TAGD GP Winter 2012

Page 1

TEXASGP Excellence

CE

a

Fellow Mas ship Mastership Ma ter Stu dy C FMellowshi ste p lub ast rTr Ma er Stu ac dy C k ste lub rTr ac k

Mastership Fellow ship Mas ter S tudy Mastership Ma FCelullbow ste Mas ship rTr Ma ter Stu ac dy C ste lub k rTr ac k

emb

y

F

lit

MasterT rack M ers

h

shi

ip

el l ow

Qu

Lifelong Learnin g

ee itt

E

yC

tion

p

w Ne

Representa

mm Co ist nt e De nc w ere Ne Conf tist en wD E Ne lity C a Qu

nt veme Achie Et rshiphics Etth e n t r n a Rec P veme ics ognn p nt Events Achie t io sithirre ship t a rtner orPmartnerCuionts nec News a f R P n n t I e c o cog C t Even t s nne Etth & ormationnCituiorrnen ConnecNewRCeosoRuercces ts n i f ogn e t Even emarningcs In ces r v n u e e tion i i r o t r h s Couinon Ac ong Le Re unt da ogn& Kno i wle n o dge t F o i i n k i t n i l r t la a & Cla ec Life eNRgeeLwceosagrn ion Legis InLfeoarrmning nJack T. Conn ces it ic n o R i g SLeirfvelo RecoAgdnvocadcy eco Resour vents it on gni ent E un ice Lifel nedRecogn Serv dvocacy F nd yrFvuic g & y Fusnladtion Ctuiorrn u c A ort F e a c y S c o & c i v n Supp Advoca n Ad g LearniAdvioocna Leg rning n o a i t e s a L l n e t s i rc on tiogi itio ong Lifel e ReTcogn Resou Advocacy Council ocacyProtec Le Lifenl ecte Recognrces r c i a dv n v c u A o i n r n i o scr CoServ Resacy Fund n Se Advocacy Coun Unit Protect cil y Care FoundatioTransc Knowledge ipts voc ocaAcdy treach Ucnyi Fund T. Claprpkort munityRe ripts dverie A Cam arad Ou t a k u cog c Advo feyssiJoanc utSreach Comnity niti g& Valu n es i n O o u o r e n n Pr ss ea e ssiCooCnamrm L e n f ion g e o o r i n i r P slat es elo ecogn t tionAwa s LegiValu f a i d L n ice R k Fou d enes Serv . Clar Awarrowth y Fun C o m Jack T vocac m G Camaraderie unication d A Advocacy Change th Grow

t ali Qu ce en fer Con ty CE e li itte rence tist en ua fe Q wD mm on Ne Co ist C ee itt ist nt nt De mm Deew Co wN ist Ne nt De

TAGD

O f f i c i a l P u b l i c at i o n o f t h e T e x a s A c ad e m y o f G e n e ra l D e n t i s tr y

W W W. TA G D . O R G

Winter 2012, Volume 38, Issue 1


2011-2012 TAGD Board of Directors

President Joey Cazares, DDS, FAGD McAllen cazaresdds@sbcglobal.net

President-Elect Mark Peppard, DDS, MAGD Austin drpep@pepdds.com

Immediate Past President Craig Armstrong, DDS, MAGD Houston carmst@aol.com

Director (2012) Jennifer Bone, DDS, MAGD Kerrville jennifer@hcfdental.com

Director (2013) Kevin Gureckis, DMD, MAGD, ABGD Boerne kevingureckis@mac.com

Director (2013) Marko Alanis, DDS Edinburg malanisdds@aol.com

TAGD Staff: Terrie Brown Administrative Assistant Laura Ceglio Communications Assistant

AGD Regional Director David Tillman, DDS, MAGD Fort Worth mdavidtillman@hotmail.com

Sandy Frizzell Member Services Director Amy Knitt Communications Director

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

Secretary - Treasurer Jamie Bone, DDS, MAGD Kerrville jamie@hfcdental.com

Director (2014) Marc Worob, DDS, FAGD Austin mworob@sbcglobal.net

It is my pleasure to serve as your Executive Director. My eleven years with the Texas Academy of General Dentistry has brought me great appreciation for the field of organized dentistry as well as many new friends and acquaintances. This past year has been a very busy one for the TAGD as we have continued to expand activities and staff suppor t. TAGD remains the top constituent in the country and it

Editor Andrew Lazaris, DDS, FAGD Plano laz2684@aol.com

Director (2012) Chris Perry, DMD, FAGD San Antonio drchristopherp@aol.com

Director (2014) Paige Sohn, DDS, MAGD Frisco frsicodental@sbcglobal.net

AGD National Trustee Douglas Bogan, DDS, FAGD Houston dwbdds@aol.com

is because of the effor ts of dedicated leaders and suppor tive members that keep it fresh and relevant to everyone. I would like to offer a special “Thank You” to all that have continued to suppor t me and the staff as we continue to work for “YOU.” We are here to serve you. Just let us know how we can help. -Connie Sonnier, CAE

Executive Director Connie Sonnier, CAE Round Rock connie@tagd.org


January Sunday

Monday

1

Tuesday

2

Wednesday

3

4

9

10

Friday

Saturday

5

6

7

13

14

San Antonio AGD Back to Basics - Session 3 w/ Dr. Jack Shirley & Dr. Bill Robbins

New Year’s Day

8

Thursday

11

12

El Paso AGD Making Sense of Dental Technology w/ Dr. Eugene Antenucci

AGD Winter Board Meeting • Las Vegas, NV Southwest Dental Conference • Dallas, TX

15

16

17

23

24

Yankee Dental Continued

20

21

27

28

Texas AGD Board Meeting

25

Chinese New Year

29

19

Dallas AGD FellowTrack Dr. Bender • Periodontics

Dr. Martin Luther King, Jr. Day

22

18

26

Texas AGD - Southeast TX Implants & Occlusion w/ Dr. Jack Shirley Panhandle AGD Restorative Dentistry w/ Dr. Allen Atlas

Yankee Dental Congress • Boston, MA

30

31

Important Contacts: TAGD: www.tagd.org 512-244-0577 Toll-free 877-464-8243 Fax: 512-244-0476 409 W. Main Street Round Rock, TX 78664

AGD: www.agd.org 888-243-3368 TSBDE: www.tsbde.state.tx.us 512-463-6400 TDA: www.tda.org 512-443-3675

Disclaimer: The TAGD does not endorse opinions or statements contained in articles or editorials published in the TexasGP. The publication of advertisements in the TexasGP does not endorse products and/ or services. The TexasGP is published quarterly by the Texas Academy of General Dentistry, 409 West Main Street, Round Rock, TX 78664. Address changes should be sent to the TAGD. The TexasGP is provided as a member service to members of the TAGD. Nonmember subscription rates are $25.00 individual and $40.00 institutional. Canadian orders add $5.00; outside the U.S. or Canada,

add $10.00. Single copy rates are $3.00 to individuals and $4.50 to institutions (orders outside the U.S. add $1.00 postage). All orders must be prepaid in U.S. dollars. Printed in U.S.A. Copyright 2012, Texas Academy of General Dentistry, Round Rock, TX. No portion of the TexasGP may be reproduced in any form without prior written permission from the TAGD. The opinions expressed in the TexasGP are not necessarily endorsed by the TAGD. The publication of an advertisement in the TexasGP does not indicate endorsement for products and services. TAGD/AGD approval for continuing education courses or course sponsors will be clearly stated.


Grassroots Advocacy Even though the next Texas Legislative session doesn’t convene until January 2013, this year will be busy for TAGD’s advocacy council as we develop legislative priorities, follow activities at the Board of Dental Examiners and monitor implementation of the new managed dental Medicaid program. -David Mintz, CAE TAGD Legislative Consultant

There are many ways you can get involved on a local level! Keep Up on Your Reading - TAGD’s Gatekeeper is the e-publication strictly relaying information that can affect your practice. The Gatekeeper covers topics and regulatory agencies to the Texas Legislature. This is a resource that was created just for you, the general dentist. TAGD Advocacy Fund - Created to help you! As the only organization that represents general dentists is Texas, TAGD’s Advocacy Fund helps the organization have a presence at the Capitol, TSBDE meetings, Medicaid meetings, and other agencies. It’s essential the voice of the GP is heard and with a small contribution to the fund we can help ensure the protection of the dental profession. Host a Fundraiser - Though TAGD does not have a PAC and is unable to host fundraisers, members can collectively provide these events that are a sure way JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

to build relationship with legislators. Members in Dallas and the Rio Grande Valley area have hosted fundraisers for legislators by contacting their office and coordinating details with staff. It’s a sure way to make an impact! Attend a Fundraiser or a Meet and Greet - Not ready to host yet? Attend a fundraiser or event held by the legislator. As some of our San Antonio AGD members know when they attended an Open House for Rep. Lyle Larson, it is a great way to get your foot in the door! You may not be able to talk politics then and there but it’s a great opportunity to introduce yourself and pass along some literature. Host a Town Hall Meeting - TAGD staff are always willing to help get our members together to generate meaningful dialogue. If you want to gather AGD members in your area, or want to volunteer to help staff as we organize new town hall meetings in preparation for the 2013 legislative session, just contact the TAGD office or e-mail Sandy@tagd.org.

If You Want to Participate Nationally... General Dentists Eyes’ Ears and Voices - The AGD also offers resources so you stay up to date on legislative activities that could affect your practice. The newest resource published weekly is General Dentists Eyes’ Ears and Voices, to let you know of legislative activities throughout the state and the country. AGD Capwiz - Make your voice heard by participating in an e-mail campaign to lawmakers about

legislation or simply inform yourself about the issues by reading the brief descriptions. A Great Dentist Goes to Washington - The AGD offers this valuable opportunity to travel to Washington D.C. in April for members to receive unique government relations training. During the conference, leaders meet with members of Congress and their staff, educating them on issues of particular interest to general dentists and the patients they serve. The first day prepares members through briefings on talking points and important issues, as well as a tutorial on how Congress works. With information on key issues and role playing activities that focus on how to interact with elected officials, at the end of the day attendees will be prepared for the next day’s visits. The second day includes visits to Capitol Hill. The AGD arranges each attendee’s meetings with his or her member of Congress. For more information on this conference visit www.AGD.org.


February Sunday

Monday

5

Tuesday

6

Wednesday

7

Thursday

Friday

Saturday

1

2

3

4

8

9

10

11

17

18

24

25

San Antonio AGD Back to Basics - Session 4 w/ Dr. Rick Schwartz & Dr. Clint Falk

12

13

14

20

21

22

23

27

28

CenTex AGD The Expansion of Esthetic Vision w/ Dr. David Sarver Houston AGD What’s Hot & Getting Hotter: Dr. Howard Glazer

Dallas AGD Dr. Chris Perry Perry-O-cclusion Chicago Dental Society Midwinter Dental Meeting

Fort Worth AGD Dinner CE

President’s Day

26

16

Dallas AGD FellowTrack

Valentine’s Day

19

15

29 Leap Day Donate a portion on your proceeds from this extra day to the TAGD Advocacy Fund

Leap Year - Since we have a leap year this year what a great opportunity to protect General Dentistry in the State of Texas by contributing to the TAGD ADVOCACY Fund . Consider donating a portion of the extra day’s proceeds and help the profession that affords us the lifestyle we all enjoy. Contact Sandy Frizell today at Sandy@ tagd.org to contribute. We need your support to continue to advocate on your behalf. - Craig Armstrong, DDS, MAGD • Advocacy Fund Chair


Congrats to Our Newest Fellows & Masters Fellows Zoel G. Allen, II, DDS, FAGD Joshua A. Austin, DDS, FAGD Andrew An Bao, DMD, FAGD D. Brev Bedford, DDS, FAGD Patrick Bell, DDS, FAGD Eric Bess, DDS, FAGD Todd Brownlee, DDS, FAGD Zahra S. Cook, DMD, FAGD Andy Brian Duke, DDS, FAGD Mel L. Hildebrand, DDS, FAGD Pai-Chun Huang, DDS, FAGD Shireen K. Irani, DDS, FAGD Joseph S. Jung, DDS, FAGD Randall Klint, DDS, FAGD Travis A. Markle, DDS, FAGD John F. McEntire, DDS, FAGD Anthony J. Mitchell, DDS, FAGD Thomas D. Nabors, DDS, FAGD

C. Ryan Oakley, DDS, FAGD Kristen Allen Oehler, DDS, FAGD Ronald L. Proctor, DDS, FAGD Eddie Clay Pruitt, DDS, FAGD Wayne C. Radwanski, DDS, FAGD Tim Rainey, II, DDS, FAGD Thomas B. Randers, Jr., DDS, FAGD Jaspreet K. Randhawa, DMD, FAGD Shane Austin Ricci, DDS, FAGD J. Joshua Seale, DDS, FAGD Ray D. Snider, DDS, FAGD J. Robert Stephen, DDS, FAGD Jasmine C. Sung, DDS, FAGD Quynh-Chi Vu Trieu, DDS, FAGD Henry Truong, DMD, FAGD

Masters David A. F. Anderson, DDS, MAGD Mark Daniel Green, DDS, MAGD

Kelly Tom Hale, DDS, MAGD Eric M. Hurst, DDS, MAGD David N. Karbach, DDS, MAGD William Montreuil, DDS, MAGD Michael B. Morehead, DDS, MAGD Gary W. Mueller, DDS, MAGD A. Fred Renfro, Jr., DDS, MAGD Susan Roshan, DDS, MAGD Stan Shelton, DDS, MAGD Robert Shelton, DDS, MAGD Saskia C. Vaughan, DDS, MAGD

Lifelong Learning and Service Recognition

AGD Aw a See the f ull list o rd Checklist f F ellowship Requirem & Master ents list ship ed on De c e m ber’s Pag TAGD C e an Exam, th help you prep for the Fello e review wsh course is o n line and ip be taken can at any t ime! We can a lso help a ccumula need for te th Fellowsh ip or Maste e hours you the Mast rship thr erTrack oug program Sandy@ . Contac h tagd.org t for more info

John Chandler, DDS, MAGD Terry Cook, DDS, MAGD Iracema Gomez Infante, DDS, MAGD

Houston AGD Sponsored Speaker • Star of the South Dental Meeting Dr. Douglas Damm Presents “Fire in the Hole” Thursday, March 29 • 9:00 a.m. - 5:00 p.m. For more information or if you would like to register for this meeting visit www.starofthesouth.org

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012


March Sunday

Monday

4

Tuesday

5

Wednesday

6

Thursday

7

Friday

Saturday

1

2

3

8

9

10

San Antonio ASDA Trade Show Dallas AGD

Paulino Castellon & Steven Sherry

Dallas AGD Competing w/ Implant Super Centers FellowTrack American Academy of Dental Practice Administration’s Annual Meeting • San Antonio

11

12

13

14

16

San Antonio AGD Back to Basics - Session 5 Resident’s Round Table

Daylight-Saving Time Begins

18

15

19

20

21

22

17

St. Patrick’s Day

23

24

Academy of General Dentistry Pediatric Dentistry w/ Dr. Fred Margolis • Itasca, Ill. Hinman Dental Meeting • Atlanta, GA

25

26

27

28

29

30

Houston AGD Sponsored Speaker Dr. Douglas Damm “Fire in the Hole” Star of the South Dental Meeting • Houston, TX

31


Grassroots Advocacy Call For Volunteers

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

The Texas AGD and AGD are looking for a few good men and women to help and lead as we continue to grow our organization. Texas AGD Committees

AGD Committees

• • • • •

Public Information PACE Committee Dental Care Advocacy Council TSBDE (Sub-Committee)

• • • • •

Annual Meetings Budget and Finance Communications Constitution, Bylaws & Judicial Affairs Dental Education

• • • • • • • • • • • • • •

Advocacy Fund (Sub-Committee) Barriers to Care (Sub Committee) Finance Committee Nominating Committee Lone Star Dental Conference Membership Fellow Track MasterTrack Master Study Club Education Committee Identify Future Leaders Emergency Preparedness Task Force New Dentist Committee Building Task Force

• • • • • • • • • • • • • •

Dental Practice Examinations Governance/Credentials and Elections Group Benefits Legislative & Governmental Affairs Membership Program Approval for Continuing Education (PACE) Self-Instruction Legislative and Governmental Affairs AGD Spokesperson Constituent Speaker/Spokesperson Member of a Scientific Review Panel Public Information Officer Reviewer for AGD Publications

If you are interested in serving on a TAGD committee contact TAGD Executive Director Connie Sonnier by calling 512.244.0577.

• •

Scout for Other CDE Meetings Liaison to Other Dental Organization(s)

For additional information contact AGD National Trustee Dr. Douglas Bogan by e-mailing dwbdds@aol.com.


April Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

1

2

3

4

5

6

7

8

9

10

11

12

13

14

Dallas AGD Installation & Member Dinner

Easter

15

16

17

A Great Dentist Goes to Washington • AGD Govt. Relations Conference

18

19

Panhandle AGD Practice Management w/ Dr. Roger Levin Dallas AGD Technology Fair

20

21

Texas AGD Texas AGD Board Meeting Strategic Planning & Leadership Training AGD Spring Board Meeting • St. Charles, IL

Fort Worth AGD Dinner CE

22

23

24

25

29

30

TAGD Leadership – Serving on the TAGD Board of Directors, and currently as a national AGD Trustee, has been incredibly fulfilling. Not only does it allow me the chance to have a direct impact in the organization and an influence in the profession, but I’ve gotten to know and work with leaders in dentistry from all over Texas and

26

27

28

Earth Day

the US. I’ve seen first hand that leadership in dentistry is not something for someone else to do; it’s a responsibility we all have to our profession and colleagues and to the patients we take care of. If you are considering the idea of serving on your local TAGD board, or beyond, I strongly encourage you to take advantage of the great opportunity. -Doug Bogan, DDS, FAGD •AGD Trustee


VU

TEXAS Meeting TAGD’ Sponsored Speaker: Dr. Michaell Huber Update on Managing Common Oral Lesions

Friday, May 4 • 8:30 a.m. - 11:30 a.m.

Texas AGD Master Study Club ...To Provide a vehicle to carry out the charge to the Masters given at the convocation. ...Because this is a study club dedicated to GPs and their needs and wants. ...To provide a way to carry on the fellowship and friendship that is uniquely AGD. The Master Study Club is a protocol presentation program and elite study club designed exclusively for those who have earned their Mastership in the Academy of General Dentistry. Master Study Club is a group for AGD Masters looking to fulfill the charges issued to them at convocation that include: 1) the responsibility to continue the journey as a lifelong learner and remain abreast of cutting-edge advances in the profession; 2) the responsibility to use your experience and position to teach and give others the benefit of what you have learned and 3) the responsibility to your community, and to exemplify dedication, concern, compassion and understanding in unselfish service. And

because the process of setting a new standard of excellence in general dentistry has just begun. JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

Learning Objectives: 1. Know the patterns of presentation of the most common or potentially serious mucosal conditions observed in dental practice. 2. Review the relevant clinical or laboratory tests necessary to diagnose mucosal conditions. 3. Review the basic therapeutic strategies used to manage mucosal conditions.

Update on Etiology and Diagnosis of Oral Cancer Friday, May 4 • 1:30 p.m.- 4:30 p.m. Learning Objectives 1. Know the most common risk factors for oral cancer. 2. Review current oral cancer risk reduction protocols. 3. Objectively assess the strengths and weaknesses of technological advances available to identify oral cancer

Update on Managing Common Oral Lesions (Repeat)

Saturday, May 5 • 8:00 a.m. - 11:00 a.m.

To register visit www.tda.org

VU


May Sunday

Monday

6

TDA Annual Session Cont..

13

Tuesday

Wednesday 1

2

Thursday

Friday 3

Saturday 4 Cinco de Mayo

TAGD Sponsored Speaker • Dr. Michaell Huber TDA’s Annual Session • San Antonio

7

8

9

10

11

12

14

15

16

17

18

19

Mother’s Day

TAGD Board Meeting

20

21

22

23

24

27

28

29

30

31

Memorial Day

5

TAGD Precaucus

25

26

Don’t forget to come by the TAGD booth at the TDA meeting. I hope to meet as many of the membership as possible during my year of presidency so come by, say hi. You can also skip those long lines for the CE scanners at the meeting; pick up your TAGD member CE form to make recording your courses simple and convenient. -Joey Cazares, DDS, FAGD • TAGD President


TAGD New Dentist Conference New Dentist Conference Chair Profile Dr. Shane Ricci received his Bachelor’s in Biology and Biochemistry with Magna Cum Laude honors from West Texas A&M University. He then obtained his Doctor of Dental Surgery degree with honors at the University of Texas Health Science Center at San Antonio (UTHSCSA). Upon completion of dental school, Dr. Ricci was accepted to an AEGD residency at the UTHSCSA to acquire an expanded understanding of all facets of dentistry. This training provided in-depth academic and clinical experiences in IV and oral sedation, implantology, wisdom teeth removal, periodontal surgery, complex restorative dentistry as well as all other areas of general dentistry. Dr. Ricci has served as President of the Dallas Academy of General Dentistry and is the current Chair of the Texas AGD New Dentist Committee and New Dentist Conference. He was also a recent nominee for New Dentist of the Year and he earned his Fellowship in the AGD.

A Lasting Partnership to Beneet Your Practice and Your Patients To learn more or join our network, call (866) 529-4827 or visit our Web site at www.UnitedConcordia.com

For nearly 40 years, United Concordia has been a responsible, exible partner. Today, we insure more than 8 million members and serve over 28,000 commercial and government accounts - including the TRICARE Dental Program and Active Duty Dental Program. We invite you to join our network and receive access to new patients, competitive reimbursements, convenient tools and information, discount programs for your practice, exceptional service, and more. Plus, we’ll support you in promoting good oral health and its contribution to improved general health to your United Concordia patients.

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

Dr. Ricci is very active in continuing education, making it a priority to stay on the cutting edge of current technology, procedures, and literature. Outside of the office Dr. Ricci is an avid golfer, soccer player, and enjoys staying active in sports and other outdoor activities. Dr. Ricci celebrated his 10 year anniversary with his wife Beth this year, and has two beautiful children, Wyatt 3, and Brecken 6 months.


June Sunday

Monday

3

4

Tuesday

Wednesday

5

6

Thursday

Friday

7

Saturday 1

2

8

9

TAGD Master Study Club 2012 TAGD New Dentist Conference Austin MasterTrack • Removable Prosthodontics & Orthodontics

10

11

12

13

14

15

16

18

19

20

21

22

23

MasterTrack Continued

17

AGD Annual Meeting • Philadelphia, PA House of Delegates Opening Session

Father’s Day

24

AGD House of Delegates

25

26

27

Summer AGD Board Mtng.

28

29

Convocation & TAGD Reception

30


Lone Star Dental Conference { S ave the D ate }

L one S tar Dental Conference S eptember 13 - 15, 2012 A ustin , TX

F eaturing :

K irk B ehrendt

About the Speaker: Kirk Behrendt is a practice

performance coach, international speaker and author.

Kirk

has invested his en-

tire professional life studying the elite practices in dentistry and the leadership that guides them.

ACT, his vision is driven by the commitment to By creating a talented team of experts, Kirk of dentistry one practice at a time. His personal

As

the

founder of

provide highly personalized care to the dental

profession.

and his team continue to positively impact the

practice

mission is to use up every ounce of his poten-

Dentistry Today Kirk as one of the Leaders in Dental Consulting in 2011. Dr. Peter Dawson called him “THE best motivator I have ever heard.” tial.

Kirk

lectures all over the world to help individuals take control of their own lives.

recently recognized

# 219328 1/1/11 - 12/31/15 Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

Learn │ Connect │ Succeed

www.TAGD.org for more info

Provided by the Texas AGD


July Sunday

Monday

1

Tuesday 2

Wednesday 3

Thursday

Friday

Saturday

4

5

6

7

Independence Day

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Join me at the 2012 Lone Star Dental Conference - You won’t want to miss this year’s Lone Star Conference in Austin in September. It’s a great time of year to be on the UT campus for a meeting, the speaker line up will be fantastic and the opportunities to mingle with our great

TAGD members will be abundant! Registration is up and running online so visit www.TAGD.org for more information on the great event we have planned for you. We also have a special surprise for attendees! The first 100 registrants will be entered in a drawing for an iPad2! - Cindy Flanagan, DDS, MAGD • 2012 LSDC Chair


Jack T. Clark Foundation Update After a year of consecutive successes for the Jack T. Clark Foundation, the board is already looking forward and making plans for the new year. On Saturday, October 29 the board of trustees met to refocus their goals in a Strategic Planning meeting led by Dr. Bob Frazer. After a very successful planning session, the board is excited to not only continue their work to further the mission of the JTCF and also to refocus their efforts to support their newly expanded vision.

As the Jack T. Clark Foundation refocuses our efforts and expands on our new vision we cannot move forward toward success without the help of our members and the public.

Revised Vision:

If all TAGD members donated just $10 a month the Jack T. Clark Foundation would have the abilities to reach and possibly exceed our goals to keep the Foundation moving and positively impact those affected by cancer.

A Year In Review 2011 Oral Cancer Screenings at Hope Fest and the Texas State Capitol • 50 people screened

Jack T. Clark Silent Auction at the 2011 Lone Star Dental Conference • $11,928 raised

Oral Cancer Seminar and Fundraiser in McAllen, Texas • Over 150 people screened and $24,740 raised JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

Thank You For Your Support

We are grateful for your participation and your support!


August Sunday

Monday

Tuesday

Wednesday 1

Thursday

Friday 2

Saturday 3

4

Dentists Who Care Charity Conference • South Padre Island

5

6

7

8

9

10

11

12

13

14

15

16

17

18

AGD Fall Board Meeting • Boca Raton, FL

19

20

21

22

23

24

27

28

29

30

31

AGD Fall Board Meeting

26

25


The Lone Star Dental Conference is Here! TAGD’s Lone Star Dental Conference Make a weekend of it and bring the family! Top 10 things to do in Austin 1. Enjoy the outdoors! Austin has many amazing outdoor activities like taking a canoe or kayak out on Lady Bird Lake or make the quick trek up to Mount Bonnell to get one of the best views of the city. 2. Enjoy Austin’s best, and nationally renowned, restaurants including Uchiko and Wink. 3. Fabulous shopping in the Warehouse District and the Domain. 4. Take your kids to the Austin Children’s Museum or the Imax Theater. 5. Take in some history at the Bob Bullock Texas History Museum and LBJ Library, all within walking distance from the conference venue. 6. Explore the great exhibits at the Blanton Art Museum located right next to the AT&T Center or visit the Austin Museum of Art at their Laguna Gloria campus. 7. Hike the beautiful greenbelt in the heart of Austin. 8. Enjoy the nightlife at places like Esther’s Follies, Pete’s Piano Bar, 4th and 6th Street districts. 9. Tour the Texas State Capitol located just few blocks from the AT&T Executive Education and Conference Center. 10. Watch millions of our resident bats fly out from under Congress Avenue Bridge.

And a few more just in case:.. 11. Explore the UT Campus, tour the Tower and DKR Memorial Stadium. 12. Take a stroll around Zilker Park and the Zilker Botanical Gardens 13. Swimming Holes - you can’t leave the Austin area in the summer without partaking in the refreshing and clear water at the famous Barton Springs, Hamilton Pool, or Krause Springs. JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012


September Sunday

Monday

2

Tuesday

Wednesday

Thursday

Friday

Saturday 1

3

4

5

6

7

8

10

11

12

13

14

15

Labor Day

9

TAGD Lone Star Dental Conference • Austin, TX TAGD Leadership Reception Texas Dentist of the Year Gala

16

Rosh Hashanah Begins

23

30

17

18

TAGD Board Meeting

19

20

21

22

26

27

28

29

Fort Worth AGD Dinner CE

24

25

Yom Kippur Begins

Join Us For the Party! - As I move into

my year as president of the TAGD I invite you to join me for the festivities held at the Lone Star Dental Conference. First, we will host the Leadership Reception; open to all conference attendees and TAGD members.

The reception kicks off the conference on Thursday night as we recognize not only TAGD leaders throughout the state, but many of the young, active new dentists that will be present for the awarding of the 2012 New Dentist of the Year Award. Friday night, I will be honored to be your emcee for the Texas Dentist of the Year Gala, a prestigious event that

highlights our brightest and our best who stand out in their communities and honor their service to mankind. It’s a night to bring out your finest attire and mix and mingle with your peers. The evening always includes good food, enjoyable entertainment and great company. I hope to see you there! -Mark Peppard, DDS, MAGD • TAGD President-Elect


TAGD Online Seminars

Not Your Average Online CE

simple • fast • effective • www.tagd.org

TAGD aims to always provide you with the highest caliber of CE in the most effective way. We understand how busy our members often are, and working your schedule to fit in CE isn’t always easy. Now, you can cut out the hefty travel expenses and take advantage of TAGD’s online resource library. Above all we think online CE should still emphasize quality, a service TAGD prides itself on being known for. Check out the array of CE possibilities available at your fingertips. Because, sometimes you just want to be able to stay home.

FEATURED COURSE:

Fellowship Exam Review

The Fellowship Exam Review course aims to prepare participants in pursuit of their Fellowship in the Academy of General Dentistry to successfully complete the FAGD Exam. The Fellowship Exam can be taken as early as your first year of active membership. The exam stresses clinical applications of accepted dental knowledge, techniques, and procedures, and consists of multiple-choice questions, administered over two eight-hour sessions. This online course is designed to instruct participants how to prepare for the examination, familiarize participants with exam format and preview material from the areas that will be covered on the exam This review will also prepare participants for the ABGD written exam. • •

$495 for AGD Members $595 for Non-AGD members

Texas State Board-Approved Online Dental Assistant Course & Exam ! Beginning September 1, 2006 all dental assistants who still need radiology registration with the State Board will need to take and pass a TSBDE approved course and examination covering required objectives in Jurisprudence, Infection Control and Radiology. The goal of the TAGD’s Dental Assistant Course is to provide sufficient information to permit dental assistants to gain knowledge and understanding of the critical concepts associated with each of these areas of certification in order to facilitate success in each examination * $125 - AGD member staff * $155 - Non-AGD member staff JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

OSHA Annual Update Course TAGD also now offers an online OSHA and HIPAA annual update course! This program is 45 minutes in duration and once completed, the registered participant may print and fill out a training record form for themselves and other participants. This course will satisfy OSHA’s requirement for an annual blood-born pathogen update. 1.5 hours of CE are offered for this course.

OSHA and HIPAA Training Course All dental offices employees can now receive OSHA and HIPAA training online from the comfort of your home or office computer. The course is designed to start, pause and resume depending on the needs of the day-to-day office activities. The total time of the course is approximately one hour and forty-five minutes. 3.5 hours of CE are offered for this course. * $159 - AGD Member * $189 - Non-AGD Member

* $89 - AGD Member * $119 - Non-AGD Member Oral Cancer, Precancer, and Differential Diagnosis of Common Oral Mucosal Conditions This online course emphasizes clinical relevance by illustrating and discussing clinical changes, which may represent early malignant or premalignant lesions. You will learn differential diagnosis by illustrating other pathologic conditions that share clinical features with cancerous and precancerous lesions. This course is a three hour video lecture and course participants will earn 6 hours of CE credit.

Advanced Rejuvenation Dr. Steve Thompson of Plano, Texas hits a home run in presenting this Level IV case. Gaining the skills to provide a complete orognathic rejuvenation is the pinnacle accomplishment in OBI Foundation’s Bioesthetic curriculum. It reflects an advanced application of what the found of Bioesthetic Dentistry, Dr. Robert Lee, describes as “The study or theory of the beauty of living things in their natural forms and functions.” 2 hours of CE is offered for this course.

* This course is $69.

• •

$49 for Members $59 for Non-members


October Sunday

Monday

Tuesday

1

7

Wednesday

2

Thursday 3

Friday 4

Saturday 5

6

Panhandle AGD Pediatrics for the GP w/ Dr. Greg Psaltis

8

9

10

11

12

13

15

16

17

18

19

20

Columbus Day

14

ADA’s Annual Session • San Francisco, CA

21

22

23

24

29

30

31

25

26

27

LIVESTRONG Challenge ADA Annual Session Cont.

28

Halloween

Looking for more CE opportunities? TAGD has plenty of resources online! Just because they are online does not mean we skimp on the quality. Each of the programs we have for you and your staff are filmed seminars; you won’t be watching just a PowerPoint presentation for these! TAGD and our components also continue to have meetings throughout the state, year-round. Check www.TAGD.org to see what’s coming up in your area. -Tor Gotun, DDS, MAGD • Education Chair


FAGD MAGD Requirements The application deadline is December 31 • Below is the listing of requirements for each award

For the complete listing of all Fellowship and Mastership requirements visit www.AGD.org. To find out how many hours away you are from your award call the TAGD office at 512.244.0577 or e-mail Sandy@tagd.org. You may be closer than you think and we can help! Fellowship Requirements 1. Current AGD membership for three (3) continuous years (36 months) by December 31 of the year in which the application is received, to begin no earlier than the month of dental school graduation; dental license has not been suspended or revoked. 2. Completion of 500 hours of FAGD/MAGD-approved continuing education credit, with at least 350 hours earned in course attendance. Mastership credit begins to accrue on the date that the 500-hours requirement has been met, as determined by the Dental Education Council. 3. Successful completion of the Fellowship Examination. 4. Attendance at a Convocation Ceremony, held during the AGD Annual Meeting, to receive the award. Successful candidates are allowed three years following approval to complete this.

Mastership Requirements 1. Current membership in good standing in the AGD at the time of application. 2. Fellowship in the Academy of General Dentistry. 3. 1100 hours of FAGD/MAGD-approved CE, 400 of which must be in participation courses.

Activities Accepted for Fellowship Credit Course Attendance Credit - A minimum of 350 hours of CE course credit is required for the award. Course content must be directly related to the practice of dentistry with the exception that 10 hours are permitted for self-improvement courses. Course credit can be earned for: 1. Scientific Programs 2. Postgraduate Education 3. Federal Dental Service Specialty Rotation Programs 4. Self-Instructional Programs 5. Self-Improvement 6. Case Presentation Required for Certification/Accreditation by Allied Dental Organizations upon request.

Subject Category Requirements A minimum number of credits must be earned in each of the 16 dental subject categories listed below. Of the ‘required minimum’ hours needed in each category, a specific portion must fulfill the ‘participation minimum’ requirements.

Other CE Activities for Credit • Teaching/Publications • Full- or part-time faculty positions at ADA/CDA–accredited institutions. • Continuing education presentations put on by PACEprogram providers. • Original presentations receive three hours of credit for each hour of teaching. • Authorship of a published scientific article in a dental or scientific journal. • Authorship of a published dental textbook or chapter in a published textbook • Authorship of a case report, technique paper or clinical research report in a dental or scientific journal published in or after July, 2000. JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

- 600 credit hours must be earned in specific disciplines, as outlined under “Subject Category requirements.” - A participation course is defined as one in which all course participants actively manipulate dental material or devices, treat patients or otherwise practice skills or techniques under the supervision of a qualified instructor. - The participation activities must represent a minimum of 30% of total course time and must directly address the educational objectives of the course and be an extension and amplification of the lecture portion of the course.

4. Attendance at a Convocation ceremony, held during the AGD Annual Meeting

Subject Participation Minimum Required Minimum Basic Sciences.....................................12................................................ 12 Endodontics .......................................30................................................ 46 Electives ............................................30................................................ 46 MPD/Occlusion ...................................30................................................ 46 Operative Dentistry ............................30................................................ 46 Oral & Maxillofacial Surgery.................30................................................ 46 Orthodontics ......................................12................................................ 12 Pediatric Dentistry .............................12.. ............................................... 12 Periodontic.........................................30................................................ 46 Practice Management.......................... 0................................................. 24 Fixed Prosthodontics ..........................30.. ............................................... 46 Removable Prosthodontics .................30................................................. 46 Implants ...........................................30................................................. 46 Oral Med/Oral Diagnosis .....................12................................................ 12 Special Patient Care............................12.. ............................................... 12 Esthetics ...........................................30................................................. 46 TOTAL HOURS....................................360.. ............................................... 544 TOTAL REQUIRED ...............................400................................................ 600


November Sunday

Monday

4

Tuesday

5

Wednesday

6

Thursday

7

Friday

Saturday

1

2

3

8

9

10

TAGD Master Study Club Austin MasterTrack • Fixed Prosthodontics & Oral Medicine

Daylight-Saving Time Ends

11

12

13

14

15

16

17

18

19

20

21

22

23

24

Veteran’s Day AMT Continued

Thanksgiving

25

26

27

28

Fort Worth AGD Dinner CE Greater New York Dental Meeting

Greater New York Dental Meeting

29

30


TAGD Advocacy Fund

Invest Today

This holiday season Donate the proceeds of your last procedure to the Texas AGD Advocacy Fund Or, if you’d prefer, for as little as $25 a month you can give yourself the gift of professional security The last couple of years have marked TAGD’s most active sessions ever advocating for general dentistry. Throughout the most recent legislative session, TAGD’s Advocacy Council monitored and took positions on more than 30 bills. TAGD was so successful that it received the Constituent Advocacy Award at the 2011 AGD Annual meeting. The TAGD Advocacy Council is looking to the future as they set their legislative priorities for 2013. To learn more about the Texas Academy of General Dentistry’s governmental affairs efforts, or to contribute to the TAGD Advocacy Fund online, visit www.TAGD.org or call 512.244.0577.

Donate to the Advocacy Fund before the new year and make a lasting contribution to protect the future of your profession.

Shoulder to Shoulder

JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

Thanks for helping ensure strong representation for our profession at the Capitol and before state agencies. TAGD Advocacy Fund suggested levels of giving: Master..........................................$1,500 annually Fellow.............................................$500 annually Member.........................................$250 annually

Members who donate to these levels will receive a lapel pin and special recognition on the TAGD website, in the TexasGP and at TAGD Advocacy Events.

Amount I authorize TAGD to charge my card on the 10th of each month (until I cancel in writing) the amount of:  $125 monthly (Master)  $50 monthly (Fellow)  $25 monthly (Member)  Other ___________ I would like to make a one-time payment in the amount of $_____________________ Information Name:__________________________________ Address:_________________________________ City/State/Zip:_____________________________ Phone:__________________________________ E-mail:__________________________________ Payment I am enclosing my investment paid by:  Check (made payable to TAGD)  Visa  MasterCard  Discover  Amex Name on card:_____________________________ Card #:_______-_________-________-________ Expiration date:________/________ Signature:________________________________


December Sunday

Monday

2

Tuesday

3

Wednesday

4

5

Thursday

Friday

Saturday 1

6

7

8

Hanukkah begins

9

10

11

12

13

14

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Christmas

15

Kwanzaa

As we come to the close of 2012 we hope it has been a wonderful and prosperous year for you and your family. Thank you for your continued support of the Texas AGD and we look forward to what 2013 has in store for us! -TAGD Leadership & Staff

New Year’s Eve


AGD Member Benefits

Your Member Benefits Being a member of the Texas AGD not only gives you access to a wide array of top-tier courses in the dentistry, but it also provides you with a whole host of incredible benefits. From achievement awards to free publications and the exclusive member discounts with the AGD Benefits Plus Program — this year make your resolution to take advantage of all Texas AGD has to offer you.

Continuing Education TAGD offers continuing education (CE) opportunities in your local area and even online. Members can also search the new AGD CE Database, one of the largest dental CE collections in the world searchable by topic, speaker, cost, location, provider, credit hours, and more. AGD Licensing Board Transcript The AGD takes the pressure of organizing CE off the general dentist. The AGD Licensing Board Transcript is customized to show the specific requirements a member needs to renew their license in their state/province. Achievement Awards The AGD offers the only achievement-based awards in general dentistry—the prestigious Fellowship (FAGD) and Mastership (MAGD) awards. You can also track your progress toward the FAGD or MAGD with the AGD Award Transcript. Advocacy and Representation Through action alerts, public awareness initiatives, and an annual trip to Capitol Hill where AGD legislative leaders meet with congressional representatives, we strive to represent and protect the interests of general dentists. Patient Education KnowYourTeeth.com is the new consumer Web portal that offers your patients dental health information in an easy and fun format from a source you already trust for dental education, the AGD. The AGD created KnowYourTeeth.com to help you improve treatment acceptance, decrease cancellations, improve office visits, and enhance your patient relationships overall. To promote this site to your patients, access the Marketing Toolkit for Web stickers to add to your own site, fliers for hand out, and a downloadable video. Free and Speedy Insurance Contract Analysis Members have free access to insurance contract analysis to assess the terms and ramifications of insurance contracts. Premier Publications Subscriptions to the AGD’s publications General Dentistry and AGD Impact are included in JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY • WINTER 2012

your membership fee as well as the Texas AGD’s official publication, TexasGP. Articles are also available online now! Annual Meeting & Exhibits Whether its on a state or national level, the Lone Star Dental Conference and the AGD Annual Meeting & Exhibits are the premiere education and networking events for general dentists. Member Discounts Save money on both professional and personal products and services through the AGD Benefits Plus program. Member Directory Search for members for networking or referral purposes. AGD Career Center Simplify your search! Whether you’re posting an open position in your practice, selling equipment, or looking for a new partner, resources are available at the AGD Career Center. Web Tools The AGD offers its members a variety of Web tools, including e-mail forwarding with an AGD e-mail address, a Member Web Page Builder, and even AGD wallpaper for your computer’s desktop. Patient Referrals As a member, you’re automatically entered into Find-an-AGD-Dentist under “Patient Referrals”. Potential patients search the online database or call the toll-free referral hotline (1.877.2X.A.YEAR) for names, addresses, and phone numbers of AGD member dentists in their area. Find a Speaker Book or find information about a speaker at your next event by using the AGD Speaker Program.


AGD Benefits Plus Program | Member Discounts Personal Services AGD Visa Platinum Credit Card Capital One has worked with the AGD Benefits Plus Program to offer you an Academy of General Dentistry Visa ®Card. If you choose the rewards card, AGD members will receive the following benefits: • 1.25 miles for every $1 you spend • Redeem rewards for travel, merchandise, gift cards or cash Discounted Car Rental Avis Car Rental • SPECIAL Annual Meeting Rate for San Diego Registered Attendees! • AGD members save up to 25% off with AWD # B184300 • Choose from the following coupon offers - Free weekend day, up to $35 off a weekly rental, free Where 2 (GPS unit). Please note that all coupons are subject to terms and conditions. • Free enrollment in the Preferred Express Service. Budget Car Rental • SPECIAL Annual Meeting Rate for San Diego Registered Attendees! • AGD members save up to 20% off with BCD # Z473900 • Choose from valuable coupon savings that can be used along with your member discount - Free weekend day, $25 off a weekly rental. Please note that all coupons are subject to terms and conditions. • Free enrollment in the Budget FastBreak Service. Automotive and Home Insurance As a member of the Academy of General Dentistry you qualify for a special group discount* on your auto, home, and renter’s insurance through Group Savings Plus® from Liberty Mutual. This unique program allows you to purchase high-quality auto, home and renters insurance at low group rates. For a free, no-obligation quote call 877-477-3320, visit us online at www.libertymutual.com/agd or call your local sales office.

Professional Services Credit Card Processing WorldPay The “WorldPay” service offers AGD members a streamlined and efficient credit card processing service. For more information on WorldPay pricing for AGD members, please call the exclusive, toll-free AGD member line 866-304-8852. AGD Members will receive: • Cost plus 30 basis points pricing • $10 monthly administration fee • A batch header fee of $0.10 per occurrence • A one-time price of $167 for each VeriFone VX510LE terminal purchased by a WorldPay customer • Third party fees will be charged separately per VISA, MC, AM EX, Discover, etc. Patient Financing CareCredit is an AGD Benefits Plus provider. AGD Members are eligible for an enrollment discount when signing up for CareCredit. For more information, please contact CareCredit at 800-300-3046, ext. 4519. Here are the benefits of the CareCredit program: • AGD Members save on enrollment • No monthly minimum use fee • Per an ADCPA study, CareCredit increases case acceptance and production • Free listing in the Online Doctor Locator; the locator has 400,000 patient visits a month

• Provides ongoing financial resources for patients and families without reapplication • Reduces time spent on Accounts Receivables Defibrillator Services ZOLL Medical Corporation offers AGD members the AED Plus defibrillator. The AED Plus delivers both a defibrillating shock along with Real CPR Help®. This real-time feedback for both depth and rate of chest compressions provides full-support to rescuers of a cardiac arrest victim. As an AGD Benefits Plus Provider, ZOLL offers: • Discounted price of $1,545 for the AED Plus (includes pulse oximeter) • Comprehensive In-service Instruction Professional Financing For more than 20 years, Bank of America Practice Solutions has served the needs of dentists by offering financial products and services to the dental community. For more information about Bank of America Practice Solutions, please call 800-497-6076 and mention code IND1011B. Bank of America Practice Solutions offers AGD members the following: • Purchase and Start-Up Opportunities: Practice Sales & Purchases New Practice Start-ups Commercial Real Estate Products • Growth & Restructuring Opportunities: Improvement and Expansion Financing Equipment Financing Practice Equity Loan Program Life and Disability Insurance Hagan Benefits, Inc. is an AGD Benefits Plus provider that offers life and disability insurance products. For more information call 1-877-280-6487. Hagan Benefits offers the following products: • Term Life Insurance • Accidental Death and Dismemberment Insurance • Long Term Disability Income Insurance • Professional Overhead Expense Insurance • Long Term Care Insurance Professional Liability and Malpractice Protection Insurance Dentist’s Advantage is an AGD Benefits Plus Provider offering professional liability coverage based on the procedures you perform. Premium credits* are available to AGD Members: • 10% AGD Member credit on professional liability insurance • 15% Credit to Fellow Awardees • 20% Credit to Master Awardees • Claims-free and risk management credits • Opportunity to add property, general liability, worker’s compensation and several coverage options Website Services The Online Practice is an AGD Benefits Plus Program provider that offers personalized websites for AGD member practices. AGD members can subscribe to The Online Practice’s Gold Package, which normally retails for $99.95, for only $49.95 a month. The package includes: • More than 100 different site designs • Unlimited website support • Customizable pre-written content • Unlimited pages and pictures • 3D educational videos, and more!


Texas Academy of General Dentistry 409 West Main Street Round Rock, TX 78664 www.tagd.org

ADDRESS SERVICE REQUESTED

2012 Texas AGD Membership Application

3. Send in your application and dues

1. Choose your interests

2012 Academy Dues - State & National ............$546  Student Dues............................................................$16

Check any areas of interest that you would like to know more about or participate in:  Educational Programs  Fellowship/Mastership Award

Or New Dentist Special Dues Rates - State & National  2011/1st year Graduate or Resident..$ 151  2010 Graduate...........................................$ 254

 Jack T. Clark Foundation/Volunteering

 2009 Graduate...........................................$ 365

 Advocacy/Representation

 2008 Graduate...........................................$ 475

 Networking  Other:_________________________________

Local Component Dues $_________ Dues vary by component area, see chart

2. Tell us about you Name______________________________________

 Brazos Valley AGD...............$25

 Panhandle AGD..................$ 0

Address_____________________________________  Central Texas AGD...............$45

 Rio Grande Valley AGD.......$40

City, State, Zip_______________________________

 Dallas AGD..........................$45

 San Antonio AGD...............$50

Phone_____-_____-______ Fax_____-_____-_____

 East Texas AGD....................$25

 Houston AGD.....................$50

E-mail______________________________________  El Paso AGD.........................$10 Date of Birth ______/_____/______  M  F  Fort Worth AGD...................$40 License #____________ Year of Graduation*______ Dental School___________________ New Dentist? If you graduated less than five years ago your dues are less (see special rates on the right)

Type of Practice - Check all that apply  Solo  Associateship

Group

 Federal Services (specify)____________________  Specialist (specify)_________________________ Sponsor Name (optional)______________________

 Heart of Texas AGD..............$15

2011 Graduate..................$25

2010 Graduate..................$35 2009 Graduate..................$45

Total Amount Due

$___________

Payment Information  Check Enclosed (Payable to Texas AGD)  Discover

 Master Card

 Visa

 AmEx

Card #_________-__________-_________-_________ Card Expiration Date________/_________ Signature_____________________________________ Today’s Date__________/__________/__________

Mail or fax your completed form to: Texas Academy of General Dentistry 409 West Main Street • Round Rock, TX 78664 • Fax 512-244-0476


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.