SOUT

HERN

ILLIN

OIS UN

IVERSITY

Schoo

l of D

ental

Med

icine

Office of

the D

ean

2800

Coll

ege Ave.,

Build

ing 2

71Alt

on, Illin

ois 6

2002

NON-

PROF

ITPO

STAG

E PA

IDPE

RMIT

NO.

4678

ST. L

OUIS

, MOContact Information

Payment Information

CE Tuition:

Please note that all contributions are tax-deductible to the fullest extent allowable by law. For participants in the golf tournament, $85 per golfer will be considered fair market value for the benefit received. The remainder of each payment will be accepted as a gift to the SIU School of Dental Medicine Benefit Fund.

SpringAlumni WeekendFriday, May 1, 2020Saturday, May 2, 2020

25th Annual PROPHY CUP CHALLENGEGOLF TOURNAMENT

SATURDAYCE PROGRAM

Checks: Please make all checks payable toSIUE FOUNDATION

Card # _____________________________

Expiration Date: ________________________

Name on Card: _________________________

Billing Address: _________________________

__________________________________

Signature: ____________________________

Credit Card: Total Payment: $

Golf

Register by Phone: 618-474-7271 Register by Mail:

SIU School of Dental MedicineAttn: Spring Alumni Weekend

2800 College Ave., Building 271Alton, IL 62002

DEADLINE for entry is April 24, 2020

Team Registration (4 players) $800

Player Registration (No. of players) $200

I cannot attend but please accept my tax-deductiblecontribution $

Golf Sponsorship:

Golf Payment:

Bronze Sponsor (1 player) $500

Silver Sponsor (2 players) $1,000

Gold Sponsor (4 players) $2,000

x

$100 SIU SDM Alumni Class Year$225 Non SIU SDM Dentist$75 Allied Personnel

Cancellation/Refund Policy:Tuition is completely refundable if course is cancelled by SIU SDM or if the registrant cancels more than 7 days prior to course. A $20 service fee will be charged if the cancellation is less than 7 days prior to the program.

SIU/SDM designates this activity for 3.0 CE Credit/Hours

Golf Total $CE Total $SUM Total $

Name __________________ Class Year: _____

Company: ____________________________

Email: ______________________________

Telephone: ____________________________

Team Information / Name of Players:

1. _________________________________

2. _________________________________

3. _________________________________

4. _________________________________

Education

CE Registration

Golf Registration

Sout

hern

Illin

ois U

nive

rsity

Sch

ool o

f Den

tal M

edic

ine

is a

n A

DA

CER

P re

cogn

ized

pro

vide

r.

FRIDAY

Prophy Cup ChallengeFriday, May 1, 2020

618-465-3111 • 314-355-8128http://www.spencertolingolf.com

Participate in the 25th AnnualProphy Cup ChallengeProceeds benefitSIU SDM Faculty Recruitment & Retention4-Person Scramble Golf TournamentSpencer T. Olin Golf Course4701 College Ave. • Alton, IL 62002

10:30 a.m. Registration Open Driving Range11:00 a.m. LunchNoon Shotgun Start5:30 p.m. Dinner/Awards Reception

Membership in the SDM Gold Circle Club

GoldSponsor$2,000

SilverSponsor$1,000

BronzeSponsor$500

TournamentParticipant

$200

Sponsor’s logo/name on the SDM website and in all Golf-relatednews items (electronic and print)

Hole Sponsor: Sponsor’s logo/name on a 1’ x 2’ sign, prominently displayednear the tee box at one (or more) of the 18 holes

Sponsor’s logo/name on “Sponsors’ List” distributed to all tournament participants

Recognition on “Sponsors’ Sign,” prominently displayed at the tournamentregistration and lunch pavilion

Recognition in the SDM Honor Roll of Donors

Greens Fees, cart, six (6) beverage tickets, lunch, driving range, attendance prize,hole-in-one contest, dinner and awards reception

PROPHY CUP CHALLENGE GOLF TOURNAMENTSPONSORSHIP OPPORTUNITIES

(4 Holes)

(x4)

(2 Holes)

(x2)

(1 Hole)

(x1) (x1)

Best Western Premier Hotel 618-462-1220Best Western Plus Hotel 618-433-9900Comfort Inn 618-465-9999Hampton Inn Suites 618-433-8999

Lodging in Alton

Kerry Studnicki is an assistant professor at Southern Illinois University Edwardsville School of Dental Medicine. He received his doctorate of pharmacy from SIUE School of Pharmacy in 2012, and was part of a task force that created a training program for opioid prescribers in rural locations.

The goal of this program is to provide dentists with information regarding the current opioid epidemic, pharmacology of opioids and pain, and best practices in treating dental pain.

Weekend ScheduleFriday, May 1 - Golf Tournament

Saturday, May 2 - Continuing Education

Kerry Studnicki, PharmD

“Safe OpioidPrescribing

for thePracticing Dentist”

CE Presentation:

Presented By:

Saturday, May 2, 2020

SIU School of Dental Medicine is an ADA CERP Recognized Provider. ADA CERPis 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. SIU School of Dental Medicine designates this activity for continuing education credits. This continuing education activity has been planned and implemented in accordance with the Standards of the ADA CERP. Concerns or complaints about a CE provider may be directed to the provider or to the ADA Commission on Continuing Education Recognition Program at www.ada.org/cerp.

Objectives:• Discuss the history of the current opioid epidemic• Describe the pharmacology of pain and opioids• Evaluate opioid and non-opioid options for acute pain management • Identify risks and symptoms of opioid use disorder• Review the treatments for opioid overdose and opioid addiction• Examine the use, impact, and information available in a Prescription Monitoring Program • Demonstrate best practices in treating dental pain including: ADA statement, interprofessional communication, and patient communication

8:00 a.m. Registration/Continental Breakfast Roller Hall, Bldg. 2638:30 a.m. Lecture - Roller Hall, Bldg. 26310:00 a.m. Break - Wall of Wines/Roller Commons10:30 a.m. Lecture - Roller Hall, Bldg. 26311:45 a.m. Questions / Answers12 Noon Wall of Wines (continued) Roller Commons12:15 p.m. Wine Lottery Drawing - Must be present to win

ADA Policy and Statement:Policy on Opioid Prescribing (2018)Resolved, that the ADA supports mandatory continuing education (CE) in prescribing opioids and other controlled substances, with an emphasis on preventing drug overdoses, chemical dependency, and diversion. Any such mandatory CE requirements should:1. Provide for continuing education credit that will be acceptable for both DEA registration and state dental board requirements2. Provide for coursework tailored to the specific needs of dentists and dental practice3. Include a phase-in period to allow affected dentists a reasonable period of time to reach compliance, and be it further

Resolved, that the ADA supports statutory limits on opioid dosage and duration of no more than seven days for the treatment of acute pain, consistent with Centers for Disease Control and Prevention (CDC) evidence-based guidelines, and be it further

Resolved, that the ADA supports improving the quality, integrity,and interoperability of state prescription drug monitoring programs.

Illinois DFPR: The Illinois Department of Financial and Professional Regulation, in November, 2019, amended the Illinois Controlled Substances Act with the addition of the Safe Opioid Prescribing Practices Continuing Education (CE) requirement in effect for all prescribers renewing in 2020. Prescribers with Controlled Substances Registrations are required to complete 3 hours of continuing education (CE) on safe opioid prescribing practices to renew their Controlled Substances Registration. This requirement can be included in the total number of hours required to renew a professional license. This requirement will be in effect for all Controlled Substances Registration renewals in 2020 and after. This SIU-SDM course meets continuing education requirements for dentists with Controlled Substances Registrations in Illinois.