Our Dental Hygiene Level One Expanded Function Courses can help make it happen!

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Five Certified Level One Expanded Function Courses for Dental Hygienists Laser Dentistry of IoAn Iowa Dental Board Approved Course Provid- April 21 & 22, 2017 or September 29 & 30, 2017 (other course dates may be added throughout the year) Are you looking for ways to increase the productivity and efficiency of your office? Are team members wanting to play a greater role in patient care & invigorate their career? Our Dental Hygiene Level One Expanded Function Courses can help make it happen! In July 2015, the Iowa Dental Board made significant changes to expanded functions. They changed the eligibility requirements, added new skills and made an expanded functions pathway for hygienists. The IDB then took it a step farther and created a two tier expanded function system for both Dental Assistants and Dental Hygienists - Level One & Level Two. With these new guidelines, now is the perfect time to explore how the Dental Assisting and Dental Hygiene expanded functions programs can benefit your office! Level One Expanded Function Courses New Eligibility Requirements! Dental Assistant Requirements: Graduate of ADA Accredited Dental Assistant Program Currently certified by DANB (is a CDA) One year of clinical practice as a RDA One year clinical practice in a state not having RDA Dental Hygiene Requirements: Licensed dental hygienist in the State of Iowa Level One Expanded Function Skills: 11 for Dental Assistants, 5 for Dental Hygienists (* below) (L) indicates course has a hands on lab component NEW! Removal of Adhesives (hand instrumentation only) (L) NEW! Prelim. Charting of Existing Restorations/Teeth ( L) *Taking Final Impressions (L) *Fabrication & Removal of Provisional Restorations (L) *Placement & Removal of Gingival Retraction (L) *Taking Occlusal Registrations (L) *Applying Cavity Liners, Bases, Desensitizing Agents & Bonding Systems Testing Pulp Vitality (L) Placement & Removal of Dry Socket Medication (L) Placement of Periodontal Dressings (L) What is Level Two Expanded Functions for Dental Assistants and Dental Hygienists? To be eligible for Level Two Expanded Functions, the participants must have successfully completed a Level One course from an Iowa Dental Board approved provider. Level Two will only be given at the University of Iowa College of Dentistry and requires passing an entrance examination. Five expanded functions are included in Level Two: Placement & shaping of amalgam following preparation of a tooth by a dentist Placement & shaping of composite following preparation of a tooth by a dentist Forming and placement of stainless steel crown Taking records for the fabrication of dentures and partial dentures Tissue conditioning (soft reline only) 5965 Merle Hay Road, Johnston, IA 50131 515.321.5942 www.impactdentaltraining.com

Certified Level One Dental Hygiene Expanded Functions Courses April 21 (pm) & 22, 2017 or September 29 (pm) & 30, 2017 29 CEU s $300 Registration Deadline: one week prior to course start date (email us if past the deadline to determine availability) Why partner with Impact Dental Training? We do things a little differently and it s noticed. Dental professionals from across the state have taken our courses, including faculty from three dental assisting community colleges. Flexibility. Team members can take only the expanded functions courses they want and/or need or enroll in the complete Level One Expanded Functions program. Hand on labs using real dental materials. Many of our courses have a hands on lab component so your team members come back better prepared to perform the skills. Small class sizes. Our priority is our student success so we purposely keep our class sizes small so they get personalized attention throughout the process. Remediation & support is given until the successful completion of IDB required post tests is achieved. Level Two Expanded Functions eligibility. Our certified Level One dental assistants and hygienists are eligible for admission into the University of Iowa College of Dentistry program. Experienced dental education as instructors. Our instructors have years of experience in dental education at the University of Iowa, College of Dentistry and/or the Des Moines Area Community College Dental Assisting and Hygiene programs. Dental Assisting Educator Council Expanded Function Curriculum. Our Iowa Dental Board approved curriculum closely follows the council s recommendations. We award CEU s for both the didactic and clinical aspects of the course. Private practice influence. We are still active in private practice so we understand the needs of an office. We know what s important. We keep it real. What our participants are saying about us The course covered everything well and since I m a hands on learner, I appreciated the labs. It made me more confident returning to our office. A.F., CDA, Ankeny My team came back with a good command of the skills and I found it easy to finish up their training in the office. Dr. J.L., Des Moines Impact Dental Training made it easy for me to get my Level One certification after having been an EFDA for years under the old system. J.I., RDA, Waukee Knowledgeable instructors. Up to date content. Very helpful. Great program. Dr. C.E. Ready to enroll or have questions? We re here to help. Seats are limited in courses with a hands on lab component. For questions, schedule, additional course information & registration materials: Online: www.impactdentaltraining.com under Expanded Functions tab Via email: lisaswettrdh@impactdentaltraining.com Course Location: All expanded function courses are held at our newly remodeled training facility, conveniently located just north of I-80 in Johnston, IA. Course Instructors include: Alan Swett, DDS, Private Practice, Adjunct Professor University of Iowa, College of Dentistry Lisa Swett, RDH, MS, former U of Iowa, College of Dentistry faculty, DMACC Dental Assisting Adjunct, Private Practice Terri Deal, RDA, CDA, EFDA Faculty, Vatterott Dental Assisting Program, former Chair DMACC Dental Assisting Program 5965 Merle Hay Road, Johnston, IA 50131 515.321.5942 www.impactdentaltraining.com

Certified Level One Dental Hygienist Expanded Functions Courses (5 Expanded Functions - 2 Day Schedule) Laser Dentistry of Iowa An Iowa Dental Board Approved Course Provider Course Information Gingival Retraction, Occlusal Registrations, Cavity Liners, Bases, Desensitizing Agents & Bonding Systems, Final Impressions, Provisional Restorations, COURSE OVERVIEW: Taught by a team of experienced dental educators, this new and updated expanded function curriculum is approved by the Iowa Dental Board and meets all the requirements for Level One Dental Hygiene Expanded Functions training in the State of Iowa. April 21, 2017 or September 29, 2017 8:00 am to 6:00 pm Lunch not provided (join us or on your own) Placing & Removing Gingival Retraction, Occlusal Registrations & Application of Cavity Liners, Bases, Desensitizing Agents & Bonding Systems April 22, 2017 or September 30, 2017 8:00 am to 5:00 pm Lunch provided Taking Final Impressions & Fabrication and Removal of Provisional Restorations, Removing Dental Adhesives (hand instrumentation only) & Preliminary Charting of Existing Teeth & Restorations Our Two Day Level One Expanded Function courses for Dental Assistants totals 44 CEU s. The monitoring nitrous course is required in addition to these two days to be certified as Level One. These courses consists of all five components required by the Iowa Dental Board. They are: 1) Meet eligibility requirements 2) Didactic component 3) Laboratory component (with lecture and/or in office with supervising dentist) 4) Clinical component (in office with supervising dentist) 5) Post course competency assessment at Impact Dental Training facility. Signature of supervising dentist and participating dental assistant required on registration. Ten of the eleven skills have hands on lab component using real dental materials so the assistants return to the office ready for their clinical component. Periodontal dressings and dry socket medications clinicals will be completed during the course. REGISTRATION DEADLINE: One week prior to course start date (email if past the date to determine availability) Pre-registration is required for each participant to determine eligibility. Registrations accepted first come, first served. Submit the registration form and a check for required course fees. Online registration available for this course on our website, www.impactdentaltraining.com. Please check your eligibility before registering. If you have questions, feel free to ask. You will receive an email confirmation of your reservation. You should not assume you have been registered for the course until the email confirmation has been received. If you do not receive email confirmation within 10 days, please let us know. COURSE ELIGIBILITY/INTENDED AUDIENCE: RDA with one year clinical experience, current CDA and/or new graduate of ADA accredited Dental Assisting Program. The eligibility section of the registration form must be completed with proper signatures in order to participate in the course. If you have questions, please contact us prior to registration TOTAL COURSE CEU s: 29 CEU s (11 Didactic/18 Clinical) COST: $300 Course fees include tuition, course materials, hands on labs, coordination of all required components with proper documentation, post test administration and remediation until successful completion of post test is achieved. At the completion of all didactic components, 11 CEU s will be awarded. Another 18 CEU s will be awarded for the completion of the lab & clinical components for each expanded function in office with your supervising dentist (submission of proper documentation required) and successful completion (75% correct) of the post course assessment. Textbooks are not included. Cash or check payable to Impact Dental Training is required with registration. (Do not send cash through the mail) We are unable to accept credit cards at this time. COURSE SCHEDULE: You must be present for the pre-test and complete lecture to receive course credit and be eligible to complete next components. Courses will be conducted 10 minute breaks every hour. Expanded functions cannot be taken individually. Please arrive 15 minutes prior to the course start time to complete registration and gather course materials. COURSE OBJECTIVES: Specific course objectives for each session will be presented at the start of each individual course. If you would like a complete copy of all course objectives ahead of time, make the request via email and we will send you an attachment.

Certified Level One Dental Hygiene Expanded Function Courses (Five Expanded Functions/2 Day Schedule Course Information for All Sessions Gingival Retraction, Application of Cavity Liners, Bases, Desensitizing Agents & Bonding Systems, Occlusal Registrations, Final Impressions, Provisional Restorations Laser Dentistry of Iowa RECOMMENDED READING/TEXTS: Bird, Doni L., and Debbie S, Robinson. Modern Dental Assisting. Eleventh Edition. Canada: Elsevier Saunders, 2015. ISBN: 978-1-4557-7451-7 Gladwin, Marcia and Michael Bagby. Clinical Aspects of Dental Materials. United States: Wolters Kluwer, 2009. ISBN: 978-0-7817-6489-6 Phinney, Donna J. and Judy H. Halstead. Delmar s Dental Assisting: A Comprehensive Approach. United States: Thomson, 2008. ISBN: 978-1-4180-4873-0 COURSE LOCATION: Impact Dental Training Center 5965 Merle Hay Road, Suite D, P.O. Box 434 Johnston, IA 50131 CONTACT INFORMATION: Phone: 515.321.5942 Text: 515-321-5942 Email: info@impactdentaltraining Website: www.impactdentaltraining.com COURSE INSTRUCTORS: Alan Swett, DDS, Lisa Swett, RDH, BS, MS, and Terri Deal, CDA, EFDA THINGS TO CONSIDER: - Bring a lab coat, sweater or jacket for lecture room as it is difficult to heat/cool the room to everyone s liking. - April 21, 2017: Lunch is on your own. Only one hour will be allowed for lunch break. We have a variety of restaurants close by. Please do not make plans with friends and family. Failure to be at the course pretest after lunch will disallow CEU s being awarded for that course. No refunds of course fees will be given due to not returning to the course on time or at all. - April 22, 2017: Lunch provided. If you have special dietary needs, please bring your own lunch. - Light snacks and water will be available every day. Feel free to bring other drink preferences. DIRECTIONS: - Take I-80/35 to Exit 131 (Merle Hay Rd) - Turn north on Merle Hay Road - Go approximately 2 miles - The Impact Dental Training Center is located on the east side of the street, in a business center with blue awnings - Next to the dental office of Drs. Alan Swett & Connor Elmitt HOTELS: - Exit 131 (Merle Hay Road): Holiday Inn & Suites or Ramada Tropics Resort - Exit 129 (one exit to the west): Hilton Garden Inn, Holiday Inn Express, Fairfield Inn, Towne Place Suites, Microtel and Stoney Creek Inn Please note: Participants are responsible for meeting all Iowa Dental Board requirements and deadlines. Course dates, fees, schedule and/or instructor subject to change A $25 processing fee will be applied to all persons requesting a refund before course date including registrants who do not meet eligibility requirements. No refunds will be issued after the course date. No shows or failures for any reason, will not be issued refunds. $37 charge will be assessed to all returned checks. Questions? Contact us at info@impactdentaltraining.com or 515.321.5942

Laser Dentistry of Iowa An Iowa Dental Board Approved Course Provider Registration Form Certified Level One Dental Hygiene Expanded Functions Courses 5 Expanded Functions - 2 Day Schedule 5965 Merle Hay Road, Suite D P.O. Box 434 Johnston, IA 50131 call or text: 515-321-5942 www.impactdentaltraining.com info@impactdentaltraining Date: April or September Registration Deadline: 1 week prior to course start date One registration page per participant. Please print clearly. (This form may be copied for additional registrations) Dental Hygienist First & Last Name: Eligibility: Year Graduated from ADA Accredited DH Program: Which one? First Year Iowa RDH: RDH Iowa License #: Current? Yes No Office Name: Sponsoring Dentist: Contact Address: Apt/Unit #: City: State: Zip Work Phone: Cell Phone: (for last minute course information &/or changes) Email (required): (you will receive email confirmation of your registration) I am registering for: Circle Month of Course Complete Level 1 RDH Exp. Functions April September 29 CEU s $300 (5 Expanded Functions/2 Day schedule - includes all labs and post tests) To be completed by the Dental Hygienist: I have met all minimum qualifications to participate in Expanded Functions Training as outlined in the Course Eligibility section and indicated above. I understand I must be present for the pre test and lecture in its entirety to gain credit. I also understand that the clinical/lab components of the certification process must be completed under the supervision of my sponsoring dentist and required documentation returned to Impact Dental Training prior to taking the final competency post test. I am solely responsible for meeting all requirements and deadlines of the Iowa Dental Board. To be completed by the Sponsoring Dentist: Hygienist Signature: The dental hygienist shown above is eligible to participate in the Expanded Function Course. I agree to sponsor her/him for the clinical/ /lab component of the certification process and to complete all required documentation accurately. DDS Signature: Return registration form and check to: Impact Dental Training, PO Box 434, Johnston, IA 50131 Online registration available for credit cards or PayPal. If you have problems, let us know. A $25 processing fee will be applied to all persons requesting a refund for any reason. $37 charge will be assessed to all returned checks. Please make sure your are eligible for the course before submitting payment. Inability to take the course due to not meeting eligibility requirements will result in the $25 processing fee. If you have questions, please contact us prior to registration. Internal Use Only: Scan Date: Date Received: Office ID: Check # : Email Confirm: Yes No Deposit Date: Signature: