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JUNE 18-19, 2021 | CAMDEN ON THE LAKE FOR THE MDA’S PREMIERE CONTINUING EDUCATION EVENT GENEROUSLY UNDERWRITTEN BY MDA’S WHOLLY-OWNED INSURANCE SUBSIDIARY

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Page 1: C4S ANNUAL CONFERENCE REGISTRATION

3340 AMERICAN AVE, JEFFERSON CITY MO 65109

JUNE 18-19, 2021 | MODENTAL.ORG/C4S

REGISTRANT Print clearly for accurate processing. One registration per person. Make a copy of registration for your records.

Name

ADA #

Office Address

City State Zip

Email

REFUNDS & CANCELLATIONSAny request for a refund/cancellation must be made in writing to Mandy Lewis at [email protected]. A $50 cancellation fee will be charged per registration through June 8, 2021. No refunds will be granted after June 8, 2021. Those who register on-site will incur an additional $25 fee.

C4S ANNUAL CONFERENCE REGISTRATION

MISCELLANEOUSBringing your children? No Yes Age(s)/Name(s) _______________________________

Where are you staying? Camden on the Lake Lodge of Four Seasons Other_____________

GUEST MEAL ONLY OPTIONIncludes attendance at the Thursday Fire & Ice Welcome Reception & Exhibits Preview, Friday/Saturday breakfast, Friday lunch, Friday ReConnect Reception and all the breaks.

Qty _________x $50

Guest Name ____________________

Member | $329 New Dentist Member | $199* Retired Dentist Member | $209 Dental Team Member | $229 Class of 2021 Member | $99*

FEES Registration includes all courses, meals and most events.

`COURSES Purple denotes New Dentist Committee recommended course Orange denotes course for the whole dental team

Friday AM - Choose One MACdentistry: The What, When, How & Why of Current Indirect Restorative Materials, Adhesives & Cements (Dudney) Making It Easy for Patients to Say “YES” (Homoly) Build a Team that Rocks (Hatch)

Friday PM - Choose One What’s a Dentist to Do?: Diagnosis, Treatment Options & Rehabilitation of Difficult & Unusual Cases (Dudney) Just Because You’re an Expert ... Doesn’t Make You Interesting (Homoly) Rock Difficult Discussions (Hatch)

Saturday AM - Choose One Be Aware of Wear: A Systematic Approach to Diagnosing, Treatment Planning & Restoring the Worn Dentition (Dudney) Positive Culture Wins in Dentistry (Wilbers) Rock the Drama Out of Your Practice (Hatch)

JUNE 18-19, 2021 | CAMDEN ON THE LAKE

FOR THE MDA’S PREMIERE CONTINUING EDUCATION EVENTTHURSDAY “FIRE & ICE” WELCOME RECEPTION & EXHIBITS PREVIEW Arriving Thursday evening? Join us from 6:30–8:30p in the Exhibit Hall for a reception and preview of exhibits. Enjoy hot wings and ice cream while socializing with other attendees and spend some one-on-one time with exhibitors.

FRIDAY CONNECT4CASH This fundraiser will be back again to benefit the MDA Foundation. It’s a countdown raffle where the final number drawn wins the big $1,500 cash prize and bragging rights as the last one standing.

RECONNECT RECEPTION Relax and unwind at the ReConnect Reception from 4:30–6p in the Exhibit Hall. Enjoy beverages, snacks and the camaraderie of your peers and exhibitors.

NEW DENTIST SOCIAL HOUR New dentists and family members are invited to a social hosted by the MDA New Dentist Committee from 6–7p. Cost is $20/person and includes appetizers, drinks and prizes. This event is exclusive to dentists who graduated 10 years ago or fewer.

H. TOADS H. Toad’s is the premier destination for all of your live entertainment and is attached to the Camden at the Lake Resort, so there is no need for transportation! Visit HToads.com for a complete schedule.

CONNECT 4 CASH RAFFLE TICKETS

Qty _________x $100 (5 MAX)

PAYMENT DETAILS

Card #

Exp Date CSV

Signature

Card Billing Address

City State Zip

Email

GRAND TOTAL

GENEROUSLY UNDERWRITTEN BY MDA’S WHOLLY-OWNED INSURANCE SUBSIDIARY

$

The Missouri Dental Association is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. The MDA designates this activity for 8+ continuing education credits.

Check VISA MasterCard Discover

Total:

Total:

SPECIAL EVENTSWill you be attending the Fire & Ice Welcome Reception Thursday evening?

No Yes Qty.________

Will you be participating in the Yoga Session Friday Morning? No Yes

NEW DENTIST SOCIAL HOUR*This event is exclusive to dentists who graduated 10 years ago or fewer. $20 per Dentist/Guest, Friday 7–8p Qty _________x $20

Guest Name ____________________ Total:

Total:

Return completed form with check or credit card payment to: Missouri Dental Association, 3340 American Ave, Jefferson City MO 65109.

Credit Card Payments Only: Fax to 573-635-0764

REGISTRATION DEADLINE: JUNE 8, 2021

AMERICAN COLLEGE DINNER$50 per Person, Friday 6–10p Qty ____ NY Strip Qty ____ Salmon

Guest Name ____________________ Total:

Non Member | $499 New Dentist Non Member | $279*

Page 2: C4S ANNUAL CONFERENCE REGISTRATION

HOTEL INFOSCHEDULE OF EVENTSTHURSDAY | JUNE 17, 20216:30–8:30P “FIRE & ICE” WELCOME RECEPTION & EXHIBITS PREVIEW

FRIDAY | JUNE 18, 20217:15–8A YOGA

8A REGISTRATION/EXHIBITS OPEN

8–9A BREAKFAST BAR

9A–NOON DR. THOMAS DUDNEY MACdentistry: The What, When, How & Why of Current Indirect Restorative Materials, Adhesives & Cements

9A–NOON DR. PAUL HOMOLY Making It Easy For Patients To Say “Yes” NEW DENTIST COMMITTEE RECOMMENDED

9A–NOON LAURA HATCH, MS, FAADOM Build a Team that Rocks

10:15–10:45A REFRESHMENT BREAK

NOON–1:30P LUNCH

1:30–4:30P DR. THOMAS DUDNEY What’s a Dentist to Do? Diagnosis, Treatment Options, & Rehabilitation of Difficult & Unusual Cases

1:30–4:30P DR. PAUL HOMOLY Just Because You’re an Expert ... Doesn’t Make You Interesting NEW DENTIST COMMITTEE RECOMMENDED

1:30–4:30P LAURA HATCH, MS, FAADOM Rock Difficult Discussions

2:45–3:15P REFRESHMENT BREAK

4:30–6P RECONNECT RECEPTION

6–7P NEW DENTIST SOCIAL HOUR

7P AMERICAN COLLEGE OF DENTISTS RECEPTION & DINNER

SATURDAY | JUNE 19, 20218A REGISTRATION OPEN

8–9A CONTINENTAL BREAKFAST

9A–NOON DR. THOMAS DUDNEY Be Aware of Wear: A Systematic Approach to Diagnosing, Treatment Planning & Restoring the Worn Dentition

9A–NOON GARY WILBERS Positive Culture Wins in Dentistry NEW DENTIST COMMITTEE RECOMMENDED

9A–NOON LAURA HATCH, MS, FAADOM Rock the Drama Out of Your Practice

10:15–10:45A REFRESHMENT BREAK

NOON CONFERENCE ENDS

SPEAKERS & COURSESTHOMAS E. DUDNEY, DMD is a 1977 graduate of Univ. of Alabama in Birmingham SOD. He has served as the Clinical Director for the Aesthetic Advantage hands-on programs at NYU and the Eastman Dental Clinic in London. Presently, he is the clinical director of the Pacific Aesthetic Continuum (PAC) hands-on programs. He has presented workshops and lectures at dental meetings and has

authored several articles on aesthetic and restorative dentistry. He is a member of the ADA, the Alabama Dental Association and the American Academy of Cosmetic Dentistry. He is also a fellow of the American Society for Dental Aesthetics and a Diplomate of the American Board of Aesthetic Dentistry.

MACDENTISTRY: THE WHAT, WHEN, HOW & WHY OF CURRENT INDIRECT RESTORATIVE MATERIALS, ADHESIVES & CEMENTSFRI AM | 2.75CEAs restorative materials, adhesives and cements continue to evolve and improve, keeping up with the latest advancements is difficult. Patients continue to have high expectations for long-term clinical success. Having an understanding and working knowledge of these materials will enable you to make sound decisions and drive that long-term success. This program will discuss factors affecting the selection of indirect restorative materials that will satisfy the aesthetic and functional goals of the patient as conservatively as possible. Cases will be used to demonstrate the use of these materials, bonding agents and cements in different clinical situations.

Objectives:• Learn about monolithic vs. layered restorations• Learn to combine aesthetics and function with emax lithium disilicate• Learn the advantages and disadvantages of full contour zirconia• Understand the benefits of the new universal adhesives• Learn which cements to use, when and why, and the long-term benefits of

bioactive cements

WHAT’S A DENTIST TO DO? DIAGNOSIS, TREATMENT OPTIONS & REHABILITATION OF DIFFICULT & UNUSUAL CASESFRI PM | 2.75CESometimes the restorative dentist encounters clinical situations that are out of the ordinary and can often be difficult to treatment plan. This program will examine several such cases in order to explore treatment options and develop treatment plans. Treatment results will be demonstrated along with helpful clinical tips on: material selection, how to determine incisal edge position, intra-oral composite mock-ups, opening bites, fabricating and evaluating provisional restorations, bonding to porcelain in the mouth, and fine tuning occlusal adjustments.

Objectives:Explore treatment options and examine clinical results for:

• Traumatic avulsion of permanent incisors

• The dark central incisor• The severely worn dentition• Class III anterior crossbite

BE AWARE OF WEAR: A SYSTEMATIC APPROACH TO DIAGNOSING, TREATMENT PLANNING & RESTORING THE WORN DENTITIONSAT AM | 2.75CEIn today’s society, tooth wear is more prevalent than ever, and it is therefore incumbent upon the entire dental team to be well-versed in recognizing the clinical signs of wear while understanding the importance of prevention when possible and the restorative options when necessary. This program will illustrate the different types of tooth wear with clinical examples and demonstrate a systematic approach to diagnosis and treatment.

Objectives:• Recognize the clinical signs of intrinsic and extrinsic erosion• Learn office protocols to help patients prevent and/or treat acid erosion• Recognize the clinical signs of horizontal and vertical wear patterns• Design an occlusal scheme that fits the grinding patterns of the patient• Understand bite opening vs. crown lengthening vs. orthodontic

intrusion to gain space for restorations

PAUL HOMOLY, DDS, CSP is a world-class leader in dental education. As a restorative dentist and acclaimed educator for more than thirty years, he’s known for his innovative and practical approach to dentistry. Paul is president of Homoly Communications Institute, a resource for practice-building skills. He has authored many highly regarded

books and has the highest earned designation in professional speaking, Certified Speaking Professional (CSP). Fewer than 15% of professional speakers have earned this and he was the first dentist worldwide to earn it.

MAKING IT EASY FOR PATIENTS TO SAY “YES”FRI AM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDThis program is perfectly suited for dentists and team members, and teaches the skills to make case acceptance from single tooth to complex care dentistry predictably successful. It’s specifically designed for you if you have a broad-base general practice and are growing the complex care aspect of your practice – cosmetic, implant, CAD CAM, 3D imaging/airway and rehabilitative dentistry. The session includes case study simulations that make your lessons immediately relevant to your everyday practice and focuses on two areas: the fundamentals/strategies of case acceptance and specific take-home procedures.

Objectives:• Left- and right-side patients – The 6 critical distinctions between

simple and complex care patients• The Four Chiefs™ – The four essential conversations of case acceptance • The Choice Dialogue – Discover the readiness of the patient for care• The Discovery Guide™ – How to talk to patients about conditions they

don’t know they have• The Cross-Over Zone™ – Discomfort when talking about money• The Case Conversation – How to lead, not sell, patients into accepting

your treatment recommendations• The Advocacy Dialogue – Managing patients who are not ready for care

The MDA has secured room blocks at two locations, both the host resort (Camden on the Lake) and another nearby resort (Lodge of Four Seasons).

LAURA HATCH, MS, FAADOM is known internationally as the Leader in Dental Front Office Solutions and Training. A keynote speaker, author, and coach, Laura is best known as the founder of Front Office Rocks™, a virtual training platform for dental teams. Using her unique style and interactive delivery methods, Laura loves to help dental teams

learn the systems and methods to achieve unprecedented results. Through this work, she has become a mentor to her clients & her colleagues. Laura is a best-selling author of her book “Step Away from the Drill” and a member of the National Speaker’s Association, the Speaking Consulting Network, the Academy of Dental Management Consultants and a Fellow of the American Association of Dental Office Managers.

BUILD A TEAM THAT ROCKSFRI AM | 2.75CETo take your practice to the next level, well-defined systems and proper training must be in place. When team members understand the ‘why’ behind ‘what’ they are asked to do, the practice runs more efficiently and smoothly. In this course, you will learn the communication skills and procedures that create the ultimate customer service experience for your patients. You will also learn how to handle common scheduling issues – reduce cancellations/no-shows, set production goals, maximize treatment coverage and increase case acceptance. Ultimately experiencing a happier, higher producing team that will improve and master the essential systems to make the practice and the team rock!

Objectives:• Define communication and how to apply the right amount • Identify and apply solutions to common appointment scheduling

problems• Differentiate between types of dental appointments, block scheduling

and production, including effective monthly goal setting• Understand the business cycle and the importance of customer service• Learn the key to case acceptance by understanding the buying cycle• Understand team management • Recognize how to become an active listener• Utilize business technology to support functions of the front office

ROCK DIFFICULT DISCUSSIONSFRI PM | 2.75CEAs a dentist, office manager or dental team member, you regularly manage patient issues, office drama and the working relationship you have with your team members, who can be your biggest advocate or detriment. This course dives into the complex relationships within the dental practice. Many dentists, office managers or team members are not trained in communication, HR or other business aspects. Laura will delve into communication techniques that work to create a true partnership between the team, the patients and the dentist that helps practices not just survive, but thrive.

Objectives:• Identify the 7 C’s of effective communication.• Define the communication cycle and understand different forms of

communication.• Learn the 33 keys to successful conversations.• How to become an active listener.• Outline the 8 tools to handle difficult conversations.

ROCK THE DRAMA OUT OF YOUR PRACTICESAT AM | 2.75CEDrama in the dental office is described as conflicts between employees, disagreements (work-related or otherwise) that get brought up in the office, complaints, rumors, inappropriate actions on the job, and other unpleasant emotional outbursts, etc. At one time or another, every office goes through a patch of team-related “drama.”This presentation will help you and your team break the cycle and rock the drama out of your practice.

Objectives:Attendees will Learn UNITY:

• Understand that culture = a shared vision and purpose• Negate gossip and drama by developing & implementing a policy• Identify potential issues and handle them before they cause conflict• T.H.I.N.K. - Apply the T.H.I.N.K. method to the drama in your office• You - Change starts with you

PAPERLESS COURSE HANDOUTSAll course handouts will be available to download

prior to the event to reduce excess paper used.

EARN 8+ CE HOURS

• The gummy smile• The appliance dependent patient• The cleft lip/ palate patient • The aging face

PROGRAMS FOR THE ENTIRE DENTAL TEAM

JUST BECAUSE YOU’RE AN EXPERT ... DOESN’T MAKE YOU INTERESTING FRI PM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDIt’s never been tougher to hold people’s attention as it is now: text messages, email, voicemail, multitasking, social media ... all of it competes for listeners’ attention. Consequently, your role as a leader/influencer is more difficult; if people aren’t listening, you’re not leading or influencing. This course is designed for all members of the dental team who want to make a greater impact during one-on-one conversations, speaking to a small group or presenting in front of a large audience. You’ll come away from this program with a greater confidence on being an interesting expert!

Objectives:• How to Peak, then Point™ and creating vivid and memorable

listener experiences • Learn about The Speech of 25™ which is a simple method for

rehearsing your presentation, giving it a natural look, sound, and feel• Understand Lead, Don’t Sell™ and how to earn belief, then ask

for action

GARY WILBERS is a successful entrepreneur and experienced trainer who helps individuals ascend to their peak. A mid-Missouri native, Gary has authored three books and spoken extensively on the topic of building a positive culture that enhances people and performance.

POSITIVE CULTURE WINS IN DENTISTRYSAT AM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDDentists of all ages face many challenges from inheriting a practice, to managing multiple personalities, to learning how to grow in leadership and balance. Plus you’re still learning to understand yourself. This course is designed to help the attendee grow in leadership through learning to cultivate a positive culture. This practical and power-packed three-hour session focuses on four foundations to building a positive culture, learning your personality profile using the Enneagram tool and learning how to be a high performer in every area of life.

Objectives:• Learn how to change your paradigm from Stuck to a Climber Mindset• Discover your Enneagram Profile Type and how your style impacts

practice culture• Connect with relationships to improve the culture of your practice• Learn how to boost your productivity to become a high performer• Learn how to integrate new habits and disciplines into action

CAMDEN ON THE LAKE Located at 2359 Bittersweet Rd, Lake Ozark. Make reservations by calling 888-365-5620 and state you are with the MDA. Reservations must be made by May 18, 2021. Room rates available are Deluxe King Suites or Deluxe Double Suites for $182 plus tax, per night and One Bedroom King Grand Suites for $222 plus tax, per night. Check in time is 4p and check out is 11a.

LODGE OF FOUR SEASONS Located at 315 Four Seasons Dr, Lake Ozark, less than a 5-mile drive from Camden on the Lake. Make reservations by calling 888-265-5500 and state you are with the MDA. Reservations must be made by April 22, 2021. There are a variety of rooms offered, based on availability at prices ranging from $172 to $392. Check in time is 4p and check out is 11a.

SHUTTLE SERVICES As a convenience for our meeting attendees, Camden on the Lake will offer a shuttle between the two resorts on both Friday and Saturday, during meeting hours.

Page 3: C4S ANNUAL CONFERENCE REGISTRATION

HOTEL INFOSCHEDULE OF EVENTSTHURSDAY | JUNE 17, 20216:30–8:30P “FIRE & ICE” WELCOME RECEPTION & EXHIBITS PREVIEW

FRIDAY | JUNE 18, 20217:15–8A YOGA

8A REGISTRATION/EXHIBITS OPEN

8–9A BREAKFAST BAR

9A–NOON DR. THOMAS DUDNEY MACdentistry: The What, When, How & Why of Current Indirect Restorative Materials, Adhesives & Cements

9A–NOON DR. PAUL HOMOLY Making It Easy For Patients To Say “Yes” NEW DENTIST COMMITTEE RECOMMENDED

9A–NOON LAURA HATCH, MS, FAADOM Build a Team that Rocks

10:15–10:45A REFRESHMENT BREAK

NOON–1:30P LUNCH

1:30–4:30P DR. THOMAS DUDNEY What’s a Dentist to Do? Diagnosis, Treatment Options, & Rehabilitation of Difficult & Unusual Cases

1:30–4:30P DR. PAUL HOMOLY Just Because You’re an Expert ... Doesn’t Make You Interesting NEW DENTIST COMMITTEE RECOMMENDED

1:30–4:30P LAURA HATCH, MS, FAADOM Rock Difficult Discussions

2:45–3:15P REFRESHMENT BREAK

4:30–6P RECONNECT RECEPTION

6–7P NEW DENTIST SOCIAL HOUR

7P AMERICAN COLLEGE OF DENTISTS RECEPTION & DINNER

SATURDAY | JUNE 19, 20218A REGISTRATION OPEN

8–9A CONTINENTAL BREAKFAST

9A–NOON DR. THOMAS DUDNEY Be Aware of Wear: A Systematic Approach to Diagnosing, Treatment Planning & Restoring the Worn Dentition

9A–NOON GARY WILBERS Positive Culture Wins in Dentistry NEW DENTIST COMMITTEE RECOMMENDED

9A–NOON LAURA HATCH, MS, FAADOM Rock the Drama Out of Your Practice

10:15–10:45A REFRESHMENT BREAK

NOON CONFERENCE ENDS

SPEAKERS & COURSESTHOMAS E. DUDNEY, DMD is a 1977 graduate of Univ. of Alabama in Birmingham SOD. He has served as the Clinical Director for the Aesthetic Advantage hands-on programs at NYU and the Eastman Dental Clinic in London. Presently, he is the clinical director of the Pacific Aesthetic Continuum (PAC) hands-on programs. He has presented workshops and lectures at dental meetings and has

authored several articles on aesthetic and restorative dentistry. He is a member of the ADA, the Alabama Dental Association and the American Academy of Cosmetic Dentistry. He is also a fellow of the American Society for Dental Aesthetics and a Diplomate of the American Board of Aesthetic Dentistry.

MACDENTISTRY: THE WHAT, WHEN, HOW & WHY OF CURRENT INDIRECT RESTORATIVE MATERIALS, ADHESIVES & CEMENTSFRI AM | 2.75CEAs restorative materials, adhesives and cements continue to evolve and improve, keeping up with the latest advancements is difficult. Patients continue to have high expectations for long-term clinical success. Having an understanding and working knowledge of these materials will enable you to make sound decisions and drive that long-term success. This program will discuss factors affecting the selection of indirect restorative materials that will satisfy the aesthetic and functional goals of the patient as conservatively as possible. Cases will be used to demonstrate the use of these materials, bonding agents and cements in different clinical situations.

Objectives:• Learn about monolithic vs. layered restorations• Learn to combine aesthetics and function with emax lithium disilicate• Learn the advantages and disadvantages of full contour zirconia• Understand the benefits of the new universal adhesives• Learn which cements to use, when and why, and the long-term benefits of

bioactive cements

WHAT’S A DENTIST TO DO? DIAGNOSIS, TREATMENT OPTIONS & REHABILITATION OF DIFFICULT & UNUSUAL CASESFRI PM | 2.75CESometimes the restorative dentist encounters clinical situations that are out of the ordinary and can often be difficult to treatment plan. This program will examine several such cases in order to explore treatment options and develop treatment plans. Treatment results will be demonstrated along with helpful clinical tips on: material selection, how to determine incisal edge position, intra-oral composite mock-ups, opening bites, fabricating and evaluating provisional restorations, bonding to porcelain in the mouth, and fine tuning occlusal adjustments.

Objectives:Explore treatment options and examine clinical results for:

• Traumatic avulsion of permanent incisors

• The dark central incisor• The severely worn dentition• Class III anterior crossbite

BE AWARE OF WEAR: A SYSTEMATIC APPROACH TO DIAGNOSING, TREATMENT PLANNING & RESTORING THE WORN DENTITIONSAT AM | 2.75CEIn today’s society, tooth wear is more prevalent than ever, and it is therefore incumbent upon the entire dental team to be well-versed in recognizing the clinical signs of wear while understanding the importance of prevention when possible and the restorative options when necessary. This program will illustrate the different types of tooth wear with clinical examples and demonstrate a systematic approach to diagnosis and treatment.

Objectives:• Recognize the clinical signs of intrinsic and extrinsic erosion• Learn office protocols to help patients prevent and/or treat acid erosion• Recognize the clinical signs of horizontal and vertical wear patterns• Design an occlusal scheme that fits the grinding patterns of the patient• Understand bite opening vs. crown lengthening vs. orthodontic

intrusion to gain space for restorations

PAUL HOMOLY, DDS, CSP is a world-class leader in dental education. As a restorative dentist and acclaimed educator for more than thirty years, he’s known for his innovative and practical approach to dentistry. Paul is president of Homoly Communications Institute, a resource for practice-building skills. He has authored many highly regarded

books and has the highest earned designation in professional speaking, Certified Speaking Professional (CSP). Fewer than 15% of professional speakers have earned this and he was the first dentist worldwide to earn it.

MAKING IT EASY FOR PATIENTS TO SAY “YES”FRI AM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDThis program is perfectly suited for dentists and team members, and teaches the skills to make case acceptance from single tooth to complex care dentistry predictably successful. It’s specifically designed for you if you have a broad-base general practice and are growing the complex care aspect of your practice – cosmetic, implant, CAD CAM, 3D imaging/airway and rehabilitative dentistry. The session includes case study simulations that make your lessons immediately relevant to your everyday practice and focuses on two areas: the fundamentals/strategies of case acceptance and specific take-home procedures.

Objectives:• Left- and right-side patients – The 6 critical distinctions between

simple and complex care patients• The Four Chiefs™ – The four essential conversations of case acceptance • The Choice Dialogue – Discover the readiness of the patient for care• The Discovery Guide™ – How to talk to patients about conditions they

don’t know they have• The Cross-Over Zone™ – Discomfort when talking about money• The Case Conversation – How to lead, not sell, patients into accepting

your treatment recommendations• The Advocacy Dialogue – Managing patients who are not ready for care

The MDA has secured room blocks at two locations, both the host resort (Camden on the Lake) and another nearby resort (Lodge of Four Seasons).

LAURA HATCH, MS, FAADOM is known internationally as the Leader in Dental Front Office Solutions and Training. A keynote speaker, author, and coach, Laura is best known as the founder of Front Office Rocks™, a virtual training platform for dental teams. Using her unique style and interactive delivery methods, Laura loves to help dental teams

learn the systems and methods to achieve unprecedented results. Through this work, she has become a mentor to her clients & her colleagues. Laura is a best-selling author of her book “Step Away from the Drill” and a member of the National Speaker’s Association, the Speaking Consulting Network, the Academy of Dental Management Consultants and a Fellow of the American Association of Dental Office Managers.

BUILD A TEAM THAT ROCKSFRI AM | 2.75CETo take your practice to the next level, well-defined systems and proper training must be in place. When team members understand the ‘why’ behind ‘what’ they are asked to do, the practice runs more efficiently and smoothly. In this course, you will learn the communication skills and procedures that create the ultimate customer service experience for your patients. You will also learn how to handle common scheduling issues – reduce cancellations/no-shows, set production goals, maximize treatment coverage and increase case acceptance. Ultimately experiencing a happier, higher producing team that will improve and master the essential systems to make the practice and the team rock!

Objectives:• Define communication and how to apply the right amount • Identify and apply solutions to common appointment scheduling

problems• Differentiate between types of dental appointments, block scheduling

and production, including effective monthly goal setting• Understand the business cycle and the importance of customer service• Learn the key to case acceptance by understanding the buying cycle• Understand team management • Recognize how to become an active listener• Utilize business technology to support functions of the front office

ROCK DIFFICULT DISCUSSIONSFRI PM | 2.75CEAs a dentist, office manager or dental team member, you regularly manage patient issues, office drama and the working relationship you have with your team members, who can be your biggest advocate or detriment. This course dives into the complex relationships within the dental practice. Many dentists, office managers or team members are not trained in communication, HR or other business aspects. Laura will delve into communication techniques that work to create a true partnership between the team, the patients and the dentist that helps practices not just survive, but thrive.

Objectives:• Identify the 7 C’s of effective communication.• Define the communication cycle and understand different forms of

communication.• Learn the 33 keys to successful conversations.• How to become an active listener.• Outline the 8 tools to handle difficult conversations.

ROCK THE DRAMA OUT OF YOUR PRACTICESAT AM | 2.75CEDrama in the dental office is described as conflicts between employees, disagreements (work-related or otherwise) that get brought up in the office, complaints, rumors, inappropriate actions on the job, and other unpleasant emotional outbursts, etc. At one time or another, every office goes through a patch of team-related “drama.”This presentation will help you and your team break the cycle and rock the drama out of your practice.

Objectives:Attendees will Learn UNITY:

• Understand that culture = a shared vision and purpose• Negate gossip and drama by developing & implementing a policy• Identify potential issues and handle them before they cause conflict• T.H.I.N.K. - Apply the T.H.I.N.K. method to the drama in your office• You - Change starts with you

PAPERLESS COURSE HANDOUTSAll course handouts will be available to download

prior to the event to reduce excess paper used.

EARN 8+ CE HOURS

• The gummy smile• The appliance dependent patient• The cleft lip/ palate patient • The aging face

PROGRAMS FOR THE ENTIRE DENTAL TEAM

JUST BECAUSE YOU’RE AN EXPERT ... DOESN’T MAKE YOU INTERESTING FRI PM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDIt’s never been tougher to hold people’s attention as it is now: text messages, email, voicemail, multitasking, social media ... all of it competes for listeners’ attention. Consequently, your role as a leader/influencer is more difficult; if people aren’t listening, you’re not leading or influencing. This course is designed for all members of the dental team who want to make a greater impact during one-on-one conversations, speaking to a small group or presenting in front of a large audience. You’ll come away from this program with a greater confidence on being an interesting expert!

Objectives:• How to Peak, then Point™ and creating vivid and memorable

listener experiences • Learn about The Speech of 25™ which is a simple method for

rehearsing your presentation, giving it a natural look, sound, and feel• Understand Lead, Don’t Sell™ and how to earn belief, then ask

for action

GARY WILBERS is a successful entrepreneur and experienced trainer who helps individuals ascend to their peak. A mid-Missouri native, Gary has authored three books and spoken extensively on the topic of building a positive culture that enhances people and performance.

POSITIVE CULTURE WINS IN DENTISTRYSAT AM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDDentists of all ages face many challenges from inheriting a practice, to managing multiple personalities, to learning how to grow in leadership and balance. Plus you’re still learning to understand yourself. This course is designed to help the attendee grow in leadership through learning to cultivate a positive culture. This practical and power-packed three-hour session focuses on four foundations to building a positive culture, learning your personality profile using the Enneagram tool and learning how to be a high performer in every area of life.

Objectives:• Learn how to change your paradigm from Stuck to a Climber Mindset• Discover your Enneagram Profile Type and how your style impacts

practice culture• Connect with relationships to improve the culture of your practice• Learn how to boost your productivity to become a high performer• Learn how to integrate new habits and disciplines into action

CAMDEN ON THE LAKE Located at 2359 Bittersweet Rd, Lake Ozark. Make reservations by calling 888-365-5620 and state you are with the MDA. Reservations must be made by May 18, 2021. Room rates available are Deluxe King Suites or Deluxe Double Suites for $182 plus tax, per night and One Bedroom King Grand Suites for $222 plus tax, per night. Check in time is 4p and check out is 11a.

LODGE OF FOUR SEASONS Located at 315 Four Seasons Dr, Lake Ozark, less than a 5-mile drive from Camden on the Lake. Make reservations by calling 888-265-5500 and state you are with the MDA. Reservations must be made by April 22, 2021. There are a variety of rooms offered, based on availability at prices ranging from $172 to $392. Check in time is 4p and check out is 11a.

SHUTTLE SERVICES As a convenience for our meeting attendees, Camden on the Lake will offer a shuttle between the two resorts on both Friday and Saturday, during meeting hours.

Page 4: C4S ANNUAL CONFERENCE REGISTRATION

HOTEL INFOSCHEDULE OF EVENTSTHURSDAY | JUNE 17, 20216:30–8:30P “FIRE & ICE” WELCOME RECEPTION & EXHIBITS PREVIEW

FRIDAY | JUNE 18, 20217:15–8A YOGA

8A REGISTRATION/EXHIBITS OPEN

8–9A BREAKFAST BAR

9A–NOON DR. THOMAS DUDNEY MACdentistry: The What, When, How & Why of Current Indirect Restorative Materials, Adhesives & Cements

9A–NOON DR. PAUL HOMOLY Making It Easy For Patients To Say “Yes” NEW DENTIST COMMITTEE RECOMMENDED

9A–NOON LAURA HATCH, MS, FAADOM Build a Team that Rocks

10:15–10:45A REFRESHMENT BREAK

NOON–1:30P LUNCH

1:30–4:30P DR. THOMAS DUDNEY What’s a Dentist to Do? Diagnosis, Treatment Options, & Rehabilitation of Difficult & Unusual Cases

1:30–4:30P DR. PAUL HOMOLY Just Because You’re an Expert ... Doesn’t Make You Interesting NEW DENTIST COMMITTEE RECOMMENDED

1:30–4:30P LAURA HATCH, MS, FAADOM Rock Difficult Discussions

2:45–3:15P REFRESHMENT BREAK

4:30–6P RECONNECT RECEPTION

6–7P NEW DENTIST SOCIAL HOUR

7P AMERICAN COLLEGE OF DENTISTS RECEPTION & DINNER

SATURDAY | JUNE 19, 20218A REGISTRATION OPEN

8–9A CONTINENTAL BREAKFAST

9A–NOON DR. THOMAS DUDNEY Be Aware of Wear: A Systematic Approach to Diagnosing, Treatment Planning & Restoring the Worn Dentition

9A–NOON GARY WILBERS Positive Culture Wins in Dentistry NEW DENTIST COMMITTEE RECOMMENDED

9A–NOON LAURA HATCH, MS, FAADOM Rock the Drama Out of Your Practice

10:15–10:45A REFRESHMENT BREAK

NOON CONFERENCE ENDS

SPEAKERS & COURSESTHOMAS E. DUDNEY, DMD is a 1977 graduate of Univ. of Alabama in Birmingham SOD. He has served as the Clinical Director for the Aesthetic Advantage hands-on programs at NYU and the Eastman Dental Clinic in London. Presently, he is the clinical director of the Pacific Aesthetic Continuum (PAC) hands-on programs. He has presented workshops and lectures at dental meetings and has

authored several articles on aesthetic and restorative dentistry. He is a member of the ADA, the Alabama Dental Association and the American Academy of Cosmetic Dentistry. He is also a fellow of the American Society for Dental Aesthetics and a Diplomate of the American Board of Aesthetic Dentistry.

MACDENTISTRY: THE WHAT, WHEN, HOW & WHY OF CURRENT INDIRECT RESTORATIVE MATERIALS, ADHESIVES & CEMENTSFRI AM | 2.75CEAs restorative materials, adhesives and cements continue to evolve and improve, keeping up with the latest advancements is difficult. Patients continue to have high expectations for long-term clinical success. Having an understanding and working knowledge of these materials will enable you to make sound decisions and drive that long-term success. This program will discuss factors affecting the selection of indirect restorative materials that will satisfy the aesthetic and functional goals of the patient as conservatively as possible. Cases will be used to demonstrate the use of these materials, bonding agents and cements in different clinical situations.

Objectives:• Learn about monolithic vs. layered restorations• Learn to combine aesthetics and function with emax lithium disilicate• Learn the advantages and disadvantages of full contour zirconia• Understand the benefits of the new universal adhesives• Learn which cements to use, when and why, and the long-term benefits of

bioactive cements

WHAT’S A DENTIST TO DO? DIAGNOSIS, TREATMENT OPTIONS & REHABILITATION OF DIFFICULT & UNUSUAL CASESFRI PM | 2.75CESometimes the restorative dentist encounters clinical situations that are out of the ordinary and can often be difficult to treatment plan. This program will examine several such cases in order to explore treatment options and develop treatment plans. Treatment results will be demonstrated along with helpful clinical tips on: material selection, how to determine incisal edge position, intra-oral composite mock-ups, opening bites, fabricating and evaluating provisional restorations, bonding to porcelain in the mouth, and fine tuning occlusal adjustments.

Objectives:Explore treatment options and examine clinical results for:

• Traumatic avulsion of permanent incisors

• The dark central incisor• The severely worn dentition• Class III anterior crossbite

BE AWARE OF WEAR: A SYSTEMATIC APPROACH TO DIAGNOSING, TREATMENT PLANNING & RESTORING THE WORN DENTITIONSAT AM | 2.75CEIn today’s society, tooth wear is more prevalent than ever, and it is therefore incumbent upon the entire dental team to be well-versed in recognizing the clinical signs of wear while understanding the importance of prevention when possible and the restorative options when necessary. This program will illustrate the different types of tooth wear with clinical examples and demonstrate a systematic approach to diagnosis and treatment.

Objectives:• Recognize the clinical signs of intrinsic and extrinsic erosion• Learn office protocols to help patients prevent and/or treat acid erosion• Recognize the clinical signs of horizontal and vertical wear patterns• Design an occlusal scheme that fits the grinding patterns of the patient• Understand bite opening vs. crown lengthening vs. orthodontic

intrusion to gain space for restorations

PAUL HOMOLY, DDS, CSP is a world-class leader in dental education. As a restorative dentist and acclaimed educator for more than thirty years, he’s known for his innovative and practical approach to dentistry. Paul is president of Homoly Communications Institute, a resource for practice-building skills. He has authored many highly regarded

books and has the highest earned designation in professional speaking, Certified Speaking Professional (CSP). Fewer than 15% of professional speakers have earned this and he was the first dentist worldwide to earn it.

MAKING IT EASY FOR PATIENTS TO SAY “YES”FRI AM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDThis program is perfectly suited for dentists and team members, and teaches the skills to make case acceptance from single tooth to complex care dentistry predictably successful. It’s specifically designed for you if you have a broad-base general practice and are growing the complex care aspect of your practice – cosmetic, implant, CAD CAM, 3D imaging/airway and rehabilitative dentistry. The session includes case study simulations that make your lessons immediately relevant to your everyday practice and focuses on two areas: the fundamentals/strategies of case acceptance and specific take-home procedures.

Objectives:• Left- and right-side patients – The 6 critical distinctions between

simple and complex care patients• The Four Chiefs™ – The four essential conversations of case acceptance • The Choice Dialogue – Discover the readiness of the patient for care• The Discovery Guide™ – How to talk to patients about conditions they

don’t know they have• The Cross-Over Zone™ – Discomfort when talking about money• The Case Conversation – How to lead, not sell, patients into accepting

your treatment recommendations• The Advocacy Dialogue – Managing patients who are not ready for care

The MDA has secured room blocks at two locations, both the host resort (Camden on the Lake) and another nearby resort (Lodge of Four Seasons).

LAURA HATCH, MS, FAADOM is known internationally as the Leader in Dental Front Office Solutions and Training. A keynote speaker, author, and coach, Laura is best known as the founder of Front Office Rocks™, a virtual training platform for dental teams. Using her unique style and interactive delivery methods, Laura loves to help dental teams

learn the systems and methods to achieve unprecedented results. Through this work, she has become a mentor to her clients & her colleagues. Laura is a best-selling author of her book “Step Away from the Drill” and a member of the National Speaker’s Association, the Speaking Consulting Network, the Academy of Dental Management Consultants and a Fellow of the American Association of Dental Office Managers.

BUILD A TEAM THAT ROCKSFRI AM | 2.75CETo take your practice to the next level, well-defined systems and proper training must be in place. When team members understand the ‘why’ behind ‘what’ they are asked to do, the practice runs more efficiently and smoothly. In this course, you will learn the communication skills and procedures that create the ultimate customer service experience for your patients. You will also learn how to handle common scheduling issues – reduce cancellations/no-shows, set production goals, maximize treatment coverage and increase case acceptance. Ultimately experiencing a happier, higher producing team that will improve and master the essential systems to make the practice and the team rock!

Objectives:• Define communication and how to apply the right amount • Identify and apply solutions to common appointment scheduling

problems• Differentiate between types of dental appointments, block scheduling

and production, including effective monthly goal setting• Understand the business cycle and the importance of customer service• Learn the key to case acceptance by understanding the buying cycle• Understand team management • Recognize how to become an active listener• Utilize business technology to support functions of the front office

ROCK DIFFICULT DISCUSSIONSFRI PM | 2.75CEAs a dentist, office manager or dental team member, you regularly manage patient issues, office drama and the working relationship you have with your team members, who can be your biggest advocate or detriment. This course dives into the complex relationships within the dental practice. Many dentists, office managers or team members are not trained in communication, HR or other business aspects. Laura will delve into communication techniques that work to create a true partnership between the team, the patients and the dentist that helps practices not just survive, but thrive.

Objectives:• Identify the 7 C’s of effective communication.• Define the communication cycle and understand different forms of

communication.• Learn the 33 keys to successful conversations.• How to become an active listener.• Outline the 8 tools to handle difficult conversations.

ROCK THE DRAMA OUT OF YOUR PRACTICESAT AM | 2.75CEDrama in the dental office is described as conflicts between employees, disagreements (work-related or otherwise) that get brought up in the office, complaints, rumors, inappropriate actions on the job, and other unpleasant emotional outbursts, etc. At one time or another, every office goes through a patch of team-related “drama.”This presentation will help you and your team break the cycle and rock the drama out of your practice.

Objectives:Attendees will Learn UNITY:

• Understand that culture = a shared vision and purpose• Negate gossip and drama by developing & implementing a policy• Identify potential issues and handle them before they cause conflict• T.H.I.N.K. - Apply the T.H.I.N.K. method to the drama in your office• You - Change starts with you

PAPERLESS COURSE HANDOUTSAll course handouts will be available to download

prior to the event to reduce excess paper used.

EARN 8+ CE HOURS

• The gummy smile• The appliance dependent patient• The cleft lip/ palate patient • The aging face

PROGRAMS FOR THE ENTIRE DENTAL TEAM

JUST BECAUSE YOU’RE AN EXPERT ... DOESN’T MAKE YOU INTERESTING FRI PM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDIt’s never been tougher to hold people’s attention as it is now: text messages, email, voicemail, multitasking, social media ... all of it competes for listeners’ attention. Consequently, your role as a leader/influencer is more difficult; if people aren’t listening, you’re not leading or influencing. This course is designed for all members of the dental team who want to make a greater impact during one-on-one conversations, speaking to a small group or presenting in front of a large audience. You’ll come away from this program with a greater confidence on being an interesting expert!

Objectives:• How to Peak, then Point™ and creating vivid and memorable

listener experiences • Learn about The Speech of 25™ which is a simple method for

rehearsing your presentation, giving it a natural look, sound, and feel• Understand Lead, Don’t Sell™ and how to earn belief, then ask

for action

GARY WILBERS is a successful entrepreneur and experienced trainer who helps individuals ascend to their peak. A mid-Missouri native, Gary has authored three books and spoken extensively on the topic of building a positive culture that enhances people and performance.

POSITIVE CULTURE WINS IN DENTISTRYSAT AM | 2.75CE | NEW DENTIST COMMITTEE RECOMMENDEDDentists of all ages face many challenges from inheriting a practice, to managing multiple personalities, to learning how to grow in leadership and balance. Plus you’re still learning to understand yourself. This course is designed to help the attendee grow in leadership through learning to cultivate a positive culture. This practical and power-packed three-hour session focuses on four foundations to building a positive culture, learning your personality profile using the Enneagram tool and learning how to be a high performer in every area of life.

Objectives:• Learn how to change your paradigm from Stuck to a Climber Mindset• Discover your Enneagram Profile Type and how your style impacts

practice culture• Connect with relationships to improve the culture of your practice• Learn how to boost your productivity to become a high performer• Learn how to integrate new habits and disciplines into action

CAMDEN ON THE LAKE Located at 2359 Bittersweet Rd, Lake Ozark. Make reservations by calling 888-365-5620 and state you are with the MDA. Reservations must be made by May 18, 2021. Room rates available are Deluxe King Suites or Deluxe Double Suites for $182 plus tax, per night and One Bedroom King Grand Suites for $222 plus tax, per night. Check in time is 4p and check out is 11a.

LODGE OF FOUR SEASONS Located at 315 Four Seasons Dr, Lake Ozark, less than a 5-mile drive from Camden on the Lake. Make reservations by calling 888-265-5500 and state you are with the MDA. Reservations must be made by April 22, 2021. There are a variety of rooms offered, based on availability at prices ranging from $172 to $392. Check in time is 4p and check out is 11a.

SHUTTLE SERVICES As a convenience for our meeting attendees, Camden on the Lake will offer a shuttle between the two resorts on both Friday and Saturday, during meeting hours.

Page 5: C4S ANNUAL CONFERENCE REGISTRATION

3340 AMERICAN AVE, JEFFERSON CITY MO 65109

JUNE 18-19, 2021 | MODENTAL.ORG/C4S

REGISTRANT Print clearly for accurate processing. One registration per person. Make a copy of registration for your records.

Name

ADA #

Office Address

City State Zip

Email

REFUNDS & CANCELLATIONSAny request for a refund/cancellation must be made in writing to Mandy Lewis at [email protected]. A $50 cancellation fee will be charged per registration through June 8, 2021. No refunds will be granted after June 8, 2021. Those who register on-site will incur an additional $25 fee.

C4S ANNUAL CONFERENCE REGISTRATION

MISCELLANEOUSBringing your children? No Yes Age(s)/Name(s) _______________________________

Where are you staying? Camden on the Lake Lodge of Four Seasons Other_____________

GUEST MEAL ONLY OPTIONIncludes attendance at the Thursday Fire & Ice Welcome Reception & Exhibits Preview, Friday/Saturday breakfast, Friday lunch, Friday ReConnect Reception and all the breaks.

Qty _________x $50

Guest Name ____________________

Member | $329 New Dentist Member | $199* Retired Dentist Member | $209 Dental Team Member | $229 Class of 2021 Member | $99*

FEES Registration includes all courses, meals and most events.

`COURSES Purple denotes New Dentist Committee recommended course Orange denotes course for the whole dental team

Friday AM - Choose One MACdentistry: The What, When, How & Why of Current Indirect Restorative Materials, Adhesives & Cements (Dudney) Making It Easy for Patients to Say “YES” (Homoly) Build a Team that Rocks (Hatch)

Friday PM - Choose One What’s a Dentist to Do?: Diagnosis, Treatment Options & Rehabilitation of Difficult & Unusual Cases (Dudney) Just Because You’re an Expert ... Doesn’t Make You Interesting (Homoly) Rock Difficult Discussions (Hatch)

Saturday AM - Choose One Be Aware of Wear: A Systematic Approach to Diagnosing, Treatment Planning & Restoring the Worn Dentition (Dudney) Positive Culture Wins in Dentistry (Wilbers) Rock the Drama Out of Your Practice (Hatch)

JUNE 18-19, 2021 | CAMDEN ON THE LAKE

FOR THE MDA’S PREMIERE CONTINUING EDUCATION EVENTTHURSDAY “FIRE & ICE” WELCOME RECEPTION & EXHIBITS PREVIEW Arriving Thursday evening? Join us from 6:30–8:30p in the Exhibit Hall for a reception and preview of exhibits. Enjoy hot wings and ice cream while socializing with other attendees and spend some one-on-one time with exhibitors.

FRIDAY CONNECT4CASH This fundraiser will be back again to benefit the MDA Foundation. It’s a countdown raffle where the final number drawn wins the big $1,500 cash prize and bragging rights as the last one standing.

RECONNECT RECEPTION Relax and unwind at the ReConnect Reception from 4:30–6p in the Exhibit Hall. Enjoy beverages, snacks and the camaraderie of your peers and exhibitors.

NEW DENTIST SOCIAL HOUR New dentists and family members are invited to a social hosted by the MDA New Dentist Committee from 6–7p. Cost is $20/person and includes appetizers, drinks and prizes. This event is exclusive to dentists who graduated 10 years ago or fewer.

H. TOADS H. Toad’s is the premier destination for all of your live entertainment and is attached to the Camden at the Lake Resort, so there is no need for transportation! Visit HToads.com for a complete schedule.

CONNECT 4 CASH RAFFLE TICKETS

Qty _________x $100 (5 MAX)

PAYMENT DETAILS

Card #

Exp Date CSV

Signature

Card Billing Address

City State Zip

Email

GRAND TOTAL

GENEROUSLY UNDERWRITTEN BY MDA’S WHOLLY-OWNED INSURANCE SUBSIDIARY

$

The Missouri Dental Association is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. The MDA designates this activity for 8+ continuing education credits.

Check VISA MasterCard Discover

Total:

Total:

SPECIAL EVENTSWill you be attending the Fire & Ice Welcome Reception Thursday evening?

No Yes Qty.________

Will you be participating in the Yoga Session Friday Morning? No Yes

NEW DENTIST SOCIAL HOUR*This event is exclusive to dentists who graduated 10 years ago or fewer. $20 per Dentist/Guest, Friday 7–8p Qty _________x $20

Guest Name ____________________ Total:

Total:

Return completed form with check or credit card payment to: Missouri Dental Association, 3340 American Ave, Jefferson City MO 65109.

Credit Card Payments Only: Fax to 573-635-0764

REGISTRATION DEADLINE: JUNE 8, 2021

AMERICAN COLLEGE DINNER$50 per Person, Friday 6–10p Qty ____ NY Strip Qty ____ Salmon

Guest Name ____________________ Total:

Non Member | $499 New Dentist Non Member | $279*

Page 6: C4S ANNUAL CONFERENCE REGISTRATION

3340 AMERICAN AVE, JEFFERSON CITY MO 65109

JUNE 18-19, 2021 | MODENTAL.ORG/C4S

REGISTRANT Print clearly for accurate processing. One registration per person. Make a copy of registration for your records.

Name

ADA #

Office Address

City State Zip

Email

REFUNDS & CANCELLATIONSAny request for a refund/cancellation must be made in writing to Mandy Lewis at [email protected]. A $50 cancellation fee will be charged per registration through June 8, 2021. No refunds will be granted after June 8, 2021. Those who register on-site will incur an additional $25 fee.

C4S ANNUAL CONFERENCE REGISTRATION

MISCELLANEOUSBringing your children? No Yes Age(s)/Name(s) _______________________________

Where are you staying? Camden on the Lake Lodge of Four Seasons Other_____________

GUEST MEAL ONLY OPTIONIncludes attendance at the Thursday Fire & Ice Welcome Reception & Exhibits Preview, Friday/Saturday breakfast, Friday lunch, Friday ReConnect Reception and all the breaks.

Qty _________x $50

Guest Name ____________________

Member | $329 New Dentist Member | $199* Retired Dentist Member | $209 Dental Team Member | $229 Class of 2021 Member | $99*

FEES Registration includes all courses, meals and most events.

`COURSES Purple denotes New Dentist Committee recommended course Orange denotes course for the whole dental team

Friday AM - Choose One MACdentistry: The What, When, How & Why of Current Indirect Restorative Materials, Adhesives & Cements (Dudney) Making It Easy for Patients to Say “YES” (Homoly) Build a Team that Rocks (Hatch)

Friday PM - Choose One What’s a Dentist to Do?: Diagnosis, Treatment Options & Rehabilitation of Difficult & Unusual Cases (Dudney) Just Because You’re an Expert ... Doesn’t Make You Interesting (Homoly) Rock Difficult Discussions (Hatch)

Saturday AM - Choose One Be Aware of Wear: A Systematic Approach to Diagnosing, Treatment Planning & Restoring the Worn Dentition (Dudney) Positive Culture Wins in Dentistry (Wilbers) Rock the Drama Out of Your Practice (Hatch)

JUNE 18-19, 2021 | CAMDEN ON THE LAKE

FOR THE MDA’S PREMIERE CONTINUING EDUCATION EVENTTHURSDAY “FIRE & ICE” WELCOME RECEPTION & EXHIBITS PREVIEW Arriving Thursday evening? Join us from 6:30–8:30p in the Exhibit Hall for a reception and preview of exhibits. Enjoy hot wings and ice cream while socializing with other attendees and spend some one-on-one time with exhibitors.

FRIDAY CONNECT4CASH This fundraiser will be back again to benefit the MDA Foundation. It’s a countdown raffle where the final number drawn wins the big $1,500 cash prize and bragging rights as the last one standing.

RECONNECT RECEPTION Relax and unwind at the ReConnect Reception from 4:30–6p in the Exhibit Hall. Enjoy beverages, snacks and the camaraderie of your peers and exhibitors.

NEW DENTIST SOCIAL HOUR New dentists and family members are invited to a social hosted by the MDA New Dentist Committee from 6–7p. Cost is $20/person and includes appetizers, drinks and prizes. This event is exclusive to dentists who graduated 10 years ago or fewer.

H. TOADS H. Toad’s is the premier destination for all of your live entertainment and is attached to the Camden at the Lake Resort, so there is no need for transportation! Visit HToads.com for a complete schedule.

CONNECT 4 CASH RAFFLE TICKETS

Qty _________x $100 (5 MAX)

PAYMENT DETAILS

Card #

Exp Date CSV

Signature

Card Billing Address

City State Zip

Email

GRAND TOTAL

GENEROUSLY UNDERWRITTEN BY MDA’S WHOLLY-OWNED INSURANCE SUBSIDIARY

$

The Missouri Dental Association is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. The MDA designates this activity for 8+ continuing education credits.

Check VISA MasterCard Discover

Total:

Total:

SPECIAL EVENTSWill you be attending the Fire & Ice Welcome Reception Thursday evening?

No Yes Qty.________

Will you be participating in the Yoga Session Friday Morning? No Yes

NEW DENTIST SOCIAL HOUR*This event is exclusive to dentists who graduated 10 years ago or fewer. $20 per Dentist/Guest, Friday 7–8p Qty _________x $20

Guest Name ____________________ Total:

Total:

Return completed form with check or credit card payment to: Missouri Dental Association, 3340 American Ave, Jefferson City MO 65109.

Credit Card Payments Only: Fax to 573-635-0764

REGISTRATION DEADLINE: JUNE 8, 2021

AMERICAN COLLEGE DINNER$50 per Person, Friday 6–10p Qty ____ NY Strip Qty ____ Salmon

Guest Name ____________________ Total:

Non Member | $499 New Dentist Non Member | $279*