www.academyforsportsdentistry.org

Academy for Sports Dentistry presents32nd Annual Symposium

Total Sports Team Dentistry:

Marketing...Relationships...Performance

June 19-21, 2014The Westin San Diego

400 West BroadwaySan Diego, CA 92101

(888) 627-9033

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Send in your registration today!

Check inside for discounts on registration fees

Electrifying and dynamic speakers. Energetic hands-on workshops. Inspiring and exhilarating learning. Coupleall that with breath-taking waterfront views, amazingly warm, sunny weather, and endless restaurants,entertainment and beauty. Let the Annual 2014 Symposium in San Diego begin!!!!

This year, the theme and title of our meeting is “Total Sports Team Dentistry: Marketing...Relationships...Performance.” I am honored to be your Symposium Chairman and even more thrilled with the, as the famousHarry Caray put it, “It might be...it could be...it is...a HOME RUN” meeting that ASD has planned for you.

For starters, we are going to “tip off“ the meeting on Thursday, June 19, with an exciting Team Dentist course.This is a great opportunity to obtain the knowledge you need to become a team dentist. Following that, Dr. BrettDorney will be “bumping and running” attendees with a mouthguard fabrication workshop and lecture. Comeand experience the new information and importance of an excellent and properly fitted mouthguard. Thursdayevening we will be “splitting the uprights“ with a Welcome Reception at the USOC Training Center in Chula Vista.A tour of the facility will be interesting as well as fun.

“Huddling” with the San Diego Chargers Team Physician Jerry Hizon is planned for Friday with an electrifyinglecture titled “Latest Trends in Sports Medicine and How to Assemble an Elite Sports Medicine Team from HighSchool to Pro Sports.” Come learn from this seasoned team doctor how you can make a difference in the lives ofathletes by assembling a sports medicine team.

Next “on deck“ for Friday, you will be fired up with a “knock-out“ lecture on how to be an “Unstoppable ProfitProducer” for your sports dental practice by the enthusiastic and ultra knowledgeable Mike Stromsoe. Mike haswowed crowds by his fun approach and extremely successful strategies. You will not want to miss this.

“Rounding the bases“ after that will be a profound lecture on the new advances in football helmet protection byMike Short from Xenith Helmet Company, as well as Doug Lambert, DDS, tackling the important subject ofrestoring the traumatic injured dental patient. Dr. Lambert will include a lecture on the use of fiberreinforcement accompanied by a workshop on splinting and the making of a bridge. Both of these subjects arevitally important to any and all team dentists.

Saturday will be full of “slam dunks“ with an Olympic update by Corey Warner, Bill Moreau and an inspiringOlympic athlete. They all will be sharing how we can give back by participating in their organization. Tomotaka Takeda will be sharing valuable recent research regarding concussion prevention with properly fittedmouthguards, and John Comisi will be “taking it to the rack“ with his lecture about the importance ofmaintaining a balanced oral environment. We will finish the day with a hands-on suturing workshop with Dr.Chester Griffiths. All of these speakers will add to and stimulate your knowledge regarding sports dentistry.

Peppered in between this brilliantly exciting meeting will be a recognition luncheon, annual business meeting,and the President‘s Reception. Last, but certainly not least, our Annual Symposium will be “hitting the hole“with our tremendous exhibitors, our always enticing silent and live auctions, surprise guests and friendlyfellowship.

As of this writing, a new development is in the works. As the MLB schedule was recently released, aPadres/Dodgers baseball game at the spectacular Petco Park is being organized for Saturday evening. As detailsare firmed up, a notice will go out to all attendees.

As the time for our meeting nears, I am so looking forward to us all being refreshed in knowledge and relaxedin spirit, and for us to leave with this thought from the late Jerry Coleman, San Diego Padres long-timeannouncer: “Oh Doctor!! You can hang a star on that one.” Looking forward to seeing you all in beautiful SanDiego.

Andrew Arriola, DDS2014 ASD Annual Meeting Chairwww.academyforsportsdentistry.org

W e l c o m e

Continuing Education CreditThe Academy for Sports Dentistry is an ADA CERP recognized provider. ADA CERP is aservice of the American Dental Association to assist dental professionals in identifyingquality providers of continuing dental education. ADA CERP does not approve orendorse individual courses or instructors, nor does it imply acceptance of credit hoursby boards of dentistry. Academy for Sports Dentistry designates this activityfor up to 24.5 continuing education credits for full participation in the TeamDentist Course (lectures), Symposium (lectures) and (hands-on) Workshops.

The Academy of General Dentistry also designates the Academy for Sports Dentistry asa nationally approved sponsor. The formal continuing education programs of thisprogram provider are accepted by AGD for Fellowship/Mastership credit. The currentterm of acceptance extends from 7/1/2010 through 6/30/2014 – Provider ID# 211120.

The Academy also has approval as a continuing education provider for certified athletictrainers by the N.A.T.A. Board of Certification (NATABOC). Attendance at the ASDmeeting counts for double credit hours towards ASD Fellowship. Academy forSports Dentistry designates this activity for up to 24.5 continuing educationcredits for full participation in the Team Dentist Course (lectures),Symposium (lectures) and (hands-on) Workshops.

Dress The weather in early June is typically warm and sunny. Expect temperatures to rangefrom 61-71 degrees. We recommend checking a 5-day forecast when packing yourbags. http://www.sandiego.org/plan-your-trip/visitor-information/weather.aspx. Therecommended attire for the Symposium is business casual.

San Diego, CaliforniaBordered by the Pacific Ocean to the west, the Anza-Borrego Desert and the LagunaMountains to the east, and Mexico to the south, the diverse neighborhoods of SanDiego are spread out over 4,200 square miles, offering endless opportunities forexploration and activities. Spend a day relaxing in one of the many beachcommunities, then hiking in the east San Diego County mountains the next. Explorethe urban neighborhoods of San Diego’s downtown, from the iconic Gaslamp Quarterto the eclectic community of Hillcrest. Visit the quaint and charming island town ofCoronado or the picturesque village of La Jolla. San Diego’s regions are so unique anddiverse; there are plenty of options to discover something new each time you visit.

The beating heart of San Diego’s downtown rests in the Gaslamp Quarter, comprised of16½ square blocks in the city’s central core. With a colorful array of restaurants, nightclubs,art galleries and boutiques, you will find plenty of things to do on foot. During the day, theGaslamp Quarter is a great place for families. Visit the New Children’s Museum or explorethe historic Victorian architecture preserved throughout the neighborhood. Shop at HortonPlaza or catch the Trolley to Balboa Park and the world-famous San Diego Zoo or Old Town.As night falls, the Quarter transforms into a veritable adult playground as the sophisticatednightclub scene comes to life. From award-winning restaurants to happening dance clubs,jazz and rooftop bars, you’ll find it in the Gaslamp Quarter.

Hotel AccommodationsThe Westin San Diego is a AAA Four Diamond Hotel centrally located in the heart ofdowntown and in the center of the city’s major attractions. The Convention Center,Seaport Village, Little Italy, historic Gaslamp Quarter, SeaWorld, San Diego Zoo, and avariety of shopping and dining options surround the hotel and are easily accessible.The hotel is a quick walk to the San Diego Trolley and Amtrak station, and a short drivefrom the San Diego International Airport and all major freeways. Enjoy the Westin SanDiego’s panoramic views of the San Diego Bay, Coronado Island and the downtowncityscape. The sophisticated urban setting begins with the 100-foot high lobbyatrium, creating a magnificent sense of arrival.

Special AccommodationsIn compliance with the Americans with Disabilities Act of 1990, the Academy for SportsDentistry will make all reasonable efforts to accommodate persons with disabilities atits meetings. Please call (217) 227-3431 with any special requests.

TransportationThe Westin San Diego provides a complimentary airport shuttle to and from the San DiegoInternational Airport so guests can arrive and depart the hotel with ease. The hotel shuttleoperates between the hours of 6:00 am –11:00 pm. Once guests have retrieved theirluggage from the airport’s baggage claim, they can call the hotel operator at (619) 239-4500 for directions to the appropriate waiting area. When departing, guests may sign upwith a luggage attendant for a scheduled time of departure. We advise that you sign upone day prior to departure in order to secure a spot. The shuttle is complimentary, butgratuities are greatly appreciated. www.westinsandiego.com. Taxi service is also availablefor a cost of approximately $15.00 one way.

Annual Symposium Silent AuctionEvery year the Academy presents a Silent Auction to benefit education and dentaltrauma and prevention research. If you have autographed items or other unique itemsyou would be willing to donate for the auction, the ASD Board welcomes your help.Please contact Shelly Lott at (217) 227-3431 or fax (217) 227-3438 with yourcontributions.

Invitation from the General Chairman

G e n e r a l I n f o r m a t i o n

Thursday, June 19, 2014

7:00 am – 8:00 am Registration/Exhibits/Continental Breakfast

8:00 am – 3:00 pm Team Dentist Course Lectures

8:00 am – 8:20 am Lecture: IntroductionSpeaker: Stephen Mills, DDS, FASDThe team dentist has become an integral part of the modernhigh-level sports medicine team. It is imperative that anydentist who takes on the role of team dentist must be aware ofhow the modern sports medical team functions in addition tohaving the specialized dental skills and knowledge that he orshe must bring to the team. This course is designed as anoverview of the major areas for which the team dentist shouldbe responsible. Dental readiness for the athlete to start andoptimally compete, the ability to rapidly recognize and treatorofacial trauma, and the ability to prevent injuries withexcellent mouth protection are the basic sections for any teamdentist course. In addition, the course will feature two specialhands-on workshops on mouthguard fabrication and intraoralsuturing to enhance the didactic portion of the presentation.There will also be a section on the legal responsibilities of theteam dentist at a variety of levels of competition to answer anyquestions that one might have about taking on the role of teamdentist. The Academy for Sports Dentistry feels that anycompetent dentist can become a skilled team dentist, but thatthe position of team dentist must only be undertaken by adentist who has the tools needed to fulfill that role completely.This course aims to provide a template for what all team dentistsmust be prepared for.

8:20 am – 9:15 am Lecture: The Athletic Trainer, the Sports Medicine Team and the Dentist’s RoleSpeaker: Gary Vitti, Certified Athletic TrainerThere are many members of the sports medicine team, all of whom have an important role in taking care of athletes.High-level athletes have many needs, and it is impossible for anindividual to be an expert in every aspect of healthcare. This iswhy the sports medicine team is comprised of many alliedhealth professionals who can deliver specialized care as needed.This presentation will discuss specifically the team dentist’s rolein the sports medicine team. In addition, we will discuss whatboth the team and athletic trainer would expect from thedentist, how to deal with high-level athletes, and otherresponsibilities in taking care of an athletic team. Afterattending this presentation, the attendee will know who themembers of the sports medicine team are; what the roles,responsibilities, skills and services of the athletic trainer are; and the importance of the team dentist on the sports medicine team.

9:20 am – 10:45 am Lecture: The Immediate Recognition and Treatment of Dental TraumaSpeaker: Mark Roettger, DDS, FASDWhether on the field, court or ice rink, it is important for theteam dentist to recognize and manage dental trauma. With thehigh-paced sports we watch and love come severe injuries thatrequire the same briskness in dealing with them. It is importantfor the team dentist to triage the more serious medical injurieson to our medical colleagues and provide first-line dental

treatment. This requires the team dentist to make an immediatediagnosis and to manage the patients‘ emergency dentalconcerns on site so they can be referred on to their own dentistsfor definitive treatment. The decisions made at the site of thetrauma strongly influence the long-term outcomes for patients.Dental injuries can be classified into those requiring immediateattention (within 5 minutes), urgent attention (within 6 hours)and less urgent attention (within 12 hours). It is a race againstthe clock. This is especially true for tooth avulsion. Immediatereplantation gives these teeth the best possible long-termprognosis. Delay in tooth replantation most certainly will leadto the eventual loss of the tooth.

Dental injuries where the tooth is displaced, such as intrusions,extrusions and lateral luxations, require urgent care by the teamdentist. Your goal for these injuries involves repositioning andstabilizing the teeth in question. Splinting mobile teeth toadjacent stable teeth with a semi-rigid splint stabilizesdisplacement injuries. Less urgent tooth injuries such as thosewhere teeth are not displaced (e.g. crown factures andsubluxations) do not require repositioning and stabilizing. This presentation uses the scientific evidence available to assistthe team dentist in making good decisions for his/her patients.A clear diagnosis leads to proper treatment. It is dentaltraumatology made easy.

10:50 am – 11:45 am Lecture: Preparation for the Team Dentist from Pre-Season Evaluation to Game-Time ReadinessSpeaker: Jeffery Hoy, DDS, FASDFor a sports team dentist, at any level, preparation and readinessis of utmost importance. We will be focusing on the key issuesof pre-season exams, dealing with the athletes, and possibleemergencies both on and off the playing surface. Thispresentation will address both the preparation and readiness forthe team dentist. At the completion of Dr. Hoy’s presentation,participants will be able to prepare for and conduct pre-seasonexams; incorporate mouthguard impressions at the time of pre-season exams; put together a game-time emergency kit; anddeal with common game-related issues.

11:50 am – 12:30 pm Lecture: Team Dentist: Drugs and AthletesSpeaker: Leslie Rye, DDS, FASD, FAGD, FICDThis presentation will cover therapeutic agents commonly usedto keep our athletes alert and free of pain and infection withoutviolating rules of the sports-governing bodies. Knowledge ofdrugs to use for acute situations and the possible drug sideeffects help keep our athletes ready for competition. Thispresentation will also cover some common infections in the oral-facial area that are highly infectious and of concern for thesafety of our athletes’ teammates. This information should be ofinterest for those treating the full athletic spectrum from theyoung weekend participant to the highly elite competitor. Theteam dentist needs to work within the parameter of permitteddrugs and outside the realm of PEDs (performance enhancingdrugs), doping and banned/illegal drugs. The treating dentistshould also have the resources to recognize these drugs.Reference information is listed to help keep the team dentistknowledgeable about banned legal or illegal drugs andsubstances.

12:30 pm Team Dentist Course: Pick Up Box Lunch

Academy for Sports Dentistry 2014 SymposiumTotal Sports Team Dentistry:

Marketing...Relationships...PerformanceJune 19-21, 2014

The Westin San Diego ~ San Diego, California

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12:35 pm – 1:30 pm Lecture: Immediate Recognition and Management of Bone Injuries and the Categorization of These InjuriesSpeaker: Matthew Jacobsen, DMD, MDThis lecture will focus on the recognition and management offacial bony trauma. We will primarily cover the diagnosis of thesimple mandible fracture and complicated mandible fracture.Recognition of other facial fractures including Le Fort I, II, IIIfracture, ZMC, NOE, and frontal sinus fracture will be included.We will then focus on the work-up and treatment of the simpleand complicated mandibular fracture. An emphasis will be onsports-related bony trauma.

1:35 pm – 2:30 pm Lecture: Legal Considerations for the Team Dentist at Different LevelsSpeaker: Lee Patalowski, DMDDr. Patalowski will give an overview of emerging ethical, legaland financial issues in sports dentistry for all levels of teamdentists. He will explore the different levels of competition andthe unique relationship each creates. Legal characterization ofthis relationship determines the parties’ respective legal rightsand duties. In addition, common-sense risk managementtechniques will be discussed.

2:35 pm – 3:00 pm Lecture: Concussions and Performance EnhancementSpeaker: Stephen Mills, DDS, FASDIt is possible that the single most important area of concern for today’s athletes is that of concussions, both their recognitionand proper handling. Mouthguards have a historical place in this discussion in the dental literature, but in the past severalyears that role has been dismissed as lacking in proper scientificbackground. This short presentation will discuss the past,present and future direction that the mouthguard/concussiondiscussion will go based on the available scientific evidence. Performance enhancement is also something that modern athletes are interested in, but we as sports dentists must be able to discuss with our teams’ players what is fact and what is fiction, what is fad and what might have worth.

3:05 pm – 5:00 pm Hands-on Mouthguard WorkshopSpeaker: Brett Dorney, BDS, FASDThe mouthguard workshop will involve Dr. Brett Dorney andother members of the ASD with experience in mouthguardconstruction as tutors. This is a hands-on course teaching thelatest mouthguard designs and techniques. The mouthguardworkshop will cover mouthguard design and fabrication with afocus on pressure lamination techniques. A lecture and a videowill start the workshop outlining sporting injury patterns andthe mouthguard designs to reduce such injuries. Recent excitingresearch from Japan in impact energy reduction will bediscussed. Each participant will be provided with correctlytrimmed maxillary models for the workshop. After thisworkshop, participants will have the knowledge to constructtheir own mouthguards or communicate the appropriateinformation to their dental laboratory.

5:30 pm Welcome Reception at the USOC Training Center in Chula VistaCome to this one of a kind event. The evening will consist of atour of the facility, and a welcome reception at the trainingcenter. Transportation will be provided to and from the hotel tothe Olympic Training Center.

Friday, June 20, 2014

7:00 am – 7:55 am Registration/Exhibits/Continental BreakfastSilent Auction Bidding

7:55 am Call to Order

8:00 am – 9:30 am Lecture: Latest Trends in Sports Medicine and How to Assemble an Elite Sports Medicine Team from High School to Pro SportsSpeaker: Jerry W. Hizon, MD, San Diego Chargers Team PhysicianDr. Hizon will discuss how treatment for athletes changesaccording to the level of athletic team you are associated with,be it professional, college, high school, or just the weekendathlete. He will also present insight into how he has assembledan elite sports medicine team from the high school toprofessional level.

9:30 am – 10:30 am Lecture: “The Unstoppable Profit Producer” – Marketing for Your Sports Dental Practice Speaker: Mike StromsoeMike has created a proven, 3-step blueprint for growing yourbusiness, creating financial security and having more freedom,all based on his distinctive philosophy developed over 28 years of research. Participants will learn real world, currententrepreneurial and marketing techniques that they will be ableto implement the day they return to their business, if not before.These life-changing topics include but are not limited to: l The Key to Drilling Down on Your Most Important Business

Growth Assetl Why People Should Do Business with YOU Over and Above

Any and All Other Optionsl If You Want to Reach 100% of Your Marketplace, You MUST

Implement 100% of the Waysl The Amazing Secrets Revealed by the Three MMM’s

10:30 am – 10:45 am Exhibits/Breaks/Silent Auction Bids

10:45 am – 12:00 pm Lecture: Diagnosis, Management andTreatment of Dental Traumatic InjuriesSpeaker: Paresh Shah, MS, DMDDental trauma in sports is a common occurrence, butmanagement can be complex, depending on the circumstances.It is important to be able to manage the situation quickly andefficiently to minimize the risk of tooth loss and optimize idealhealing. This lecture will review a variety of traumatic injuries tothe teeth and jaws. We will review systematic ways to triageand manage an injury, minimize risks and optimize outcomes.We will review a variety of restorative and surgical techniquesusing different materials to provide participants with solutionsthat may be implemented easily. Participants will learn toevaluate various dental injuries and assess risks to prioritizeappropriate treatment; learn practical restorative and provisionaltechniques to optimize restoration of injured teeth; learnpractical, appropriate surgical techniques to extract traumatizedteeth and preserve bone for implant treatments; learnatraumatic extraction techniques; and learn simple graftingtechniques to help optimize implant placements.

12:00 pm – 1:00 pm Recognition Luncheon

1:00 pm – 2:00 pm Lecture: “Adaptive Fit, Adaptive Hit” – New Advances inFootball Helmet ProtectionSpeaker: Mike Short, Xenith Helmet CompanyMike will discuss changes in helmet technology and fit systems.The presentation will also address how the components ofhelmets work independently and together to reduce impact.

2:00 pm – 3:30 pm Lecture: “Bad Bounces and Broken Teeth”Conservative Options for Restoring the Active AthleteSpeaker: Doug Lambert, DDS, FACD, FASDA, FASD, ABADWe are in an age of active lifestyles, with an emphasis onparticipating in sporting activities at both the youth and adultlevels. Not surprisingly, athletic injuries to the orofacial regionand the dentition are on the rise. However, restoring the injuredathlete’s dentition can be challenging, especially if he/she is still

planning to participate in sports. When evaluating the optionsfor material choices and techniques, the use of direct compositeresins continually rises to the top of the list, thanks to itsconservative nature, flexibility to restore today’s injury, and useas a transitional or long-term solution, and is likely the leastcostly alternative to the patient in many cases. At the conclusionof this presentation, participants will understand how theexpanded use of composites can offer unique solutions to yourrestorative dilemmas; gain knowledge of the latest materials andbonding agents; and learn how to create full contoured crownsand fiber reinforced bridges from composite resins.

3:30 pm – 3:45 pm Exhibits/Breaks/Silent Auction Bids

3:45 pm – 5:15 pm Lecture: Maintaining a Balanced Oral Environment Speaker: John C. Comisi, DDS, MAGDThe infective process of dental decay has been a primary focus ofthe modern dental practice. However, it often becomes a “onestep forward, two steps back” game. Sports drinks, frequentsnacking and even some available over-the-counter oral careproducts can contribute to the challenges found in the oralenvironment. What do we as dental professionals do to help our patients cope and manage this disease process? Whatprocedures, techniques and materials can we use to slow downthe process and perhaps reverse it? This presentation willexplore the latest concepts of patient care, including cariology,preventive care, diagnostics, and minimally invasive dentistry,and how bioactive materials can and should be considered foruse in your dental practice. At the conclusion of thispresentation, participants will understand the conditions neededin the oral cavity to help patients achieve a balanced oralenvironment; learn how to make patients part of the solution totheir oral care, not the problem; understand the remin-deminprocess of the oral cavity and caries progression; evaluatepreventive care considerations and diagnostics that can help aidin caries detection and treatment; and review the realm of glassionomers and other bioactive materials and their place in today’sdental care armamentarium.

6:00 pm – 9:00 pm President’s Reception/Silent Auction & Live Auction

Saturday, June 21, 2014

7:00 am – 7:55 am Registration/Exhibits/Continental Breakfast

8:00 am Call to Order

8:00 am – 8:30 am Annual Business Meeting

8:30 am – 10:00am Lecture: Sports Nutrition for the Olympic Athlete to the High School AthleteSpeaker: Elizabeth BroadThis presentation will introduce the current sports nutritionrecommendations for elite athletes, including fueling, recovery,hydration and supplements. The objective will be for participantsto understand how to appropriately interpret theserecommendations according to the level of sports participation andthe type of sport undertaken, including recreationalexercisers/weekend warriors, junior athletes, and elite seniorathletes.

10:00 am – 10:30 am Exhibits/Breaks

10:30 am – 12:00 pm Lecture: Update on the Sochi Olympics and the U.S. Olympic Sports Medicine Program Speaker: Bill Moreau, DC, DACBSP, CSCSThere were a number of challenges and celebrations at this pastyear’s Winter Olympics in Sochi. We will provide insight not onlyon how our athletes fared in Sochi, but more importantly, how

the medical clinic functioned at Sochi. We will also provideinsight into “The Team Behind the Team” at the Winter Olympicsand Paralympics. Discussion will involve what went well, whatcould have been better, and what we learned moving forward tothe next set of Olympics.

Lecture: The USOC’s National Medical Network and How ASD Members Are Becoming Part of ThisSpeaker: Cory Warner, MHA, MPT

Team USA is comprised of thousands of elite athletes who arespread across the U.S. To deliver best of class health care to TeamUSA, the United States Olympic Committee has developed aUSOC National Medical Network, which includes members of theAcademy for Sports Dentistry, physical therapy, and chiropractic.In addition, other opportunities may be opening up where teamdentists may play a vital role in becoming involved with andassisting Team USA at some of our Olympic venues. At theconclusion of this presentation, participants will know how theycan help Team USA through the USOC National Medical Network.

12:00 pm – 1:00 pm Lunch on your own

1:00 pm – 1:45 pm Lecture: Recent Research on Concussion Prevention and the Effect ofClenching with Properly Fitted MouthguardsSpeaker: Tomotaka Takeda, DDSThis presentation will describe an effect of properly fittedmouthguards on not only dental related injuries but alsoconcussions. Namely, it will focus on the importance of properocclusion and clenching. Sports mouthguards help protect theteeth against injury. However, they do not necessarily preventdental injury on all occasions. Levels of protection ofmouthguards are different among types and qualities – custommade or boil and bite offer different protection capacity.Occlusion significantly influences level of protection. Thispresentation will cover results of both laboratory and on fieldstudies. As a main topic of concussion prevention effect, recentresearch in rugby play will be explained. From a sports dentistryviewpoint or hypothesis, increased mastication muscle activity orvoluntary clenching due to the presence of a mouthguard mayenhance cervical muscle activity and thereby reduce the damagefollowing impact. Measurements were performed during rugbycontact practice involving head acceleration and masseter andsternocleidomastoid muscles activities. After the rugby playerswere instructed to clench their masseter muscles, markeddecreases in head acceleration were observed. Mechanisms ofmouthguards on concussion reduction or prevention will bereviewed as well. Further, this presentation will touch on anongoing soccer heading study. At the conclusion of thepresentation, participants will understand the importance of and effect of clenching with proper mouthguards on both dental related injuries and concussion prevention.

1:45 pm – 2:00 pm Break

2:00 pm – 3:30 pm Advanced Suture Workshop: “Lips & Layers”Speaker: Chester F. Griffiths, MD, FACSSuturing techniques and materials are varied and unique to eachapplication. Understanding the origin, materials and specificapplications for each suture material will be discussed. It is theobjective of this presentation to inform participants of thehistory of sutures to help them choose materials and enhancetheir practice.

3:30 pm – 3:45 pm Closing Remarks and Dismissal

7:00 pm San Diego Padres Ballgame – We may have tickets availablefor the San Diego Padres versus the Los Angeles Dodgers game.Once we have more information, it will be sent via email.

Elizabeth BroadLiz Broad has been a sports dietitian for over 20 years in Australia,Scotland and now the USA. Liz is currently the Senior Sports Dietitian,Paralympic Programs, at the US Olympic Committee. She has workedwith a wide range of sports and levels of athlete from juniordevelopment through Olympic and Paralympic summer and wintersports.

John C. Comisi, DDS, MAGDDr. Comisi has been in private practice in Ithaca, New York, since 1983.He is the Chief Dental Officer at Vigilant Biosciences, Inc., and Presidentand CEO of Dental Care with a Difference®, PC, where “KnowledgeBrings Health.”® He is a graduate of Northwestern University DentalSchool and received his Bachelor of Science in biology at FordhamUniversity. He is a respected key opinion leader and a member of theCatapult Group, the dental industry’s premier speakers bureau. He isalso an editorial board member for Dental Product Shopper, a member

of the editorial advisory board of Dental Products Report, and sits on the continuing educationadvisory board of Dental Learning. Dr. Comisi is a Master of the Academy of General Dentistry andholds Fellowships in the Academy of Dentistry International, the American College of Dentistry,the Pierre Fauchard Academy and the International College of Dentistry. He is also the Academy ofGeneral Dentistry’s Speaker of the House.

Brett Dorney, BDS, FASDDr. Brett Dorney graduated from Sydney University Australia in 1971and obtained his fellowship from the Royal Australian College ofDental Surgeons in 1985. He has been awarded fellowships from theAcademy for Sports Dentistry and the International College of Dentists.Dr. Dorney has been presenting in Australia and overseas for the past20 years on the prevention and treatment of traumatic dental injuries.

He has been a member of the Academy for Sports Dentistry since 1995 and was president in 2006.A career highlight was being Deputy Director of Dental Services for the Sydney 2000 Olympic andParalympic games. At present he is a clinical lecturer with Sydney University, being involved ingraduate and undergraduate teaching.

Chester Griffiths, MD, FACSDr. Chester F. Griffiths entered the private practice of otolaryngology,head and neck, cosmetic and reconstructive surgery with his father,Cadvan Owen Griffiths Jr., MD, a plastic and reconstructive surgeon inBrentwood, California, in 1989. He completed a three-year generalsurgery residency and a three-year residency in otolaryngology, headand neck surgery at the prestigious Thomas Jefferson UniversityHospital and Mercy Catholic Medical Center in Philadelphia, where heserved as a chief resident in his final year. He completed a visiting

fellowship in plastic and reconstructive surgery in Rio de Janeiro, Brazil, with world-renownedplastic surgeon Dr. Ivo Pitanguy. Dr. Griffiths finished medical school at 21 years of age and wasfully licensed to practice medicine at age 22. Dr. Griffiths is fluent in both Spanish andPortuguese. Dr. Griffiths has been active on the medical staffs of St. John’s Medical Center andUCLA Medical Center, Santa Monica. Dr. Griffiths is double board certified by the American Boardof Otolaryngology, Head and Neck Surgery and the American Board of Facial Plastic andReconstructive Surgery. Since entering private practice, Dr. Griffiths has volunteered at the VeniceFamily Clinic, treating the uninsured as a consultant and performing surgical procedures pro bono.He feels compassionate about offering access to medical care for the indigent and working poor.In recognition of his service, Dr. Griffiths received the Morton K. Rubenstein Award for OutstandingVolunteer Physician in 1995. He is currently on the Board of Directors of the Venice Family Clinic,striving to continue healthcare access for the uninsured. Dr. Griffiths also served as the Chairmanof the Department of Surgery at UCLA Medical Center, Santa Monica for 10 years, stepping downin 2008, and Vice Chief of Staff for three years. Dr. Griffiths is an Assistant Clinical Professor atUCLA School of Medicine, actively participating in teaching family practice residents. He receivedthe Thomas L. Stern Award for Excellence in Residency Teaching. Dr. Griffiths has been elected byhis peers to many leadership positions, including Treasurer of Saint John’s Hospital Medical Staff,Vice President of the Los Angeles County Medical Association Bay District, and the ExecutiveMedical Board of UCLA Medical Center, Santa Monica. He is a member of numerous societies andis a Fellow of the American Academy of Otolaryngology and the American College of Surgeons.He participates in annual medical lecture series and is retained by many attorneys, medicalmalpractice liability carriers and pharmaceutical companies to serve as an expert in his fieldrelated to medical quality of care issues.

Jerry W. Hizon, MDFor over 25 years, Dr. Jerry Hizon has been a team physician for localhigh schools. He is the Immediate Past President of the RiversideCounty Medical Association and has been selected to be on the Boardof Governors for the brand new Temecula Valley Hospital. Dr. Hizon iscurrently a member of the American Academy of Family Physicians,the American College of Sports Medicine, the NFL Team PhysicianSociety, and the California Medical Association, and is one of theteam doctors for the National Football League San Diego Chargers.

Jeffrey Hoy, DDS, FASD Dr. Jeffrey Hoy graduated from the University of Southern CaliforniaSchool of Dentistry and has been treating dental trauma and sports-related dental injuries for over 30 years. Dr. Hoy is an activemember of the Academy of Osseointegration, the Academy ofDental Sleep Medicine, the Academy for Sports Dentistry, and theInternational Association of Dental Traumatology. Dr. Hoy is amember of the National Hockey League Team Dentists Associationand currently serves on the Board of Directors of the Academy for

Sports Dentistry as Secretary. In addition to serving as team dentist for the National BasketballAssociation Los Angeles Lakers and the Women’s National Basketball Association Los AngelesSparks, he is the dental consultant for the Harvard Westlake High School Department of SportsMedicine. Dr. Hoy maintains a full-time private practice in Torrance, California.

Matthew Jacobsen, DMD, MD Dr. Jacobsen grew up in southeastern Massachusetts in the town ofMarion. He attended Bowdoin College, where he played footballand graduated cum laude with a degree in Biology and minor inChemistry. Dr. Jacobsen started his dental experience at theUniversity of Connecticut in 1999 and graduated in 2003 withseveral honors and distinctions in oral and maxillofacial surgery,including the American Association of Oral and MaxillofacialSurgeons Award, the Dr. Richard G. Topazian Award in Oral and

Maxillofacial Surgery, and the American College of Dentists Award. Following his graduation fromUCONN, he was accepted into the combined Harvard University/Massachusetts General HospitalOral and Maxillofacial Surgery program. He completed his internship in oral and maxillofacialsurgery at the Massachusetts General Hospital in 2003. Dr. Jacobsen graduated from HarvardMedical School in 2006. He then completed two years of general surgery at MassachusettsGeneral Hospital. Finally, he finished his oral and maxillofacial training in 2009, during whichtime he served as the Chief Resident of the Oral and Maxillofacial Surgery Division atMassachusetts General Hospital and Children’s Hospital in Boston. Dr. Jacobsen practices a broadscope of oral and maxillofacial surgery, including dentoalveolar and implant surgery, with anadditional emphasis on orthognathic, reconstructive, and TMJ surgery. He is a member of theAmerican Dental Association and the American Association of Oral and Maxillofacial Surgeons. Heis involved in the community, serving on the active medical staff at both Maine Medical Centerand Mercy Hospital and on the Greater Portland Cleft Lip and Palate Team. He is a team OMFS forthe local AHL Portland Pirates.

Douglas L. Lambert, DDS, FACD, FASDA, FASD, ABADDouglas L. Lambert, DDS, FACD, FASDA, FASD, ABAD, graduated fromthe University of Minnesota Carlson School of Management in 1980and the University of Minnesota School of Dentistry in 1984, wherehe received the Outstanding Senior Student Award and theQuintessence Award. He is a Fellow in the American College ofDentists, the Pierre Fauchard Academy, the Academy for SportsDentistry, and the American Society for Dental Aesthetics, and a

Diplomat of the American Board of Aesthetic Dentistry. He has been recognized annually as oneof the top dental educators by Dentistry Today for twelve consecutive years and has been honoredas a top dentist by Mpls.St.Paul Magazine and Minnesota Monthly each year for the past elevenyears. Dr. Lambert has held many societal positions in organized dentistry, including PastPresident of the Minneapolis District Dental Society, six years as a Trustee to the Minnesota DentalAssociation, and a delegate to the ADA. He has authored and co-authored several articles oncosmetic and aesthetic topics, has presented numerous lectures and hands-on seminars nationallyand internationally for dental organizations, universities, and study clubs, and is part of theeducation team for the post-graduate course in esthetic dentistry at the University of MinnesotaSchool of Dentistry and the Catapult Group. He also serves as an independent consultant and

Presenters . . .

clinical researcher for many dental manufacturers and as the Team Dentist for the Minnesota Lynxof the WNBA. Dr. Lambert is senior partner in an aesthetic-based practice in Edina, Minnesota,emphasizing cosmetic, comprehensive, and sports dentistry. In his spare time, he enjoys relaxingwith his family at their cabin in Wisconsin and playing a little golf.

Stephen Mills, DDS, FASDDr. Mills is originally from Peekskill, New York, and attendedWestminster College in New Wilmington, Pennsylvania, where hereceived his B.S. in 1977. He then entered the State University ofNew York at Buffalo School of Dentistry and earned his DDS in 1981.After three years on active duty in the US Army, he worked to get hiscertificate in Pediatric Dentistry at the Department of PediatricDentistry of the University of Connecticut, which he completed in1987. Upon completion of his specialty training, he moved to Maine

to enter into the private practice of pediatric dentistry. His commitment to sports dentistry beganin 1991 as he followed the direction of his mentor and friend Dr. Cosmo Castaldi. He joined theAcademy of Sports Dentistry and after years on the Board of Directors became President of thisorganization in 2001-2002. Currently he serves the Academy as the editor of its newsletter, whichappears regularly in the internationally read journal Dental Traumatology. He is board certified inpediatric dentistry and is active in the Academy of Pediatric Dentistry, serving as a legislativeadvocate to the members of the US Congress. He is also the President of the Maine Society ofPediatric Dentistry.

William Moreau, DC, DACBSP, CSCSDr. Bill Moreau, DC, DACBSP, CSCS, is a chiropractic physician andconservative evidence-based sports medicine clinician who startedwork with the USOC in 2009 after more than 25 years of privatepractice. He became the Managing Director of Sports Medicine forthe USOC in February 2012. Prior to this promotion, Dr. Moreauworked at the USOC as the Director of Clinics. Dr. Moreau overseesthe sports medicine activities of the USOC, including clinics, gamesand the USOC National Medical Network. Dr. Moreau served as the

Medical Director for Team USA at the London 2012 Olympic Games, where he managed theimplementation of medical care to more than five hundred athletes as provided by more than 100medical providers. Dr. Moreau founded Fortis Cura, Inc., a consulting company dedicated toadvancing patient centered care through the utilization and development of evidence-basedmusculoskeletal care pathways. He has been featured in Bloomberg Business Week, USA Today,Time, NPR, NBC, GE Healthcare News and Kaiser Health News and as a speaker for the USADepartment of Health and Human Services Consumer Health IT Summit. Dr. Moreau hassuccessfully presented over 450 postgraduate presentations, with a primary focus on sportsmedicine, throughout the United States and internationally. He has over 30 years of clinicalexpertise in both general practice and sports medicine, including Olympic, professional,collegiate, high school and recreational athletes. Dr. Moreau is well published with a focus onathletic injuries, with an emphasis in the study of concussion in sport. He serves on the editorialreview board of the Journal of Chiropractic Medicine and has served for many years with theAmerican Chiropractic Board of Sports Physicians. Dr. Moreau and his wife Karen live in BlackForest, Colorado. They have two sons, a daughter-in-law and a yellow Labrador.

Lee Patalowski, DMDDr. Lee Patalowski is a graduate of Temple University School ofDentistry. He currently practices general dentistry in Lancaster,Pennsylvania, where he maintains active staff privileges in theDepartment of Surgery, Dentistry Section at Lancaster GeneralHospital. He is a Diplomate of the American Board of Special CareDentistry and the National Dental Board of Anesthesiology, a Masterin the Academy of General Dentistry, a Fellow in the Academy ofDentistry for Persons with Disabilities, and a Master in the College of

Conscious Sedation. In addition to private practice, Dr. Patalowski is the Founder and Director ofthe Center for Sports Dentistry. Prior to returning to private practice, he was an Assistant ClinicalProfessor in the Department of Oral Maxillofacial Pathology, Medicine and Surgery at TempleUniversity School of Dentistry and in the clinical faculty practice at the University of PennsylvaniaSchool of Dental Medicine. Dr. Patalowski has extensive experience in sports dentistry and dentaltrauma as a former Chief of Dentistry in a hospital-based dental clinic and director of one of thebusiest dental school emergency clinics in the country.

Mark Roettger, DDS, FASDMark Roettger first received his Bachelor of Science degree in biologyfrom the University of Minnesota in 1977. He then received hisDoctor of Dental Surgery degree from the University of Minnesota in1982. He currently serves on the dental staff of the University ofMinnesota Hospital, and is the Director of the University of MinnesotaPhysicians Dental Clinic as well as the Director of the General PracticeResidency program at the University of Minnesota Medical Center.He is a member of the American Dental Association, the Minnesota

Dental Association, the American Association of Dental Research, and the American Academy ofOral Medicine. He has lectured throughout the United States and Canada on topics including TMJ,dental trauma, sports dentistry, mouthguard fabrication, management of head and neck cancerpatients, and dental management of medically complex patients. Dr. Roettger has been amember of the Academy for Sports Dentistry since 1983. He served as President of the Academyfrom 1998-1999. He is a Fellow in the Academy for Sports Dentistry (2000). In addition, he hasserved as Editor of the ASD Newsletter from 2000-2007. He has also served as editorial reviewerfor The Physician and Sportsmedicine. Dr. Roettger has 30 years of sports dentistry experience andcurrently has a lecture series on sports dentistry with Dr. Steve Mills.

Leslie Rye, DDS, FASD, FAGD, FICDDr. Rye has provided general dental care for over 30 years in Reston,Virginia. She is a Past President of the Academy for Sports Dentistryand has served on boards of several professional and communityorganizations. Dr. Rye has earned special professional recognitionsas a Fellow in the Academy of General Dentistry, the Academy forSports Dentistry and the International College of Dentists. She hasbeen an educator in many oral medicine, pharmacology and sportsdentistry programs. Dr. Rye has participated and chaired many

school and community health outreach programs, which includes volunteering as a provider incustom mouthguard programs for professional and organized youth sports.

Paresh Shah, MS, DMD, Cert. Esthetic Dent.Dr. Paresh Shah maintains a private practice in Winnipeg, Canadawith a focus on implant, cosmetic and interdisciplinary care. Hegraduated from the University of Manitoba in 1991. Dr. Shahreceived a Masters in Physiology in 1987 (U of Manitoba) and has aProficiency Certificate in Esthetic Dentistry from the University ofBuffalo (SUNY) in 2007. He has served as a clinical mentor in the PostGrad Program for Esthetic Dentistry at the University of Minnesota

and a part-time instructor at the University of Manitoba Faculty of Dentistry. He has taken wellover 1800 hours of advanced education in esthetics, materials, implants, occlusion andinterdisciplinary care. He also serves as a consultant for numerous dental manufacturers inproduct development and evaluations and is a member of the Catapult Group speakers bureau .He is the co-director of a Seattle Study Club in Winnipeg, section editor for Esthetics with theCARDP Journal and Spectrum Journal and has fellowships in numerous organizations including theICOI and AGD. He lectures internationally on esthetics, implants, interdisciplinary care and stagingcomplex restorative cases in general practice.

Mike Short Mike Short is a Client Relations Manager for Xenith HelmetCompany, working with the NFL and colleges. Prior to his work withXenith, Mike was the Director of Equipment for Florida AtlanticUniversity from 2001-2011 and for the University of Miami from1985-2011. He is a member of the Athletic Equipment ManagersAssociation and has been certified since 1987. Mike has presentedhelmet fitting and safety seminars to AEMA, high school coachesassociations and parents. He has also published three articles in

Athletic Management on equipment fitting and maintenance.

Mike StromsoeAfter working in the restaurant and produce businesses, MikeStromsoe joined his father’s insurance agency in 1986. He started hisown successful agency, which he and his wife still run today, alongwith two additional businesses. Among many things, it is Mike’s corebelief that one gets what one gives in this world. His passion isteaching and inspiring people who want to be taught and inspired.Register Early

Presenters . . . continued

Mike has created a proven, 3-step blueprint for growing your business, creating financialsecurity and having more freedom, all based on his distinctive philosophy developed over28 years of research. Mike’s unique tools can be immediately implemented by anybusiness team. Since Mike still owns and operates his own “Living Agency Laboratory,” hecontinues to refine his philosophies and brings to market only the tools that work.

Tomotaka Takeda, DDSDr. Tomotaka Takeda is an Assistant Professor in theDepartment of Sports Dentistry at the Tokyo Dental Collegein Tokyo, Japan. He is a graduate of Nihon University Schoolof Dentistry and received his Doctor of Dental Surgery degreefrom the Graduate School of Nihon University. His initialmajor was in prosthodontics. In 1999, he first visited Dr.Brett Dorney in Sydney to learn sports dentistry. He movedto Tokyo Dental College after he returned to Japan. Currently,

he is ardently engaged in research, education, and treatment. He supports several rugbyteams, plus many other athletes in karate, boxing, skating, and skiing. He hopes toprevent more dental-related injuries, including jaw fractures and concussions. He hasfrequently contributed to Dental Traumatology and has added greatly to the literature onsports dentistry. Dr. Takeda has been a member of the Academy for Sports Dentistry since1999. He loves sports and sports dentistry.

Gary VittiGary Vitti has worked in the health care field for over 30years, with the last 29 as the Head Athletic Trainer for thestoried Los Angeles Lakers. During his tenure with the team,he has worked with such basketball greats as Kareem Abdul-Jabbar, Magic Johnson, James Worthy, Shaquille O’Neal andKobe Bryant, to name a few. From 1984 to 1992, Vitti wasalso the Head Athletic Trainer for the Los Angeles Strings ofWorld Team Tennis. His work with teams and exhibition

matches include but are not limited to tennis greats Jimmy Connors, John McEnroe, BjornBorg, Martina Navratilova, Billy Jean King and Chris Evert. In addition to his workexperience, Vitti lectures internationally, has written a syndicated column, created anexercise video, published articles in peer reviewed journals, and appeared in twoHollywood movies. He has also been featured in Sports Illustrated, ESPN, Fox News Sports,The Doctors, HOOP, and Time Warner Cable Network, as well as several internationalpublications. Along with his professional life, Vitti is known for his philanthropic work. Hecreated the National Basketball Athletic Trainers Association Foundation. During histenure as Chairman, the Foundation was involved with organ and tissue donation, theMiami Project for Paralysis, and the National Kidney Foundation, and provided countlessscholarships for young athletic training students. Vitti created the National AthleticTrainers Association annual blood drive, which set records for convention blood drives forthe American Red Cross. He also served on the board of A Window Between Worlds, anorganization that uses art as a healing tool for survivors of domestic violence. He currentlyis on the advisory board of Team Heal, an organization that provides health care andeducation as well as scholarships in underserved communities, and he is also a strongsupporter of the Boys and Girls Club. Vitti’s work has been recognized and awarded by the26th US Senate District, the 35th US Congressional District, the City of Los Angeles, theCalifornia Legislature, the US Naval Medical Center of San Diego, his alma mater SouthernConnecticut State University, the Philippine Sports Commission, NBATA, Loyola Athletics,Team Heal, STR Basket Italia, and the Kappa Alpha Psi Fraternity.

Cory Warner, MHA, MPTCory Warner, MHA, MPT, was selected as the Director of theNational Medical Network for the United States OlympicCommittee in June 2012. In this role, he has beeninstrumental in establishing national and regional medicalpartners to support Team USA athletes. Prior to this position,Cory has served in a variety of administrative and clinical rolesincluding Service Line Director for Orthopedics, Neurosciencesand Rehabilitation at Memorial Health System in Colorado

Springs, Colorado; Manager of Physical Therapy and Sports Medicine at the NebraskaMedical Center in Omaha, Nebraska; and Owner/Director of Mountain Land PhysicalTherapy and HPC in Billings, Montana. He has a master’s degree in health careadministration from Clarkson College in Omaha, Nebraska, as well as a master’s degree inphysical therapy from the University of Mary in Bismarck, North Dakota.

Call for Abstracts – Poster Presentations . . .All submissions to the Annual Symposium must be accompanied by anabstract using the format provided. Abstracts that do not follow theseguidelines may be disqualified.

1.) General Guidelinesa. Abstract must be submitted as an attached Microsoft Word

document to email address: sportsdentistry@consolidated.netb. Use 11 point Times New Roman font.c. Do not use bold, italic or underline unless otherwise indicated.

2.) Heading section (title, author, affiliation)a. This entire section should be bold.b. Use a clear, concise title that reflects the study/survey, etc.c. List the title capitalizing only the first letter of the title and ending

with a period.d. List authors’ names, last name first, followed by initials. Do not

separate initials by periods or include authors’ degrees.e. Separate authors’ names by commas, with no period following final

name.f. Place an asterisk after the presenter’s name.g. List all affiliations following the last author’s name and enclose

them in parentheses. If there is more than one affiliation, separatethem by semicolons.

h. Include the city and state after each affiliation using uppercasepostal abbreviations for state names (e.g., University of Michigan,Ann Arbor, MI).

i. Do not place a period at the end of the Heading section

3.) Subhead section (if applicable) Identify any supporting agency and grant number in 10 pointitalicized font, written as a complete sentence, and begin as follows:Research supported by…

4.) BodyThe body cannot exceed 200 words and should follow the usualsequence of purpose, methods, results and conclusions. Abbreviationsshould be defined on first mention.

Poster PresentationsPosters should be designed to fit a 4’ (120cm) high by 6’ (180cm) wideposter board.  The poster session will last about one hour andpresenters must be available for the entire viewing time.

Deadline for submissions: April 15, 2014

Questions? Contact Ms. Shelly LottAcademy for Sports Dentistry118 Faye Street, P.O. Box 364Farmersville, IL 62533, USAor email sportsdentistry@consolidated.netPhone (217) 227-3431Fax (217) 227-3438www.academyforsportsdentistry.org

Academy for Sports Dentistry 32nd Annual SymposiumJune 19-21 , 2014 • SAN DIEGO, CALIFORNIA

R E G I S T R A T I O N I N F O R M A T I O NMEALSWelcome Reception on Thursday; continental breakfasts on Friday and Saturdaymornings; Recognition Lunch on Friday and the President’s Reception on Friday evening are included in the Symposium registration fee.

REGISTRATION BY MAILRegistrations must be submitted along with your check in US funds to:Academy for Sports Dentistry11P.O. Box 364Farmersville, IL 62533 USAFax: 217-227-3438Email: sportsdentistry@consolidated.net

8 Faye Street

REFUND POLICYA full refund, less a $50.00 administrative fee, will be made up to three weeks prior tothe Symposium. No refunds after May 30, 2014.

Please return form as soon as possible to:

32nd Annual SymposiumAcadem y for Sports D entistry118 Faye Street P.O. Box 364 Farmersville, IL 62533 USA

www.academyforsportsdentistry.org

Complete this form and mail with your check or go to the website and submit with your credit card payment today! Please type or print.Name ____________________________________________________________ DDS or DMD AGD # ___________________________________________

Address _______________________________________________________________________________________________________________________________City ___________________________________________________________ ____________________________________ State__________________ Zip _______________ Country _________________________________

Office Number ________________________ Fax Number ________________________ E-mail _________________________________________________________

League / Team __________________________________________________________________________________________________________________________League / Team __________________________________________________________________________________________________________________________

2014 SYMPOSIUM REGISTRATION FEES

Team Dentist Course feeSymposium registration fee

Discount for referral program ___Additional tickets for optional events

______%Workshop fees

TOTAL AMOUNT ENCLOSED

MEMBER BRING A COLLEAGUEAny current ASD members who bring a nonmember registrant to the 2014 Symposium will receive 10% o� of their registration fee for each nonmember registrant they bring. In addition, each nonmember registrant sponsored by an ASD member will also receive the 10% discount.

Referred by ______________________________________________________ASD Member

#__________ of nonmembers referred (see attached forms)

__________ % off of registration fee for nonmember referrals

HOTEL RESERVATIONSThe Academy has a special group rate of $209.00 single or double per night. This special rate is in e�ect until May 21, 2014. However, we suggest you reserve early, as there is a limited number of rooms at the group rate. Please make your reservations directly with the Westin San Diego by calling (888) 627-9033. Indicate you are attending the 2014 Academy for Sports Dentistry Symposium.

Recognition Luncheon $60.00 x _______ Tickets = $________

President‘s Reception $70.00 x _______ Tickets = $________

USOC Reception $40.00 x _______ Tickets = $________

REGISTRATION CALCULATION BOX$_______________________________$_______________________________$_______________________________$_______________________________$_______________________________$_______________________________

Credit card payments are accepted at www.academyforsportsdentistry.org

Continental breakfast, break and box lunch are included in the Team Dentist Course registration fee.

Spouse’s Name If Attending __________________ _________

Symposium Only (14 CEU)

❏ Members $ 625.00

❏ Nonmembers $ 725.00

❏ Hygienists, Dental Assistants, Lab Technicians, Athletic Trainers, Residents* $ 425.00

(Includes USOC Welcome Reception, two continental breakfasts, breaks, Recognition Luncheon and President‘s Reception)

*Students/Residents who do not want CEU credit are complimentary.(Meals are not included, but tickets for above Receptions and Luncheon can be purchased separately.)

Team Dentist Course Only (7 CEU and certification)

❏ Members $ 365.00

❏ Nonmembers $ 465.00

❏ Hygienists, Dental Assistants, Lab Technicians, Athletic Trainers, Licensed Residents* $ 160.00

(Includes continental breakfast, breaks, and box lunch.)

*Students/Residents who do not want CEU credit or certi�cation are complimentary.(Meals are not included.)

Symposium and Team Dentist Course Package

❏ Members $ 840.00

❏ Nonmembers $ 940.00

❏ Hygienists, Dental Assistants, Lab Technicians, Athletic Trainers, Licensed Residents* $ 440.00

(Includes all meals, receptions, and luncheon listed for Symposium and Team Dentist Course above.)

*Students/Residents who do not want CEU credit or certi�cation are complimentary.

(Meals are not included, but tickets for Symposium Receptions and Luncheon can be purchased separately.)

Workshops (3.5 CEU for both; must also be registered for Symposium and/or Team Dentist course) Mouthguard Workshop (2 CEU)

❏ Members $ 75.00 ❏ Members $ 75.00

❏ Nonmembers $100.00 ❏ Nonmembers $100.00Optional Events: The following event tickets are included in the full Symposium registration. However, extra tickets can be purchased for these events for students, residents who are not receiving CEU credit or certi�cation, spouses and guests.

10% discount for nonmembers who are attending with an ASD member.

In the event of a cancellation of a colleague, you will be responsible for the 10% balance due on your registration fee.

Nonmember registration fee must be paid at the same time as the member registration fee.

Suturing Workshop (1.5 CEU)