2018 A Regional Dental Conference JUNE 5-10, 2018 PERDIDO BEACH RESORT ORANGE BEACH, ALABAMA
Featuring the 149th Annual Session of the Alabama Dental Association PRE-REGISTRATION INFORMATION • REGISTER ONLINE AT GULFCOASTDENTALCONFERENCE.ORG #GULFCOASTDENTALCONFERENCE • JOIN OUR SOCIAL MEDIA CONTEST!!! TABLE OF CONTENTS
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2018 Continuing Education ...... 4-9 A Regional Dental Conference ALDA Annual Session ...... 10 Continuing Education that focuses on clinical growth and practice success served with Alabama hospitality Exhibits ...... 10 ALDA President Gordon Isbell and his family invite Special Events ...... 11 you to join us for the fourth annual Gulf Coast Dental Conference, a regional dental conference produced Frequently Asked Questions . . . . .12 by the Alabama Dental Association, a membership Conference at a Glance ...... 12 organization of 1,700 Alabama dentists. Dentists and members of the dental team from all over Registration Forms ...... 13-14 the Southeast and beyond will gather on Alabama's beautiful gulf coast for over 70 hours of high quality, Hotel Registration . . Inside Back Cover innovative continuing education that's relevant to Sponsors ...... Back Cover Gordon and Cindy Isbell clinical growth and practice success. Unsurpassed networking opportunities abound with a two-day Exhibit Show featuring 75+ commercial exhibits and numerous social events, entertainment and family-fun outings. It’s the perfect mix of business and pleasure! Bring your family, friends and office staff! You won’t want to miss this exciting experience! DYNAMIC • FUN • INNOVATIVE • INSPIRATIONAL • RELEVANT 2018 GCDC PLANNING COUNCIL General Chairs Dr. Mike Edwards Dr. John Barnes Program Our Focus Dr. Jennifer Doobrow, Co-Chair/2017 General Chair Is On You and Dr. Ross Isbell, Co-Chair Dr. Mike Edwards Dr. John Barnes Dr. Jennifer Dr. Ross Isbell Dr. George Your Team! Entertainment Doobrow Petznick Dr. George Petznick, Chair The GCDC focuses Committee: Dr. Adolphus Jackson on clinical growth and Dr. Mike Williamson Hospitality practice success for: Dr. Glen Brawley, Co-Chair Dr. Joe Hastings, Co-Chair General Dentists Hygienists Dr. Adolphus Dr. Mike Dr. Glen Brawley Dr. Joe Hastings Dr. Michael Corporate Sponsors Jackson Williamson Maniscalco Dr. Michael Maniscalco, Chair Specialists Dental Assistants Committee: Dr. Mike O’Brien New Dentists Lab Technicians Dr. Art Steineker Dental Students Office Managers Exhibits Dr. Bud Rogers, Co-Chair Dr. Bill Chesser, Co-Chair Registration Dr. Mike O’Brien Dr. Art Steineker Dr. Bud Rogers Dr. Bill Chesser Dr. Steve Dr. Steve Frederick, Chair Frederick Committee: SOCIAL MEDIA Dr. Clay Ellis Dr. Randy Hawkins CONTEST Dr. Noah Miller Dr. Kim Whitt Visit the Social Media Booth in registration Speaker Hosts Dr. Parrish King, Chair June 5-9 and take your photo, featuring the Dr. Clay Ellis Dr. Randy Hawkins Dr. Noah Miller Dr. Kim Whitt Dr. Parrish King Committee: reason why you attend the GCDC. Upload Dr. Mark Summerford Dr. Kyle Trammell to Facebook, Twitter or Instagram to be Photographer entered in the contest. Dr. Mathew Litz 2019 General Chair Go to aldaonline.org Dr. Deborah Bishop for more information. Annual Prayer Breakfast Dr. Mark Dr. Kyle Trammell Dr.Matthew Litz Dr. Deborah Dr. Steve Mitchell Dr. Steve Mitchell Summerford Bishop 2
REGISTRATION TUESDAY, JUNE 5 INFORMATION Noon ALDA Annual Session: Executive Committee 3:00 - 5:00 pm Registration REGISTRATION 4:00 pm ALDA Annual Session: Board of Trustees WEDNESDAY, JUNE 6 Register Online at gulfcoastdentalconference.org 8:00 am - 4:00 pm Registration Early pre-registration is encouraged in order to receive 8:30 am - 12:30 pm CPR (4 CEUs) lower registration fees and ticket prices. Name badges 9:00 - 4:30 pm Dr. Mark Hyman, “A Day in the Life of a Top Gun Dental Team: Bullet Proof Case and tickets for pre-registered attendees will be mailed Acceptance” (6 CEUs) to the primary registrant (dentist) two weeks prior to the Noon Past Presidents’ Luncheon meeting. Registration packets (including name badges 1:30 - 4:30 pm Tennli Nelson, “Patient Relationship Management: Taking Care to the Next Level” and tickets) will be distributed onsite for all attendees who (3 CEUs) register after May 30. Name badges will be required for 3:30 pm ALDA Annual Session: House of Delegates/ General Assembly admittance to all events and the Exhibit Hall. Registration 5:30 - 7:00 pm Kick-Off Pool Party hours are as follows: THURSDAY, JUNE 7 8:00 - 4:00 pm Registration June 5, 3:00 pm - 5:00 pm June 8, 8:00 am - 4:00 pm 8:00 - 1:00 pm Exhibitor Registration June 6, 8:00 am - 4:00 pm June 9, 8:00 am - 10:00 am 8:30 am - Noon Dr. Roy Sonkin, “Forensic Odontology: CSI It Ain’t!” (3.5 CEUs) June 7, 8:00 am - 4:00 pm 9:00 am ALDA Annual Session: Reference Committee 9:00 am - 4:30 pm Dr. Howard Glazer, “I Have It…You Need It! Must Have Products and Materials” In addition to the meeting registration fee, appropriate (6 CEUs) fees for certain courses or activities will apply. There is Noon Voyagers Cooking Demonstration and Luncheon no meeting registration fee for spouses, children or Noon - 6:00 pm Exhibit Hall Open non-dentist guests. 1:00 - 5:00 pm Dr. Ross Nash, “Hands-On Workshop” Presented by Coltene (4 CEUs) Before After 1:30 - 3:30 pm Dr. Roy Sonkin, “Forensic Odontology: CSI It Ain’t! Hands-On Workshop” (2 CEUs) May 11 May 11 On-Site 4:30 - 6:00 pm Exhibit Hall “Sip, Spend & Save” Cocktail Reception ADA Member Dentist* $250 $300 $350 FRIDAY, JUNE 8 ALDA Member Dentist* $250 $300 $350 7:00 - 8:30 am Dental Prayer Breakfast Military/Federal Dentist $250 $300 $350 7:30 am AGD Board of Directors Meeting ADA Non-Member Dentist* $600 $650 $775 8:00 am Exhibit Hall “Muffins & Mimosas” Breakfast Open House Retired ADA Member* $0 $0 $0 8:00 - 2:00 pm Exhibit Hall Open 8:00 - 4:00 pm Registration Student/ Resident ASDA Member $0 $0 $0 9:00 am - Noon Dr. Howard Glazer, Hands-On Workshop: “Composites Can Be Beautiful!” (3 CEUs) Dental Hygienist $50 $60 $70 9:00 am - 4:30 pm Dr. Scott Maclean, “Hot Topics in Implant Dentistry” (6 CEUs) Dental Assistant $50 $60 $70 9:00 am - Noon Dr. Mick Falkel, “Local Anesthesia Potpourri: From Complications to Success” Office Staff $50 $60 $70 (3 CEUs) Lab Technician $50 $60 $70 9:00 am - 4:30 pm Dr. Chris Salierno, “How Not to Fail Miserably in Private Practice” (6 CEUs) Dentist Spouse $0 $0 $0 Noon Alabama Dental Alumni Luncheon Non-Dentist Guest $0 $0 $0 1:30 - 4:30 pm Infection Control, Dr. Roy Sonkin, “Not Just a Four Letter Word and a Female Hippopotamus: OSHA and HIPAA Myths and Realities” (3 CEUs) Youth (ages 4-10) $0 $0 $0 1:30 - 4:30 pm Dr. Mick Falkel, “Technique, Anatomy and Physiology in the Digital Era” (3 CEUs) Child (ages 0-3) $0 $0 $0 5:00 - 6:00 pm Alabama Society of Periodontists Reception *ADA = American Dental Association 8:00 - 9:30 pm Beach Bonfire and Ghost Crab Hunt All ADA members from any state are eligible to register as Rate A. Presented by the Council on the New Dentist ADA membership will be verified. Sponsored by Patterson Dental Supply CONTINUING EDUCATION SATURDAY, JUNE 9 7:00 am ACD Business Meeting Most courses qualify for continuing education credit 7:30 am ACD/ ICD Joint Breakfast accepted by the Board of Dental Examiners of Alabama 7:30 - 8:30 am ProAssurance Dental Loss Prevention Seminar (1 CEU) (BDEA). The number of CE hours (CEUs) is 8:00 am ICD Business Meeting noted following each course synopsis. 8:00 - 10:00 am Registration Approved PACE Program Provider 8:00 - 11:00 am Alabama Medicaid (2 CEUs) FAGD/MAGD Credit 9:00 am - Noon Dr. Scott Maclean, “Hot Topics in Implant Dentistry – Hands-On Workshop” (6 CEUs) Approval does not imply acceptance by a state or 9:00 am - Noon Tennli Nelson, “Trusting Tech: Integrating Technology while Managing Patient provincial board of dentistry or AGD endorsement 2/1/2017 to 1/31/2019 Relationships” (3 CEUs) Provider ID# 219230 9:00 am - 4:30 pm Dr. Ross and Debra Nash, “Esthetics in Action” (6 CEUs) 10:00 am - Noon Board of Dental Examiners “Alabama Dental Hygiene Program Instructor Certification Training” (2 CEUs) CHILDCARE SERVICES 11:00 am Alabama Society of Oral & Maxillofacial Surgeons Business Meeting There is a licensed babysitting service available in the 11:00 am Alabama Academy of Pediatric Dentists Business Meeting area. Sitters will care for children in their parents’ room. 2:00 pm ALDA Annual Session: House of Delegates The approximate cost for one child is $40.00 for 4 hours. 6:30 pm President’s Beach Party featuring live music by 8 Track Rewind Fees are subject to change. Please contact the 9:30 pm Fireworks Show on the Beach babysitting service directly to make arrangements. SUNDAY, JUNE 10 Nanny’s Care 251.986.8200 [email protected] 9:00 am ALDA Annual Session: Member Recognition Breakfast 3 CONTINUING EDUCATION WEDNESDAY, JUNE 6
CPR PATIENT RELATIONSHIP MANAGEMENT: Conducted by the Orange Beach Fire and Rescue Department TAKING CARE TO THE NEXT LEVEL Wednesday, June 6 / 8:30 am - 12:30 pm Presented by Solution Reach EVENT CODE: CPR Wednesday, June 6 / 1:30 - 4:30 PM FEE: $65/$85* PER DENTIST OR STAFF MEMBER EVENT CODE: NE1 / FEE: NO CHARGE *Registration increases after May 11 This course is recommended for the entire dental team. This course is recommended for the entire dental office team. TENNLI NELSON This American Heart Association program consists of a lecture, hands- Tennli Nelson is the Vice President of Sales and Business on practical skills and a written exam. Upon completion, participants Development at Solution Reach. Her position provides will be able to recognize and respond to cardiac and obstructed airway her the opportunity to travel across the country, engaging emergencies. Certification is effective for two years. Wear casual clothing. with dental practitioners and companies, to understand the ongoing patient engagement needs and pain points. 4 CEUs Over the last 12 years, she has been an integral part of developing a communication platform that helps bridge the gap between A DAY IN THE LIFE OF A TOP GUN DENTAL TEAM the practice and the patient, introducing technology and behavior change BULLET PROOF CASE ACCEPTANCE that provides immediate solutions. Sponsored by Solution Reach SYNOPSIS: When patients quit coming back to a practice, it is often for Wednesday, June 6 / 9:00 am - 4:30 pm different reasons than providers assume. Doctors recently surveyed said 80 percent of patients who do not return had either moved or changed EVENT CODE: HYM / FEE: NO CHARGE to an insurance plan the practice doesn’t accept – but only 38 percent This course is recommended for the entire dental team. of patients who changed doctors cited those reasons. Conversely, the MARK E. HYMAN, DDS, MAGD survey found doctors believe only 22 percent of patients switch for better Dr. Mark Hyman is a renowned, full-time practicing dentist in treatment or service. In reality, 58 percent of patients cited that exact Greensboro, NC. His work is characterized by his warmth, reason for switching. The bottom line: if you’re not connecting with enthusiasm, sense of humor and passion for dentistry. patients and actively engaging with them, you’re going to have a harder As an accomplished speaker, Dr. Hyman has lectured time keeping your current patients – or attracting new ones. However, throughout North America and internationally receiving connecting with patients isn’t just about sending email blasts or calling rave reviews. For the past fourteen years, Dentistry Today them with appointment reminders. It’s about truly engaging them in a magazine has selected Dr. Hyman as one of the top 100 speakers in meaningful way that elevates their care. Explore tactics on how providers dentistry. He is an Adjunct Full Professor at the UNC School of Dentistry in faced with limited time and resources can offer ongoing, relevant and Chapel Hill, NC, has taught at the Pankey Institute in Florida and at Spear actionable communication to every patient. Education in Arizona. Get ready to laugh and learn during a unique day that 3 CEUS promises to transform your entire team! SYNOPSIS: Listen, learn, and laugh your way through a fast paced, humorous review of “A Day in the Life” of a dynamic real world private dental practice. • Learn how to capitalize on one another’s skills to improve the productivity of your practice and the quality of the service your team produces • Review clinical cases from the Dr., consultant, and team’s perspective • Debate the fact that “Communication is a wonderful thing - we should try it sometime!” • Learn systems you can implement today to lower stress, prevent burnout, and increase your enjoyment of dentistry • Discover how to take what seems to be ordinary pieces of your practice and turn it into extraordinary internal marketing that has your patients raving about you to their friends and family 6 CEUS
4 THURSDAY, JUNE 7
FORENSIC ODONTOLOGY: I HAVE IT…YOU NEED IT! CSI IT AIN’T! MUST HAVE PRODUCTS AND MATERIALS Thursday, June 7 / 8:30 am - Noon Sponsored in part by Alabama Academy of General Dentistry EVENT CODE: SO1 / Fee: No Charge Thursday, June 7 / 9:00 am - 4:30 pm This course is recommended for the entire dental team. EVENT CODE: GL1 / Fee: No Charge ROY SONKIN, DDS This course is recommended for the entire dental team. SYNOPSIS: Deployment as a Forensic HOWARD S. GLAZER, DDS, FAGD Odontologist is physical, emotionally Dr. Howard Glazer is a Fellow and Past President of the Academy of General and intellectually demanding. It taps into Dentistry, and former Assistant Clinical Professor in Dentistry at the Albert the need to be a provider of services Einstein College of Medicine (Bronx, NY). He is a Fellow of the American with reverence and respect to the College of Dentists, International College of Dentists, American Society friends and families who are seeking the for Dental Aesthetics, the American Academy of Forensic Sciences, and identification and repatriation of their a Diplomate of the American Board of Aesthetic Dentistry. Dr. Glazer is an loved ones to achieve some sense of closure for their Attending Dentist at the Englewood Hospital (Englewood, NJ). Additionally, loss. Attendees will gain knowledge and insight into the he is the Deputy Chief Forensic Dental Consultant to the Office of Chief Medical Examiner, City use of forensic odontology and the various hurdles one of New York. must overcome. For the past several years, Dr. Glazer has been named as one of the “Leading Clinicians in The history and evolution of forensic odontology will be Continuing Education” by Dentistry Today, and most recently was named as one of the Top discussed, featuring the speaker’s experiences at the Dentists in New Jersey by New Jersey Monthly & 201 Magazine. He lectures throughout the World Trade Center, Hurricanes Rita and Katrina, the United States, Canada, and overseas, on the subjects of dental materials, cosmetic dentistry, Rio Tinto Helicopter Crash in Peru, the Battle of Saipan forensic dentistry and patient management. Additionally, Dr. Glazer is a frequent author of in the Philippines and others. dental articles and has been published throughout the world. Currently he publishes a monthly Following the presentation, a limited number of column in AGD IMPACT entitled “What’s Hot and What’s Getting Hotter!” He maintains a attendees will have the opportunity to participate in a general practice in Fort Lee, NJ. two-hour hands-on workshop. (see below) SYNOPSIS: This is a program about real dentistry for real people by a real dentist! Dr. Glazer OBJECTIVES: will present a potpourri of the materials and techniques that he uses to make the day more productive, easier and fun! The entire dental team will benefit from learning together about the • To gain knowledge of the history of forensic latest products and how they will benefit your patients. Dr. Glazer writes a monthly column by odontology the same title for AGD Impact magazine, and reviews new products and materials on a regular • To visit mass disaster identification in Peru, Saipan, basis for his column. Mississippi and Louisiana TOPICS MAY INCLUDE: • To be exposed to several odontologic techniques in • Curing lights…to light up your life the identification process • Desensitization & Adhesives…a sticky subject made simple 3.5 CEUs • Composites for esthetic fillings…not just white ones • Impression materials...it’s true…first impressions are important FORENSIC ODONTOLOGY: CSI IT AIN’T! - • Provisional materials…provisionals should look great A Hands-On Workshop • Burs…so many and so little time Limited to 25 participants. Completion of morning • Lasers…simple, easy and quick w/ great results lecture required for participation. • Endodontic instruments…getting to the root of the matter Thursday, June 7 / 1:30 - 3:30 pm • Cements...that which holds the relationship together EVENT CODE: SO2 • Tissue retraction and fluid control...essentials of clear fields Fee: $75/$95* per dentist • Reducing Sensitivity with topical paste application & Fluoride varnishes *Registration increases after May 11 • Matrix bands for perfect, predictable contacts…contact perfect every time This course is recommended for dentists. • Whitening systems that work ROY SONKIN, DDS • Oral cancer prevention…dentists can save lives SYNOPSIS: Antemortem and postmortem radiographs • Patient communication…high-tech and really cool will be provided. Newly acquired skills will be tested to • Going Digital…simple, easy and soon to be a must make positive identifications. • Loupes, instruments, equipment potpourri Both the seasoned veteran and the neophyte will learn OBJECTIVES: from this presentation so that they better understand 1. To learn the different types of materials in various product categories the role of the forensic dentist during deployment in a 2. To learn what is faster, easier and better mass fatality incident. 3. To be able to evaluate product claims and merit 2 CEUs 4. To understand the benefits of buffered anesthesia 5. To understand the value of continual doctor/patient communication 6. To understand how to utilize many of the newer bioactive materials 6 CEUs 5
THURSDAY, JUNE 7 CONTINUING EDUCATION •FRIDAY, JUNE 8
THE VALUE OF CONSERVING AND HOT TOPICS IN IMPLANT DENTISTRY PRESERVING FROM THE INSIDE OUT: Presented by Nobel Biocare A MINIMAL INTERVENTION APPROACH Friday, June 8 / 9:00 am - 4:30 pm TO RESTORING TEETH EVENT CODE: MA1 / Fee: No Charge HANDS-ON WORKSHOP This course is recommended for the entire dental office team. Limited to Presented by Coltene SCOTT MACLEAN, DDS FACD FICD FADI FPFA Thursday, June 7 / 1:00 - 5:00 pm Dr. Scott MacLean has a dental YouTube site with over 2.7 million views. He EVENT CODE: NA1 / $75/$95* per dentist is a key opinion leader for Nobel Biocare, Digital Smile Design, Seattle Study *Registration increases after May 11 Club, Aurum Ceramics and 3M ESPE. This course is recommended for dentists. Dr. MacLean has a full-time dental practice in Halifax, Nova Scotia, focusing Limited to 25 attendees on implant and restorative dentistry. He is a part-time clinical instructor at Dalhousie University School of Dentistry. He previously taught the Dental ROSS W. NASH, DDS Implant Elective at Dalhousie for approximately 10 years. Dr. MacLean is a beta tester Dr. Ross Nash maintains a full-time private for a major implant dental company and has been involved with designing implants practice in Charlotte, North Carolina, where and components. He has published numerous papers on implant dentistry and digital he focuses on cosmetic and esthetic dental communication. treatment. He presents lectures and hands on He is a director at the Seattle Study Club in Atlantic, Canada. His fellowships include the workshops nationally and internationally on American College of Dentists, the International College of Dentists, the Academy of Dentistry dental esthetics, full mouth rehabilitation and International, and the Pierre Fauchard Academy. He is past President of his Provinicial (State) dental materials. Dr. Nash is an author and Dental Association and has held many positions both locally and nationally. During his dental editorial advisor to numerous dental publications and has studies, he was class president and valedictorian of his class. authored a chapter for two textbooks on esthetic dentistry. He is founder of the Nash Institute for Dental Learning in SYNOPSIS: This lecture will give you a sneak peak of the digital dentistry role as it relates Huntersville, NC, where he teaches esthetic and cosmetic to dental implants, crowns and guided surgery. The audience will explore the IOS intraoral dental procedures and full mouth rehabilitation for the scanning connection to STL files and the relationship to the digital workflow. Dr. MacLean general practice. Dr. Nash is a member of the ADA, and his makes the topic very easy to understand using detailed videos and visuals. component dental societies. He is an accredited member “Smart Fusion” technology is the newest digital planning and placement tool that every and fellow in the American Academy of Cosmetic Dentistry. person on the implant team should understand. The digital treatment workflow has become When he isn’t talking about dentistry, or teaching about a tool to make easy and predictable planning for implant cases from the simple cases to the dentistry, he is doing dentistry! most complex cases. Dr. MacLean will show the most advanced treatment planning tools SYNOPSIS: This dynamic educational workshop focuses for creating excellence in implant dentistry. Participants are encouraged to bring their IPADS on the practical application of minimally invasive restoration and or laptops to this unique treatment planning event. Cases will be digitally shared allowing into your dental practice. Attendees will learn how to use for a real time view of how Nobel Clinician and Nobel Procera technology are integrated. new materials and technologies to preserve tooth structure The dental team will visually see how important this breakthrough is to create an ideal and provide affordable, life-enhancing treatments for their prosthetic table for the “All on 4” cases. Learn where the implant go on these full arch cases. patients. Understand how much prosthetic space is required for bar fabrication. Plan for long-term success! During this fast-paced course, attendees will learn about biomechanical function and preservation of tooth structure The second part of this lecture will focus on the ASC abutment. “Angulated screw channel» during bulk filling, bonding and composite restoration technology was developed to improve the screw retained options for the implant team. procedures. Minimally invasive concepts and methods Dr. MacLean will show how this technology works and offer reasons why it should be are explored using a combination of lecture and hands-on considered. Dr. MacLean will show how to immediately place implants, immediately exercises in three modules. temporize them, how to use custom impression coping, and design ASC screw retained crowns. The technology is now available to easily offer advanced custom work with amazing • Module 1: Dentin substitution using a biomimetic bulk-fill outcomes. Dr. MacLean will share some very valuable soft tissue tricks. The abutment and composite material (tooth #3, MOD-LI, class II) the new screws and tool required will be discussed to enable the clinician to start using • Module 3: Freehand restoration using a next-generation this technology immediately. Even if you do not do screw-retained options, this lecture universal submicron composite (anterior class IV, tooth #9) will demonstrate why this technology will improve your cement retained outcomes as well. 4 CEUs This technology will revolutionize the implant world and improves the delivery of care in your practice. Dr. MacLean has over 2.7 million views on YouTube. Come and see what the social media world is tuning in to see! Dr. MacLean will show how important it is to work with Dental Technicians and teams that understand these technologies. Come see why the implant world is buzzing with enthusiasm! • Understand IOS intraoral scanning and how it relates to implant dentistry • Understand dental implant screw retained options and why they are important • Understand immediate placement and temporization using the digital workflow • Understand how to scan dental implants for restorations 6 CEUs 6
CONTINUING EDUCATION •FRIDAY, JUNE 8
COMPOSITES CAN BE BEAUTIFUL! LOCAL ANESTHESIA POTPOURRI: COMPOSITE LAYERING AND CLASS II FROM COMPLICATIONS TO SUCCESS RESTORATION – HANDS-ON WORKSHOP Friday, June 8 Friday, June 8 / 9:00 am - Noon Morning Session 9:00 am - Noon EVENT CODE: GL2 / Fee: $75/$95* per dentist LOCAL ANESTHESIA – TECHNIQUE, ANATOMY *Registration increases after May 11 AND PHYSIOLOGY IN THE DIGITAL ERA This course is recommended for dentists. Friday, June 8 Limited to 36 Participants Afternoon Session 1:30 – 4:30 pm HOWARD S. GLAZER, DDS, FAGD EVENT CODE: FAL / Fee: No Charge This course is recommended for the entire dental office team. See Bio on Page 5 MICHAEL I. FALKEL, D.D.S SYNOPSIS: This will be a program integrating didactic material and hands- Dr. Falkel is a class of 1987 graduate of University of the Pacific, Arthur A. on experience with anterior and posterior Dugoni School of Dentistry in San Francisco, California. He completed his composites in addition to “no flow flowables.” general practice residency at the Veterans Administration Hospital at West Participants will be offered an opportunity Los Angeles and has been in general practice in Monterey, California, to explore the technique of layering and since 1989. Having experienced frustration with the performance of blending composite shades to ensure an local anesthetic in his practice, particularly around the frequency of failed aesthetic result using the latest state-of-the-art composite anesthetic, delayed onset, injection pain and post-operative discomfort, he began research resins. Suggestions on the use and securing of a matrix, as into the pharmacokinetics of dental anesthetic. Based on this research, he has developed well as finishing and polishing will also be discussed and an alternative new paradigm in anesthetic delivery science for dentistry. Dr. Falkel is the demonstrated. Intra-occlusal splinting will be included using founder of Onpharma Inc., an anesthetic technology and products company. resin impregnated quartz fibers. Participants will have a first- MORNING SESSION: This course covers topics including: pharmacology of local hand opportunity to try these techniques on models. anesthetics, chemistry, formulation, physiology, local anesthetics and infected tissue and COURSE OBJECTIVES: buffering; causes of injection pain; measuring and achieving anesthetic success, definition 1. to understand the structure of dentin and enamel as they of success, failures and consequences of failed anesthetic, how to eliminate certain types relate to shade of failures; real time course of analgesia in dentistry, anesthetic performance background, clinical data review of time course of analgesia, impact of time course to the daily practice, 2. to understand the layering concept in order to apply products that improve the time course of analgesia; and local complications of anesthetic composites to anterior and posterior restorations injections, ten most common complications. 3. to learn how to finish and polish restorations LEARNING OBJECTIVES: 4. to learn to properly place and secure matrix for perfect • Review pharmacology of local anesthesia contacts • Understand injection pain and its implications 3 CEUs • Participant will be able to (a) describe the causes, (b) properly diagnose, and (c) treatment plan the effective management of local anesthetic complications. 3 CEUS AFTERNOON SESSION: This presentation will focus on the techniques and anatomy for all dental injections through an exciting, novel digital teaching modality. Visualization of vital structures and anatomical landmarks will be delivered in an unforgettable approach using CT and MRI scan data with 3D volume rendering and maximum intensity imaging. Utilizing this teaching approach can make all techniques easier, safer and more effective. LEARNING OBJECTIVES: 1. Feel confident delivering local anesthesia by having a thorough review of head and neck anatomy 2. Describe all dental block and infiltration injection techniques to achieve comfortable and effective anesthesia for all procedures 3. Describe how to reduce anesthetic failures, decrease stress associated with delivering anesthetic for both the patient and the dental provider. 3 CEUS
7 CONTINUING EDUCATION FRIDAY, JUNE 8 SATURDAY, JUNE 9
HOW NOT TO FAIL MISERABLY IN PRIVATE PRACTICE A CRACKED TOOTH HURTS – Sponsored in part by Alabama Academy of General Dentistry A CRACKED FOUNDATION IS DANGEROUS Friday, June 8 Presented by ProAssurance 9:00 am - 4:30 pm Saturday, June 9 / 7:30 - 8:30 am EVENT CODE: SAL / Fee: No Charge EVENT CODE: PRO / Fee: No Charge This course is recommended for the entire dental office team. This course is recommended for dentists. CHRIS SALIERNO, DDS A key building block of a successful dental practice is having a good risk management foundation. Planning for unexpected cracks in the Dr. Chris Salierno is a general dentist from Long Island, New foundation makes them more manageable should they occur. This York. He graduated from Stony Brook School of Dental Medicine presentation will cover timeless risk issues that dental practices may in 2005. Dr. Salierno has served as the National President of face. Areas of discussion will include customer service, informed the American Student Dental Association, Chair of the ADA New consent, documentation and disclosure. Attendees will leave with Dentist Committee, and as President of his local dental society. He a better understanding of how these issues influence both practice lectures internationally on clinical dentistry, practice management, and patient safety. and leadership development. His material can be viewed on his blog, The Curious Dentist. In 2014, Dr. Salierno became the Chief Editor of Dental Economics. The Dental Loss Prevention Seminar will focus on current risk management and liability issues. ProAssurance policyholders will SYNOPSIS: We have been trained to be outstanding clinicians, not savvy earn a 10% discount at their next policy renewal for attending this business owners. Many of us are afraid, or simply ignore, the business end of our seminar. Dentists who are not currently insured with ProAssurance profession. We’re unsure of how to read a profit and loss statement or motivate will receive the 10% discount if they become insured within one year our staff. Leading a successful practice doesn’t have to remain a mystery. This of this seminar. course will discuss the most common mistakes we make that can slowly and silently ruin our offices. You will leave armed with tools for best practices and 1 CEU practical tips. TOPICS COVERED INCLUDE: TRUSTING TECH: INTEGRATING TECHNOLOGY • Understanding financial statements WHILE MANAGING PATIENT RELATIONSHIPS • Controlling overhead costs Presented by Solution Reach • Managing and inspiring your team Saturday, June 9 / 9:00 am - Noon • More effective scheduling, case presentation, and billing EVENT CODE: NE2 / Fee: No Charge • Cost-effective ways to market and grow your practice This course is recommended for the entire dental office team. 6 CEUs TENNLI NELSON See Bio on Page 4 INFECTION CONTROL - NOT JUST A FOUR SYNOPSIS: Dental offices are busy. Fortunately, LETTER WORD AND A FEMALE HIPPOPOTAMUS: there are ways to create a connection beyond OSHA AND HIPAA MYTHS AND REALITIES the operatory room. Technology is a big piece of Friday, June 8 the solution. According to results from a recent Surescripts survey, patients look favorably on 1:30 - 4:30 pm practices that use technology, believing that doctors EVENT CODE: INF / $65/$85* per dentist or staff member who use technology are: *Registration increases after May 11 • 70% more organized and efficient ROY H. SONKIN, DDS • 40% more innovative See Bio on Page 5 • 33% more competent SYNOPSIS: Established in 1970 and 1996, these regulatory This is because technology has universally become part of the agencies have a significant impact on our dental practices. human daily experience and not in a bad way. Because digital Whether you are aware or not, non-adherence to these communication is so pervasive, contact that would once have been regulations can result in substantial injury to your reputation and few and far between can now be more frequent. In other words, imposition of weighty fines. Attendees will learn the basics of when used correctly, technology is actually enhancing human their responsibilities in order to comply with current standards. relationships, not replacing it. The key is to integrate the right 3 CEUs technology, in the right way, into a practice. 3 CEUs
8 SATURDAY, JUNE 9
ESTHETICS IN ACTION - CLINICAL ALABAMA MEDICAID BILLING UPDATE TECHNIQUES, TEAM SKILLS AND Saturday, June 9 / 9:00 - 11:00 am PRACTICE DEVELOPMENT STRATEGIES EVENT CODE: AMB / Fee: No Charge Saturday, June 9 / 9:00 am - 4:30 pm This course is recommended for the entire dental office team. EVENT CODE: NA2 / Fee: No Charge This session is recommended for anyone currently enrolled in Medicaid or interested in becoming a This course is recommended for dentists. Medicaid provider. A general billing update and an overview of Medicaid will be discussed during this ROSS W. NASH, DDS and DEBRA ENGELHARDT-NASH lecture and question/ answer session. Topics for this workshop include: • New changes in Medicaid coverage • Requirements for Treatment Approval See Bio for Ross Nash on page 6 • Prior Authorization Process • Documentation Requirements DEBRA ENGELHARDT-NASH 2 CEUs Debra Engelhardt-Nash has been in dentistry over 30 years. She is a trainer, author, presenter and consultant. She is a repeat presenter for HOT TOPICS IN IMPLANT DENTISTRY HANDS-ON WORKSHOP the American Dental Association, the American Presented by Nobel Biocare Academy of Cosmetic Dentistry and the Chicago Saturday, June 9 / 9:00 am - Noon / Limited to 40 participants Dental Society Midwinter Meeting. EVENT CODE: MA2 / Fee: $75/$95* Ms. Nash is a founding member and is serving three terms as President of the National Academy This course is recommended for the entire dental office team. of Dental Management Consultants. Debra is also SCOTT MACLEAN, DDS, FACD, FICD, FADI, FPFA a member of Speakers Consulting Network and See Bio on Page 6 a board member of the American Academy of SYNOPSIS: Join us for this unique Hands-On experience featuring hot topics Dental Practice Administration. She is on the ADA in implant dentistry: Practice Management Advisory Board. - Intra Oral Scanning - Immediate Temporization - Guided Implant Surgery Debra has been repeatedly recognized by Dentistry Today as - Restorative options - Immediate lower bars with nextday restoration a leader in continuing dental education and al eader in dental consulting. She has also been chosen as one of the Top 25 • "Smart Fusion” technology is the newest digital planning and placement tool that every person on the Women in Dentistry for 2014 by Dental Products Report. She is implant team should understand. The digital treatment workflow has become a tool to make easy and the 2015 recipient of the Gordon Christensen Lecturer Recognition predictable planning for implant cases from the simple cases to the most complex cases. Dr. MacLean award presented by the Chicago Dental Society. will show the most advanced treatment planning tools for creating excellence in implant dentistry. Participants are encouraged to bring their IPADS and or laptops to this unique treatment planning event. SYNOPSIS: Esthetic and cosmetic dental treatment has increased Cases will be digitally shared allowing for a real time view of how NobelClinician and NobelProcera rapidly in the United States and abroad. Media attention has technology are integrated. The dental team will visually see how important this breakthrough is to create driven public demand to request (and expect) these types of an ideal prosthetic table for the “All on 4” cases. Learn where the implants go on these full arch cases. procedures from their general dentist. Dr. Nash will illustrate Understand how much prosthetic space is required for bar fabrication. Plan for longterm success! up-to-date techniques to integrate conservative esthetic and treatment in the general practice. He will discuss modern • "Angulated screw channel" technology was developed to improve the screw retained options for the materials, procedures, and technology that can aid the dentist implant team. Dr. MacLean will show how this technology works and offer reasons why it should be in-patient care of office productivity. Dr. Nash will review treatment considered. Dr. MacLean will show how to immediately place implants, immediately temporize them, diagnosis and restorative selection. Esthetic rehabilitation cases how to use custom impression coping, and design ASC screw retained crowns. The technology is with an emphasis on conservation of natural tooth structure will be now available to easily offer advanced custom work with amazing outcomes. This technology will reviewed. revolutionize the implant world and improves the delivery of care in your practice. Introducing this type of dentistry into the practice and increasing Dr. MacLean has over 2.7 million views on youTube. Come and see what the social media world is patient acceptance requires a careful and caring team approach. tuning in to see! Dr. MacLean will show how important it is to work with Dental Technicians and teams Ms. Engelhardt-Nash will describe specific steps to boost team that understand these technologies. Come see why the implant world is buzzing with enthusiasm. Dr. effectiveness and offer practice management techniques to MacLean will impress you like he has done to many others around the world! increase productivity. 6 CEU Together, Dr. Nash and Ms. Engelhardt-Nash will discuss increasing effectiveness in treatment consultations and fee ALABAMA DENTAL HYGEINE PROGRAM I presentations. This is a comprehensive overview of clinical NSTRUCTOR CERTIFICATION TRAINING techniques, practice management and team development. Saturday, June 9 / 10:00 am - Noon • Learn how to introduce cosmetic possibilities to patients. • Discover the three types of treatment offered to patients. EVENT CODE: ADH / Fee: No Charge • Learn conservative clinical treatment techniques. This course is recommended for dentists. • Create a new patient experience that increases treatment Alabama dentists who wish to be certified as an Instructor in the Alabama Dental Hygiene Program are acceptance for all care. now required to complete an in-person training course conducted by the Board of Dental Examiners of Alabama. This course will cover the application requirements of the program, both for the instructor TOPICS INCLUDE: and the student hygienist, the academic and clinical coursework, and the examination and licensing • Everything’s elective! process. ADHP Instructor Certifications are valid for three years and the course is also required upon • Treatment Presentation Skills renewal of current certifications. The application fee for the ADHP Instructor Certification is $75, to be • How to establish fees for treatment paid by check or money order when the application is submitted to the Board. The $75 application • The Consultation fee includes the cost of this certification course. Course attendees may claim 2 hours of continuing • Team Effectiveness education credits. Please contact Ms. Hilda Johnson, RDH at the Board of Dental Examiners for any • Latest trends in Cosmetic and Esthetic Treatment questions related to the ADHP and Instructor Certification. 6 CEUs 2 CEUs 9 ALDA 149th ANNUAL SESSION ACTIVITIES SPECIAL EVENTS
Tuesday 4:00 pm Board of Trustees Wednesday 3:30 pm House of Delegates / General Assembly Thursday 9:00 am House Reference Committee Hearing Saturday 2:00 pm House of Delegates (final meeting)/ Election of Officers Sunday 9:00 am General Assembly, Awards & Installation Breakfast, Grand Door Prize Drawing
ADA PRESIDENT-ELECT JEFFREY M. COLE, DDS, MBA ADA President-Elect Jeffrey Cole, who practices general dentistry in Wilmington, Delaware, will be our guest for the afternoon House of Delegates/ General Assembly. Dr. Cole served as the ADA Fourth District Trustee. He served as the chair of both the Budget and Finance Committee and the Strategic Planning Committee. He was a member of the ADA Council on Dental Practice before being installed as a trustee. Dr. Cole is involved in several additional dental organizations including the Academy of General Dentistry, where he served as president in 2012-13. He is a Fellow of the International College of Dentists, the American College of Dentists and the Academy of Dentistry International. He was president of the Delaware State Dental Society in 2008-09 and received its Distinguished Service Award in 2015. Dr. Cole graduated from the Georgetown University School of Dentistry in Washington, D.C., in 1986. A decade later, he earned a masters in business administration degree from Temple University in Philadelphia.
n EXHIBIT HALL EVENTS n EXHIBITS “Sip, Spend & Save” Cocktail Reception Visit the 2018 Exhibit Show to Thursday – 4:30 - 6:00 pm Event Code EXR source some of the most innovative Join our Exhibitors for the “Sip, Spend & Save” Cocktail Reception! Enjoy technology, products and services complimentary beer, wine, light hors d’oeuvres and door prizes galore! Come available to the dental industry. relax, network and take advantage of Exhibitor Reception Specials! More than 75 commercial exhibits will be open Thursday afternoon “Muffins & Mimosas” Breakfast Open House and Friday. Save your orders so Friday – 8:00 - 9:00 am Event Code EXB you can take advantage of the Join our Exhibitors for the “Muffins & Mimosas” Breakfast Open House! Enjoy Exhibitors' promotions and meeting mimosas, a light breakfast and door prizes galore! Start your day off right with this specials. Remember to support fun networking opportunity and take advantage of Exhibitor Open House Specials! the Exhibitors who support our Mega Shopper Drawing for attendees who have made purchases meeting. of $1,000 or more! Door prize drawings will be held Attendees who make Exhibit Hall purchases of $1,000 or more will be entered both days for dentists and auxiliary into our “Mega Shopper” drawing! Just tear off the bottom of the form provided personnel. Complimentary keg beer, by the Exhibitor when you make your purchase! “Mega Shoppers” will be the only popcorn and lemonade all day in the attendees eligible for this drawing! Exhibit Hall! Free 2019 GCDC Registration to Dentists spending $2,500 n EXHIBIT HALL or more! All dentists who spend a total of at least $2,500 with our Exhibitors during the SCHEDULE show will receive free GCDC registration in 2019. Simply email your receipt to Thursday – Noon - 6:00 pm [email protected] and receive a voucher for free 2019 registration! Friday – 8:00 am - 2:00 pm Thursday, June 7 and Friday, June 8 Cash and gift prizes for dentists and dental team attendees during clinical breaks both days! 10 SPECIAL EVENTS Beach Bonfire KICK-OFF POOL PARTY Presented by the Council on the New Dentist Wednesday, June 6 / 5:30 - 7:00 pm Sponsored by Patterson Dental Supply Friday, June 8 / 8:00 - 9:30 pm Event Code: BON / Fee: No Charge Event Code: KOP / Fee: No Charge Pre-registration is required by May 25 Let’s get this party started! Join all the statewide EVERYONE INVITED! dental organizations for a conference Kick-Off Pool Join us for this exciting new event right on the beach! Party! Enjoy live music, complimentary beer, wine Enjoy a glowing bonfire, live music, homemade s’mores, complimentary beer and soft drinks! and light hors d’oeuvres while Bring beach chairs for the bonfire, and a flashlight, bucket and net for a ghost crab hunt! you chill by the pool or swim This event is presented by the ALDA Council on the New Dentist and sponsored by Patterson Dental Supply. Admission is free, but pre-registration is required by May 25. with the kids! Don’t miss this exciting new event! Admission is free, but pre-r egistration is required by June 1.
NEW= EVENT
VOYAGERS COOKING DEMONSTRATION AND LUNCHEON Thursday, June 7 / Noon Event Code: VOY / Fee: $40/$45* per person *Registration increases to the higher fee if postmarked after May 11. President’s Beach Party Add an entertaining element to your lunch by learning the secrets behind the kitchen doors. Bring your friends and enjoy an Featuring live music by 8 Track Rewind entertaining, informative and fun cooking demonstration and multi- SATURDAY, JUNE 9 course luncheon by the Voyagers’ master chef. Wine service is 6:30 pm - Cocktails and Music / 7:00 pm - Dinner included. Only limited reservations are available, so register early. Sponsored in part by ProAssurance and UBS 50TH ANNUAL DENTAL PRAYER EVENT CODE: PB1 Adult / Fee: $40/ $45* BREAKFAST Friday, June 8 / 7:00 - 8:30 am EVENT CODE: PB2 Youth (ages 4-10) / Fee: $15/ $18* Event Code: DPB / Fee: $20/$25 per person EVENT CODE: PB3 Child (ages 0-3) / Fee: No Charge The 50th Annual Dental Prayer Breakfast will include a feature *Fee increases after May 11 presentation and fellowship. Join us for an evening of fun on the beach deck honoring The annual breakfast is an inspirational gathering that includes all ALDA President Gordon Isbell and his wife, Cindy. religious persuasions. Dentists, spouses, hygienists, assistants, exhibitors and guests are encouraged to attend this rewarding Enjoy a dinner buffet and dance the night away to live breakfast. music by 8 Track Rewind - a power trio performing ALABAMA DENTAL ALUMNI LUNCHEON classic rock hits from the 8-track, vinyl LP and cassette Friday, June 8 / Noon - 1:30 pm eras! Then enjoy the spectacular fireworks show! Event Code: ALU Complimentary keg beer and rum punch will be provided. Fee: $40 per person Don’t miss this night of great food, The annual Alabama Dental Alumni Luncheon will dancing, fireworks and fun! feature Wimp Sanderson and Sonny Smith. Wimp Sanderson and Sonny Smith are retired Wimp men’s college basketball coaches. Wimp Sanderson Sanderson coached at the University of Alabama from 1981 to 1992 and led the Crimson Tide to ten NCAA ALDA MEMBER RECOGNITION BREAKFAST Tournaments and six trips to the Sweet 16. Sonny Smith served as head coach for Auburn University Sunday, June 10 / 9:00 am EVENT CODE: MRB / Fee: $20 from 1978 to 1989 and won the 1985 SEC Join your colleagues for the Member Recognition Breakfast Tournament championship and made five NCAA and Closing General Assembly. Tournament trips while at Auburn. After retiring from In addition to presentations in recognition to members, the morning Sonny Smith coaching, Sanderson and Smith hosted a sports talk will include the installation of ALDA officers. Plus…several drawings radio show “The Sonny and Wimp Show” on WJOX-AM for six years will be held during the buffet-style breakfast. in Birmingham, Alabama. Presently, both do color commentary for NCAA basketball and appear regularly on radio shows. 11 frequently asked CONFERENCE AT A GLANCE questions Quick Reference Registration Codes for Ticketed Events Do you have questions or WEDNESDAY, JUNE 6 need registration assistance? Time Event Title Event Code Fee Call (888) 645-4544 8:30 am - 12:30 pm CPR CPR $65/$85* What are the Benefits of Pre-Registration? By registering before May 11, you receive the lowest 9:00 am - 4:30 pm Mark Hyman HYM No Charge registration fees and ticket prices. An asterisk (*) indicates the increased event fee if you register after May 11 (Mail in 1:30 - 4:30 pm Tennli Nelson NE1 No Charge registration forms must be postmarked by May 11). Early pre-registration also ensures participation in limited ticket 5:30 - 7:00 pm Kick-Off Pool Party KOP No Charge events. How Can I Pre-Register? THURSDAY, JUNE 7 Online Registration – Online pre-registration will be available 8:30 am - Noon Roy Sonkin SO1 No Charge through May 25. Visit gulfcoastdentalconference.org to register. 9:00 am - 4:30 pm Howard Glazer GL1 No Charge When Will I Receive Badges and Tickets? Name badges and tickets for pre-registered attendees will be Noon - 1:30 pm Voyagers Cooking Demonstration VOY $40/ $45* mailed to the primary registrant (dentist) two weeks prior to the conference – please be sure to bring these materials with 1:00 - 5:00 pm Ross Nash NA1 $75/$95* you to the conference. Registration packets (including name 1:30 - 3:30 pm Roy Sonkin SO2 $75/$95* badges and tickets) will be distributed on-site for all attendees who register after May 25, 2018. Name badges will be 4:30 - 6:30 pm Exhibit Hall Reception EXR No Charge required for admittance to all events and the Exhibit Hall. What Are the Registration/Check-In Hours On-Site? FRIDAY, JUNE 8 Registration/ Check-In hours are as follows: June 5, 3:00 - 5:00 pm 7:00 - 8:30 am 50th Annual Dental Prayer Breakfast DPB $20/$25 June 6, 8:00 am - 4:00 pm June 7, 8:00 am - 4:00 pm 8:00 - 9:00 am Exhibit Hall Breakfast EXB No Charge June 8, 8:00 am - 4:00 pm June 9, 8:00 - 10:00 am 9:00 am - Noon Howard Glazer GL2 $75/$95* Name badge covers and meeting materials will be distributed at the recessed registration desk located outside 9:00 am - Noon Michael Falkel FAL1 No Charge the lecture foyer. 9:00 am - 4:30 pm Scott Maclean MA1 No Charge How Much Does It Cost to Attend Each Seminar? Courses that appear in the brochure with a fee of no charge 9:00 am - 4:30 pm Chris Salierno SAL No Charge are ALDA-sponsored courses and are covered by the general registration fee for dentists and dental staff. There is no 1:30 - 4:30 pm Michael Falkel FAL2 No Charge general registration fee for spouses, children or non-dentist guests. 1:30 - 4:30 pm Roy Sonkin INF $65/$85* There are additional fees for some courses and events. These Noon - 1:30 pm Alabama Dental Alumni Luncheon ALU $40 fees are listed near the course or event title in this brochure and on the “Meeting At A Glance” shown to the right. 8:00 - 9:30 pm Beach Bonfire BON No Charge How Do I Become an ADA Member So I Can Take Advantage of Reduced Registration Fees? SATURDAY, JUNE 9 A reduced registration fee is just one of the many 7:30 - 8:30 am ProAssurance PRO No Charge The Business of Dentistry Panel: Ask the advantages of ADA and State Association membership. Experts For membership information, please contact ALDA at 9:00 - 11:00 am Alabama Medicaid AMB No Charge (800) 489-2532 or email [email protected]. How Do I Know Which Courses Are Right for Me? 9:00 am - Noon Scott Maclean MA2 $75/$95* Recommendations on appropriate attendees are noted in the brochure with each course description. 9:00 am - Noon Tennli Nelson NE2 No Charge How Do I Record My CE hours? 9:00 am - 4:30 pm Ross Nash/Debra Nash NA2 No Charge Continuing education signature rosters will be distributed during all CE sessions. CE certificates and other materials 10:00 am - Noon ADHP Certification Training ADH No Charge will be provided on-site. It is your responsibility to record CE hours and keep the certificate as proper verification of your 6:30 pm - 7:00 pm Presidents Beach Party attendance for your records. Most courses qualify for continuing education credit accepted by the Board of Dental Adult PB1 $40/ $45* Examiners of Alabama. The number of CE hours (CEUs) is Youth (ages 4-10) PB2 $15/ $18* noted following each course synopsis. Most courses qualify for AGD PACE credit as well. Child (ages 0-3) PB3 No Charge SUNDAY, JUNE 10 REGISTER ONLINE AT 9:00 am ALDA Member Recognition Breakfast MRB $20 gulfcoastdentalconference.org *Fee Increases after May 11. All attendees must register to attend all events outlined above, regardless of the fee associated with the event. 12
$350 $350 $350 $775 $0 $0 $65 $65 $65 $65 $0 $0 $0 $0 On-Site Continued on next page $300 $300 $300 $650 $0 $0 $55 $55 $55 $55 $0 $0 $0 $0 After May 11
$250 $250 $250 $600 $0 $0 $45 $45 $45 $45 $0 $0 $0 $0 American Express American Express Before May 11 Before p Total Fees ______Total Print name as it appears on card Mastercard Mastercard p Visa p Be sure to complete the front and back of this form. Please print all information. to complete the front Be sure ADA Member Dentist* ALDA Member Dentist** Military/Federal Dentist ADA Non-Member Dentist* Retired ADA Member* Retired Student ASDA Member*** Dental Hygienist Dental Assistant Office Staff Lab Technician Dentist Spouse Non-Dentist Guest Youth (ages 4-10) Youth Child (ages 0-3) REGISTRATION FORM FOR ALL ATTENDEES REGISTRATION Complete one form for each dentist. Photocopy this form to accomodate additional registrants. Complete one form for each dentist. Photocopy this to accomodate additional registrants. A *ADA = American Dental Association as Rate A. eligible to register any state are All ADA members from ADA membership will be verified. **ALDA = Alabama Dental Association ***ASDA = American Student Dental Association AA A1 B C D E F G H I J K L Exp. Date ______Printed Name ______Check Enclosed p Zip ______Zip ______State ______Same as Above p 2018 Signature indicates approval for charges to your account indicates approval Signature Register online at gulfcoastdentalconference.org or by mail. Registrations will not be accepted phone fax. Register online at gulfcoastdentalconference.org Mail registration forms to: Gulf Coast Dental Conference, 6840 Meadowridge Court, Alpharetta, GA 30005. Please do not mail your form to the ALDA Office. 6840 Meadowridge Court, Alpharetta, forms to: Gulf Coast Dental Conference, Mail registration METHOD OF PAYMENT Checks must be made payable to the Alabama Dental Association. Credit Card # ______Card Credit ______Signature Other ______DO YOU HAVE QUESTIONS OR NEED REGISTRATION ASSISTANCE? CALL (888) 645-4544 ASSISTANCE? QUESTIONS OR NEED REGISTRATION DO YOU HAVE Business Phone ( ) ______Fax ( ) ______Email ______Billing Address Holder’s Card DENTIST (PRIMARY REGISTRANT) DENTIST (PRIMARY Name ______Name for Badge ______of Graduation ______Year ______Mailing Address City ______State ______p City ______
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Total Fee $ Total Total Fee $ Total Total Fee $ Total ______$ ______TOTAL FEE TOTAL FEE TOTAL FEE TOTAL for all attendees) Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # Event Code # ______
Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $ Fee $
(Includes registration courses and special event fees ______Event Code # Event Code # ______Event Code # ______Event Code # ______Event Code # Event Code # ______Event Code # ______Event Code # ______FEES TOTAL Event Code # Event Code # ______Event Code # ______Event Code # COURSES AND SPECIAL EVENTS COURSES AND SPECIAL EVENTS COURSES AND SPECIAL EVENTS Fee $ Fee $ Fee $ Category Category Category REGISTRATION REGISTRATION REGISTRATION Photocopy this form for additional registrants. REGISTRATION FORM CONTINUED REGISTRATION First Name First Name First Name received by May 11, 2018. An administrative charge of $25 will be applied if the written cancellation is after 18. No refund issued 31, Last Name Last Name Last Name Cancellation Policy: Cancellations must be made in writing and mailed to Gulf Coast Dental Conference, 6840 Meadowridge Court, Alpharetta, GA 30005. A full refund will given if the written cancellation is ouse, staff, children and non-dentist guests. Please complete the first section for dentist (primary registrant) and one each additional attendee including sp ouse, staff, DENTIST BADGE NAME ______ADDITIONAL BADGE NAME A. ______ADDITIONAL BADGE NAME ADA # ______
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$235 $245 $251 $264 $309 ROOM RATES* . . . . . based on availability. rooms King size beds and Gulf Front type not be available, you will assigned a room Should your requested and put on a wait list. room standard Standard Double or King** Standard Pass View Double or King** Pool View Double or King** Double or King** Gulf Front Suite Courtyard Advance deposit enclosed (or) NOTE: Check-in time is 4:00 p.m. Check-out 12:00 Noon. * An 11% lodging tax will be added. ** must card rate by check or credit room An advance deposit equal to one night’s request. accompany the reservation Policy: Early Departure In the event an individual needs to check-out prior confirmed departure date, the Resort must be notified prior to or at check-in. After check-in, there fee of 50% the daily rate. will be an early departure Cancellation Policy: will be no penalty there be necessary, Should cancellation of any reservation office is notified no later than 4:00 p.m., 3 days prior the reservations provided to the arrival date. Should cancellation occur after this time or if hotel is not refunded. When cancelling, notified of cancellation, the deposit will not be not charged. Charge you are your cancellation number to insure please record will not be waived without this number. name ______Card Credit # ______Card Credit Expiration Date ______Signature ACCOMMODATIONS A three night minimum is required. A three p p p p p p Diners Club and Discover. VISA, American Express, The hotel accepts MasterCard, -
______No. of Children Perdido Beach Resort Perdido Beach Blvd. 27200 Perdido Orange Beach, AL 36561 251-981-9811 or fax 251/981-5672 Telephone Reservations must be made via internetvia made be must Reservations by form this on or RESERVATION REQUEST RESERVATION perdido beach resort perdido or through the link provided the link provided or through Register via internet at www.perdidobeachresort.com (Code: 14199) at gulfcoastdentalconference.org OR RETURN THIS FORM TO: To receive the special group rate, please complete the reservation form below and for rate, please complete the reservation the special group receive To ward (via mail, fax or internet)Beach Resort. Reservations will not be ward to Perdido telephone. by accepted will apply. An additional $10 daily charge per extra adult sharing a double room Special Requests ______May 11. Requests received after May 11 are subject to availability and higher rates. and higher availability to subject are 11 May after received Requests 11. May Annual Session Activities: June 5-10, 2018. Name ______Address City/State/Zip ______Phone ______Arrival Day/Date ______Day/Date ______Departure No. of Adults ______If sharing, name ______for single or double occupancy. Rates are room. in parent’s stay free Children
15 Presorted First-Class U.S. Postage PAID Montgomery, AL Permit No. 456 2018 Alabama Dental Association 836 Washington Avenue Montgomery, AL 36104
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Alabama Association of Endodontists | Alabama Society of Periodontists Alabama Academy of Pediatric Dentistry | Alabama Association of Orthodontists Alabama Academy of General Dentistry | Alabama Society of Oral and Maxillofacial Surgeons