplomate of the American Board ofCraniofacial Pain and Dental Sleep Medicine in October 2013 and boardmember and diplomate of the Board of the American Sleep and BreathingAcademy in March 2014. Dr. Alpher earned his bachelor of science in biologyfrom the University of Maryland and his doctorate of dental surgery fromGeorgetown University Dental School. He completed a residency program at Providence Hospital and postgraduate studies in oral pathology and periodontics at the Walter Reed Army Institute of Research.

Dr. Oliver Roberson began his professional career in the U.S.Naval Nuclear Submarine service in mechanical engineeringand weapons maintenance, after 10 years transitioning into a health care career. He believed that his engineering back-ground would assist him and be useful in understanding the

complexities of the human body. Dr. Roberson is a cum laude graduate ofLife University College of Chiropractic in Atlanta, Georgia and Excelsior University in New York. Initially specializing in sacral occipital technique(SOT), Dr. Roberson has since devoted years of post-graduate study to atlasorthogonal procedures, ergonomics assessment, clinical biomechanics,

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rehabilitation, sports injuries and somatic muscle re-education. Roberson isa member of the American Chiropractic Association, American Academy ofSpine Physicians, American College of Sports Medicine and Academy ofSpinal Biomechanics and Rehabilitation. He treats and specializes in numer-ous sports-related injuries as well as upper cervical specific conditions, sleepapnea, TMJ disorder, myofascial pain, headaches and chronic pain.

Dr. David Gergen is the president of Pro Player Health Allianceand owner and operator of Gergen’s Orthodontic Lab inPhoenix, Arizona. He started his lab in 1986 and has grown itinto one of the most respected labs in the country employingover 40 people. One of his proudest achievements is receiving

the National Leadership Award for Arizona Small Businessman of the Year in2004. Since receiving the award for Finest Orthodontic Technician in thecountry given by Columbus Dental in 1986, he has worked for some of thepioneers in the orthodontic and sleep dentistry fields. He was the personaltechnician for Dr. Harold Gelb, Dr. Robert Ricketts, Dr. Ronald Roth, Dr. A.Paul Serrano, Dr. Clark Jones, Dr. Arthur Gaus, Dr. Joseph R. Cohen and Dr. Edward Spiegel. He has also taught orthodontic technicians at ArizonaInstitute of Technology for dental and medical careers and has been activeon the Arizona State University Sports and Medicine team since 1991. In2012 he received a lifetime achievement award by the Gelb Academy asAmerica’s greatest orthodontic technician of all time.

Marty Russo earned his BA and JD from DePaul University, and has a lifetime of experience in the hallways of the U.S. Congress. A Chicago native, he was first elected to the U.S.House of Representatives at age thirty, going on to representthe 3rd District of Illinois for nine terms. An energetic advocate

for good government, Russo developed a wide range of friendships on bothsides of the political aisle and was known for his deep understanding of thelegislative process and strategies for success, serving on key House commit-tees including Ways and Means, Budget, Steering and Policy, Energy andCommerce, Small Business, Judiciary, and as a member of House Democraticleadership (Floor Whip). After leaving Congress, Russo served as CEO of oneof the premier government relations firms, representing hundreds of nonprofits, corporations and associations. Currently he is a successful entrepreneur and an active speaker and lecturer on leadership topics.

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General Information

Location

Clarion Resort Fontainebleau Hotel10100 Coastal HighwayOcean City, Maryland 21842-2698

The Clarion Resort Fontainebleau Hotel is located between 100th Street and Old Landing Road in Ocean City, Maryland.Look for the Clarion Hotel sign on theocean side.

Conference Parking

Ample free parking is available surround-ing the hotel. Additional free parking islocated across the street. Both parkinglots have “Clarion Hotel” signs.

Accommodations

The Clarion Resort Fontainebleau Hotel is one of Ocean City’s finest full-servicehotels. Located directly on the beachoverlooking the Atlantic Ocean, the Clarion offers the ultimate in comfort. In addition to the standard accommoda-tions, the hotel also provides room service; free weekday newspapers; giftshop; beauty shops; bellman; in-room microwaves, refrigerators and safes; twoocean-front restaurants; nightclub; liveentertainment both inside and on thebeach; fitness center and sauna; heatedindoor and outdoor pools. This hotel isclose to area attractions and outlet shop-ping. The Ocean City airport is only ninemiles from the hotel. The Clarion is a convenient drive from Baltimore, Wash-ington, D.C., Philadelphia and New York. A limited number of rooms have been reserved at a special reduced room rate.Interested participants should contactthe hotel directly at 800-638-2100 andask for the Summer Dental Symposiumgroup rate. Reservations must be madeby June 29, 2015. For more informationabout the hotel, visitwww.clarionoc.com.

Registration

Online—To pay with a credit card or check,please visit www.udel.edu/dental.

Fax—To pay by credit card, purchaseorder or government voucher, fax formon the next page to 302-831-0701.

Phone—Have your credit card and courseinformation ready, then call 302-831-7600, weekdays.

Mail—Please see form on the next page.You can also download the registrationform at www.udel.edu/dental.

Price

Symposium registration weekly rate is$750 for dentists and $375 for dental hygienists or other team members. Thedaily rate is $225 for dentists and $100 fordental hygienists or other team members.The P.A.N.D.A. course is $150 for dentistsand $75 for dental hygenists or otherteam members.

The registration fee includes seminar instruction, course materials, certificatesof attendance and continental breakfasteach day. Participants assume responsi-bility for living accommodations and allother meals.

Refund Policy

A full refund will be given for written cancellations received before July 20, 2015.No refunds will be given after this date.The University of Delaware is not respon-sible for any cancellation or change feesassessed by airlines or travel agencies.

For More Information

If you have any questions about this conference, please call 302-831-3474, or write to [email protected].

Registration FormContinuing Dental Education Summer Symposium

July 27–31, 2015n Mr. n Ms. n Dr.

Name ____________________________________________Degree____________________

Name as you would like on your name badge ______________________________________

Email address ________________________________________________________________

Employer __________________________________________________________________

Home address ______________________________________________________________

City ________________________________State ____________Zip __________________

Telephone __________________________________________________________________

How did you hear about the symposium?

Symposium Registration Fee—Full payment is due with registration. Please indicate theprogram(s) you wish to attend. If you are registering for the week, please select the Tuesdayseminar you wish to attend.

Enclosed is my check for $ ____________ made payable to the University of Delaware.When you provide a check as payment, you authorize us either to use the information from your check to make a one-time electronic funds transfer from your account or to process the account as a check transaction.

Please charge $ ________ to my n Visa n MasterCard n American Express n Discover

Card No. _______________________________________________ Exp. Date ____________

Security Code (on back of card) ___________________

Authorized Signature __________________________________________________________

Registrants are responsible for all fees unless written cancellation is received by July 20, 2015. Please duplicate form for additional enrollments.

Dentist rate:nWeekly ......................................$750 ............(200-001)n Mon. (Nutrition) ....................$225 ............(201-001) n Tues. (P.A.N.D.A.) ....................$150 ............(202-001)n Tues. (Implants)......................$225 ............(202-003)nWed. (Street Drugs) ..............$225 ............(203-001)n Thurs. (Infection Control) ..$225 ............(204-001)n Fri. (Sleep Medicine) ............$225 ............(205-001)

Dental Hygienist/Team Member rate:nWeekly ......................................$375 ............(200-002)n Mon. (Nutrition) ....................$100 ............(201-002)n Tues. (P.A.N.D.A.) ....................$75 ..............(202-002)n Tues. (Implants)......................$100 ............(202-004)nWed. (Street Drugs) ..............$100 ............(203-002)n Thurs. (Infection Control) ..$100 ............ (204-002)n Fri. (Sleep Medicine) ............$100 ............(205-002)

Return to: Continuing Dental Education Summer Symposium, University of DelawareDivision of Professional and Continuing Studies, 201 John M. Clayton Hall, Newark, DE 19716-7410Attn: RegistrarPhone: 302-831-7600, Fax: 302-831-0701

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n Postcardn AGD websiten DCEdental Newslettern NJ Dental Association Journaln Virginia Dental Association website

n EmailnWeb searchnWord of mouthn Other (please specify)_____________________________________


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