Anesthesia

Anesthesia

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  • Includes Credits

    CE Hours: 1.0

    Description: This presentation will evaluate current best practices relative to the administration of local anesthesia for endodontic treatment and pain management. The future of local anesthesia will also be discussed and explored.

    Learning Objectives: 

    • Describe the current best practices and protocols for achieving effective local anesthesia for endodontic treatment.
    • Utilize findings from the current literature to make evidence-based clinical decisions regarding administration of local anesthesia for the management and prevention of odontogenic pain.
    • Summarize new concepts and ideas regarding the future of local anesthesia and pain control.

    Sara Fowler, DMD, MS

    Dr. Sara Fowler received her DMD from the University of Nevada Las Vegas School of Dental Medicine, a graduate of the school’s inaugural class. A native of Columbus, Ohio, Dr. Fowler returned to complete post-graduate training at The Ohio State University College of Dentistry, first with a General Practice Residency, followed by Endodontic Fellowship, and Advanced Endodontic Residency. After working in private practice, Dr. Fowler returned to teach at Ohio State and is now an Associate Professor with tenure in the Division of Endodontics. She is the director of Predoctoral Endodontics and the Emergency Dental Care Clinic, maintains private practice in the Ohio State Dental Faculty Practice, and actively participates in teaching and research with the Advanced Endodontic Residency Program.

    Disclosure:

    In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.

  • Includes Credits

    CE Hours: 1.0

    Description: Profound local anesthesia is a crucial step for a pain free endodontic treatment and building patient rapport. This presentation will discuss pain diagnostics and an array of clinical strategies to enhance the efficacy of administration of local anesthetics based on the best available evidence. Myth and versus reality of achieving profound and predictable local anesthesia every time will be discussed. An extra emphasis will be put on mandibular molars diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis which are the most challenging cases.

    Learning Objectives:  

    • Assess goals of utilizing various local anesthesia techniques and drugs in endodontics
    • Employ case based strategies for profound anesthetic effect
    • Achieve predictable local anesthesia for mandibular molars

    Ellie Shadmehr, D.D.S., M.S.

    Dr. Ellie Shadmehr has been a practicing endodontist since 2011. She earned her DDS and Master's Degree/Endodontic Certificate from Isfahan University of Medical Sciences in 2011. She then earned an Advanced Endodontic Certificate from the State University of New York at Buffalo. Upon completion she moved to California in 2018 and joined the Division of Endodontics at UCSF as a predoctoral director. Dr. Shadmehr is a researcher who has presented at several national and international conferences. She has published more than 35 peer-reviewed articles and two books. She also has registered patents in the field of endodontics. Her patents are regarding two innovative designs to remove separated instruments from root canal systems. She serves as an editor and reviewer for numerous International Endodontic Journals. She has lectured at several meetings and has received several awards including the American Association of Endodontics Research Award Competition in 2017. She spends her time out of office, running, hiking and traveling

    I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.

    Omar E. Abusteit, BDS, MSD

    Dr. Abusteit was born and raised in Egypt where he earned his dental degree from Cairo University and practiced general dentistry for a few years before moving to the USA to pursue postgraduate studies in endodontics. He received fellowships in Endodontics from UCLA School of Dentistry and Medical University of South Carolina College of Dental Medicine. Later, he completed his endodontic specialty training and earned a Master of Science in Dentistry from the Medical University of South Carolina where he also served as the chief endodontic resident. Dr. Abusteit is a diplomate of the American Board of Endodontics and he is currently serving as an Assistant Professor in the Division of Endodontics at the University of Minnesota School of Dentistry and he maintains a private practice limited to endodontics in Minneapolis, Minnesota. Dr. Abusteit has lectured and presented on various endodontic topics in conferences, meetings, and study clubs nationally and internationally.

    Speaker Disclosure 

    I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.

  • Includes Credits

    CE Hours: 1.0

    Description: The management of emergencies is an integral part of dental practice as patients may present at any time with an emergency. Pain associated with the dental pulp and/or periapical tissues is the most common emergency. Such endodontic emergencies may occur before, during or after endodontic treatment. Hence, all Dentists and Endodontists must be able to effectively manage endodontic emergencies in order to predictably relieve the patient’s pain, reduce any swelling, and return the tooth to normal function. Such patients may have to be “squeezed in” to an already busy day’s schedule of booked patients so efficient management is also essential. Predictable management is based on the general principles of accurate diagnosis and appropriate treatment, and in some cases post-operative medication. Whilst this sounds simple, there can be complicating factors - such as obtaining adequate local anesthesia to allow pain-free pulp removal from teeth with acute irreversible pulpitis. This presentation will outline the common endodontic emergencies and how to predictably, effectively and efficiently manage them.

    Learning Objectives:  

    • Explain the common endodontic emergencies and when they occur
    • Differentiate between the various endodontic emergencies in order to accurately diagnose each condition
    • Explain appropriate strategies to effectively and predictably manage emergencies in an efficient manner

    Paul V. Abbott, B.D.Sc., M.D.S., FRACDS(Endo)

    Paul Abbott is an Emeritus Professor of Dentistry at The University of Western Australia. He is a Specialist Endodontist. Prior to taking a full-time University position in 2002, he spent 17 years in private specialist endodontic practice and he also held part-time academic positions at The University of Western Australia and the University of Melbourne. He was Dean and Head of the School of Dentistry at The University of Western Australia and Director of the Oral Health Centre of Western Australia from 2003- 2009. He has presented over 1000 lectures and courses in 49 countries. He has published 230 articles in refereed journals, 25 textbook chapters and 47 Newsletter articles. From 2015-2022, he was the Editor-in-Chief of the international journal Dental Traumatology. Prof. Abbott’s main research and clinical interests revolve around dental
    traumatology, tooth resorption, the diagnosis and management of pulp, root canal and peri-radicular conditions, with particular emphasis on pain control and disinfection of the root canal system. Prof. Abbott has received numerous awards for excellence in teaching and service to the dental profession, particularly in education and research. In 2015, the Governor-General of Australia appointed Prof. Abbott as an Officer of the Order of Australia (AO) - one of the highest honours in Australia – “For distinguished service to clinical dentistry, and to higher education, as an academic, researcher and author, to endodontics as a practitioner, and to professional organisations.”

  • Includes Credits

    CE Hours: 1.0

    Description: Systemic health is related to oral health and vice versa. Many systemic diseases are manifested in the oral cavity and many oral conditions and therapies have a profound impact upon systemic diseases. In addition, some of the therapies used to these conditions have significant effects on the oral cavity. For those reasons, it is important for dentists (and dental health care professionals) to know about their patients' medical conditions before treating them and to understand which diseases manifest themselves in the oral cavity. This lecture will present a general overview of the principles of the management of medical conditions in dental patients. The participant will be updated upon current understanding of medical conditions such as antibiotic prophylaxis, bleeding and cardiovascular conditions.

    Learning Objectives:  

    • Describe the changing epidemiology of medical problems in dental patients
    • Review the medical manifestations and treatment options for medical problems in dental patients
    • Review the current dental management for patients with medical problems in dental practice

    Nelson L. Rhodus, D.M.D., M.P.H.

    DR. NELSON L RHODUS is a Morse Distinguished Professor and Director of Oral Medicine in the University of Minnesota School of Dentistry . He is an adjunct Professor of Otolaryngology in the School of Medicine . He is a Diplomate ( and Past President) of the American Board of Oral Medicine. He is an inductee in the University of Minnesota Academic Health Center Academy of Excellence and the Academy of Distinguished Teachers and the University of Minnesota Scholar’s Walk of Fame. He is on the Hospital Staff of the University of Minnesota Hospital and the Cancer Center. He has published over four-hundred scientific papers and abstracts and presented over four-hundred fifty lectures and courses throughout the United States and abroad . He co-authors a textbook: DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT and he is an editor of the Journal of Oral Surgery, Oral Medicine., Oral Pathology and Oral Radiology

  • Includes Credits

    CE Hours: 1.0

    Description:  The aim of this study was to identify preoperative factors associated with local anesthesia failure.

     At conclusion, participants should be able to:

    • List the three methods used in this study to define anesthesia failure during non-surgical root canal treatment
    • Discuss the factors associated anesthesia failure found with each individual method of evaluation
    • Discuss the factors associated with anesthesia failure common in multiple methods of evaluation


    Dustin Weitz, DDS, MS

    Ronald Ordinola-Zapata, DDS, MS, PhD

    Dr. Ronald Ordinola Zapata is an Associate Professor at the Endodontic Division University of Minnesota School of Dentistry. Dr. Zapata completed his Endodontic residency program at the IB Bender Endodontic Division, Albert Einstein Medical Center in Philadelphia, (2018), and a Certificate in Clinical Research at the School of Public Health, University of Minnesota. In 2021 Dr. Zapata achieved the Diplomate status of the American Board of Endodontics. Dr. Zapata enjoys teaching, writing scientific papers, and documenting challenging cases. In his academic career, Dr. Zapata has published more than 100 scientific papers in peer-reviewed journals and lectured internationally in more than 10 countries. Dr. Zapata also serves as Associate Editor of the International Endodontic Journal (UK) and is a member of the Scientific Advisory Board of the Journal of Endodontics (USA).

    Speaker Disclosure 

    I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.

    Scott B. McClanahan, D.D.S., M.S.

    Dr. Scott B. McClanahan received his D.D.S. from the University of North Carolina at Chapel Hill in 1981 and entered the U.S. Navy. As an out service resident, he completed his certificate of residency in endodontics at Northwestern University Dental School and received a M.S. from Northwestern University in 1989. After three tours of duty as a clinical endodontist, Dr. McClanahan was assigned to the faculty of the Endodontics Department at the Naval Postgraduate Dental School (NPDS), Bethesda, MD in 1998 and in 2001, assumed the responsibilities of Chairman of the Endodontics Department and Director of the Advanced Specialty Education Program in Endodontics. He retired from active duty in September 2005 and in November, joined the faculty at the University of Minnesota, School of Dentistry where he is holds the academic rank of Professor and is the Director of the Division of Endodontics and Director of Graduate Endodontics. He is a Diplomate of the American Board of Endodontics and a director of the board 2013-9 as well as the current board president. Dr. McClanahan is a Fellow of the International College of Dentists.

    Michael Shyne, MS

    Alan S. Law, DDS, PhD

    Dr. Alan Law received his Doctor of Dental Surgery and Certificate in Endodontics from the University of Iowa College of Dentistry, Iowa City, Iowa. He also completed his PhD, “Mechanisms and Modulation of Orofacial Pain”, with the Department of Pharmacology at the University of Iowa. Dr. Law has published over 40 articles in scientific and clinical journals, and has co-authored chapters on The Non-Odontogenic Toothache and Regenerative Endodontics in Pathways of the Pulp, and has lectured at over 300 local, national and international meetings. Dr. Law is a member the American Dental Association, American Association of Endodontics, and Omicron Kappa Upsilon Dental Honor Society, and a Fellow of the American College of Dentists and the International College of Dentists. He is a Past President of the American Association of Endodontists, Past President of the Minnesota Association of Endodontists, and Past President of the American Board of Endodontics. He is in full –time practice in the Twin Cities, and President of The Dental Specialists, a multi-specialty dental practice with over 35 specialists. He is also a Research Professor in the Division of Endodontics at the University of Minnesota.

    Speaker Disclosure

    In accordance with this policy, I declare I have a past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith, as indicated: National Dental Practice-Based Research Network and the American Dental Association.

    Donald R. Nixdorf, DDS, MS

    After graduating from the University of Alberta Faculty of Dentistry, Dr. Nixdorf completed hospital dentistry residency at The Ohio State University, Anesthesia fellowship at Johns Hopkins University, Orofacial Pain fellowship at the University of Alberta, and a Master of Science in Clinical Research at the University of Minnesota. As a Diplomate of the National Dental Board of Anesthesiology (NDBA) and the American Board of Orofacial Pain (ABOP), he maintains a specialty Orofacial Pain practice on the diagnoses and management of chronic TMD pain, headaches, and neuropathic pain within multi-disciplinary settings. Dr. Nixdorf’s research has focused on the topics of non-odontogenic “tooth” pain from a classification, diagnosis, epidemiology, and treatment perspectives, as well as TMD and, most recently, dental MRI, with over 85 published articles. Dr. Nixdorf is Professor, Division Director, and past Graduate Program Director at the University of Minnesota in the Division of TMD & Orofacial Pain.

  • Includes Credits

    CE Hours: 1.5

    Description: This course will review the latest studies on pain management from the perspective of treating both acute and persistent post-endodontic pain. We will provide recommendations for suitable drugs, their dosing and rationale using case based scenarios to best manage endodontic patients in pain.

    Learning Objectives: 

    • Describe common mechanisms for acute and persistent post-endodontic pain
    • Describe a strategy for selection of various medications for treating these patients
    • Describe indications, contraindications and potential adverse effects of these medications

    Kenneth Hargreaves, D.D.S., Ph.D.

    Ken Hargreaves received his DDS from Georgetown University, his PhD in physiology from the Uniformed Services University of the Health Sciences in Bethesda, MD, and his certificate in Endodontics from the University of Minnesota. Ken spent 5 years at the Pain Clinic of the NIDCR and 7 years as an associate professor of Endodontics and Pharmacology at the University of Minnesota. He joined the University of Texas Health Science Center at San Antonio in 1997, as professor and Chair of the Department of Endodontics and is cross-appointed as professor in the Departments of Pharmacology, Physiology and Surgery in the Medical School. He maintains a private practice limited to endodontics and is a Diplomate of the American Board of Endodontists. Ken has received an NIH MERIT Award for research, two IADR Distinguished Scientist Awards, the ADA Gold Medal for Research and the Louis I. Grossman Award from the AAE. He has published more than 190 articles and, with Harold Goodis and Frank Tay, co-edited the 2nd edition Seltzer and Bender’s Dental Pulp, and, with Lou Berman, co-edited the 11th edition of Cohen’s Pathways of the Pulp. Ken also serves as editor of the Journal of Endodontics.

    Speaker Disclosure: 

    I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation

    Nikita Ruparel, D.D.S., M.S., Ph.D.

    Dr. Ruparel is Board certified Endodontist who practices in San Antonio at UT Faculty Endodontics. She is the Director of the Advanced Program in Endodontics at UT San Antonio. She received her certificate in Endodontics in 2013 after receiving her doctoral (PhD) and DDS at The University of Texas Health Science Center at San Antonio. Her practice in Endodontics includes all aspects of modern endodontics. She also lectures at national and international meetings on pain biology and management and regenerative endodontics. She has also been awarded the American Association of Endodontics Educator Fellowship for committing her career to academics. Nikita Ruparel is committed to a long-term career as a clinician-scientist.

    Speaker Disclosure

    I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.

  • Includes Credits

    CE: 1.5

    Course Description: The safety of sedation and anesthesia has been controversial for decades and has been the focus of a Consensus Development Conference held at NIH (Laskin and Dionne, 1986), workshops (Dionne et al. 2006) and large clinical trials to identify drugs, doses and combinations that optimize the relationship between clinical efficacy and patient safety (Dionne et al. JADA 2006). A recent case series to re-examine the safety of sedation resulted in a preliminary finding of N=39 deaths reported in the public domain. Most of the deaths in the series were attributed to respiratory depression, consistent with the administration of drugs that suppress respiration at the doses administered. The ADA revised their guidelines in 2016 for teaching the various levels of sedation which usually translates into regulations by state dental boards for training and emergency preparedness. What is often omitted is consideration of the drugs and doses that have evidence to support their safety when administered by dentists in an outpatient setting. The objective of this program is to review the evidence and rationale for minimizing adverse events associated with providing enteral sedation, and to present clinical strategies for effectively managing anxious patients with drugs that provide a wide margin of safety.

    At the conclusion, participants should be able to:

    • Describe that patient-centric relief of anxiety for a dental procedure is not synonymous with CNS depression resulting in the appearance of sedation.
    • Explain the scientific basis for the efficacy and safety of anxiolytic drugs.
    • Provide enteral sedation with anxiolytic and analgesic effects similar to parenteral sedation but without the risks of 'eminence-based' drugs, doses and combinations prone to significant morbidity and mortality in the dental office.

    Raymond Dionne, D.D.S., M.S. Ph.D.

    Dr. Dionne received a DDS from Georgetown University and a PhD from the Medical College of Virginia. He conducted clinical and translational pain research at the National Institute of Dental and Craniofacial Research for 34 years, as well as practiced dentistry part-time in the District of Columbia. He is currently a restless retiree living in Missouri.

    Speaker Disclosure

    In accordance with this policy, I declare I have a past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith, as indicated: AIM Targeted Therapeutics: Consultant on preclinical development of an investigational analgesic formulation (Ongoing); Rilento Pharma: consultant for pre-clinical development of investigational analgesic formulation (Ongoing)

    Raymond A. Dionne, DDS, MS, PhD

    I declare I have a past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith, as indicated: Aegis Dental Network () : Consultant, Honorarium; Charleston Laboratories () : Consultant, Honorarium; Novartis Consumer Health () : Consultant, Honorarium

  • Includes Credits

    CE Hours: 1.0 CE hour 

    Description: Prilocaine plain has a high pH and concentration (4%), which could decrease the pain of injection and increase success. The purpose of this study was to compare pain associated with anesthetic solution deposition and the degree of pulpal anesthesia obtained with the combination of prilocaine and lidocaine versus a lidocaine and lidocaine combination when used for inferior alveolar nerve blocks (IANBs).

    At the conclusion, participants should be able to:

    • Evaluate if the combination 4%prilocaine/2% lidocaine with epinephrine resulted in an increase in anesthetic success of the inferior alveolar nerve block when compared to two cartridges of 2% lidocaine with epinephrine
    • Describe if 4% prilocaine resulted in less anesthetic solution deposition pain.
    • Discuss the side-effects when prilocaine is used clinically.

    Oliva Cook, DMD, MS

    Dr. Olivia Cook is a born native of Jackson, MS.  After graduating high school, she continued her undergraduate studies at Ole Miss.  Dr. Cook then completed her dental school training at The University of Mississippi in Jackson and her endodontic specialty training at The Ohio State University in Columbus, Ohio.  During her post-doctoral training, Dr. Cook was extensively trained in local anesthesia and pain management with an emphasis on emergency patients.  Dr. Cook then moved back to Madison, MS upon completion of her residency program. 

    Dr. Cook is a member of the American Dental Association, the Mississippi Dental Association, and the American Association of Endodontist.  In her free time, she enjoys being an active participant in her church and spending time with her husband and daughter.

    John Nusstein, DDS, MS

    Dr. John Nusstein is a tenured Professor and the Chair of the Division of Endodontics at The Ohio State University College of Dentistry in Columbus, Ohio.

    Melissa Drum, DDS, MS

    Dr. Drum received her DDS from the University of Minnesota and her endodontic certificate/master's degree from The Ohio State University. She teaches at the dental student and resident levels and is the Advanced Endodontic Program Director and past Predoctoral Endodontic/Emergency Clinic Director.  Dr. Drum is active in service at the college, state and national levels and is a full tenured professor.  She has published more than 80 articles, multiple book chapters, and coauthored a book. Dr. Drum became a Diplomate of the ABE in 2008 and is currently a Director and President of the ABE.  She was named holder of the Al Reader Endowed Professorship in 2013.  Dr. Drum received the AAE Edward M. Ostetek Award in 2014 as well as numerous local teaching and research awards over the years.  Dr. Drum hates writing and reading bios and is much more fun than this paragraph describes.

    Sara Fowler, DMD, MS

    Dr. Sara Fowler received her DMD from the University of Nevada Las Vegas School of Dental Medicine, a graduate of the school’s inaugural class. A native of Columbus, Ohio, Dr. Fowler returned to complete post-graduate training at The Ohio State University College of Dentistry, first with a General Practice Residency, followed by Endodontic Fellowship, and Advanced Endodontic Residency. After working in private practice, Dr. Fowler returned to teach at Ohio State and is now an Associate Professor with tenure in the Division of Endodontics. She is the director of Predoctoral Endodontics and the Emergency Dental Care Clinic, maintains private practice in the Ohio State Dental Faculty Practice, and actively participates in teaching and research with the Advanced Endodontic Residency Program.

    Disclosure:

    In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.

    Al Reader, DDS, MS

    Dr. Al Reader is a Professor in the Division of Endodontics and is a previous program director of Advanced Endodontics at the The Ohio State University.

    John Draper, MS, PhD

    Dr. John Draper has a PhD and MS in statistics from Ohio State and is a senior lecturer in the Department of Management Sciences. He provided the statistical support for this research project.

  • Product not yet rated Includes Credits

    CE Hours: 1.0 CE hour 

    Description: This systematic review compared the anesthetic efficacy between Gow-Gates (GG), Vazirani-Akinosi (VA), and mental incisive (MI) nerve blocks (NBs) with inferior alveolar nerve blocks (IANBs) in mandibular teeth with irreversible pulpitis using meta-analysis and trial sequential analysis (TSA).

    At the conclusion, participants should be able to:

    • Discuss the different anesthetic techniques used to anesthetize mandibular teeth 
    • Discuss the anesthetic efficacy between different techniques used to anesthetize mandibular teeth 
    • Discuss the quality and strength of evidence in this systematic review

    The authors deny any conflicts of interest related to this study.

    Venkateshbabu Nagendrababu, BDS, MFDS RCS (Glasg), MDS, PhD

    Hany Mohamed Aly Ahmed, B.D.S., H.D.D. (Endo), Ph.D.

    Shaju Jacob Pulikkotil, BDS, MDS, PhD

    Sajesh K. Veettil, MPharm,

    Lalli Dharmarajan, BDS

    Frank C. Setzer, D.M.D., Ph.D., M.S.

    Dr. Setzer graduated from the Dental School of the Friedrich- Alexander-University Erlangen-Nuremberg, Germany, in 1995, where he also received his doctoral degree in 1998. He pursued his endodontic specialty training at the University of Pennsylvania after working for nine years in a multi-specialist private practice as associate and partner. Dr. Setzer graduated from the endodontic program of the University of Pennsylvania in 2006, receiving the Louis I Grossman Postdoctoral Student Award in Endodontics. He earned a Master of Science in Oral Biology and a DMD degree in 2008 and 2010, respectively. Dr. Setzer serves as the Clinic Director and Pre-Doctoral Program Director at the Department of Endodontics of the University of Pennsylvania. Dr. Setzer lectures on several topics of endodontics throughout the United States, Europe, South America, and Asia. He has authored articles on endodontics in peer-review journals and serves as Associate Editor for Endodontics for Quintessence International and, amongst other journals, on the scientific advisory board of Journal of Endodontics, International Endodontic Journal and Journal of the American Dental Association.

    Speaker Disclosure 

    I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.