MidWinter 2022

Thursday, February 10, 2022

 

7:30am–9:30am • 2 CEU, Core
California Dental Practice Act: Where’s the Line?
Nancy Dewhirst, RDH, BS (Sponsored by PCIHIPAA – SDDS Vendor Member)
This course covers topics and regulations that are required by the California Dental Practice Act (DPA) for re-licensure, illustrated by stories and violations of the law. Examine scope of practice, licensure & qualifications, unprofessional conduct, drug offenses, consent, and mandated reporting. Learn how those regulations define dental practice limits, how to find answers to legal questions addressed by the DPA, enforcement and where to locate resources.
Course objectives:

• Understand how the DPA scope of regulations defines dental practice limits
• Understand how the California Dental Board enforces the DPA
• Learn how to locate information and resources related to the DPA

7:30am–9:30am • 2 CEU, Core
Botched or a Complication?
Jagdev Heir, MD, DMD, FACS (Sponsored by Zest Dental Solutions – SDDS Vendor Member)
Ever wonder what goes through an oral surgeon’s mind when they see a botched case or a complication? Come and find out along with how to handle simple and complex complications. See what surgical assistants and RDAs can do to help the doctor.
Course objectives:

• Learn how to handle complications, for both the doctor and the RDA
• Understand the various issues related to dentoalveolar, implants, cosmetic complications
• Learn about procedures gone wrong
• Learn about complications occurring from complications

7:45am–9:45am • 2 CEU, Core
Stage it, Grade it – Now What? Treating the Diagnosis of Periodontal Disease
Theresa Worsham, DMD (Sponsored by Straumann – SDDS Vendor Member)
This course discusses the broad range of infectious periodontal disease, including the etiology of the different infectious diseases. Focus will be on recognizing the different signs of periodontal disease and proper treatment course. Cases will be discussed throughout the course to develop a solid foundation.
Course objectives:

• Recognize the signs of the different types of periodontitis in this new grading system
• Understand proper treatment planning for even the most challenging cases
• Recognize case presentations of the typical, abnormal and the weird

8:00am–9:30am • 1.5 CEU, Core
Are You Trying to Treat TMJ Using Dental Procedures?
Rich Hirschinger, DDS, MBA (Sponsored by gentle jaw)
TMJ, or what most patients think is TMJ, is not usually related to occlusion or the temporomandibular joint; it is usually related to the musculature that closes the jaw from “excessive occlusion.” These muscles can cause a lot of pain, even suicidal pain, and the pain can be treated using medical procedures provided by a dentist.
Course objectives:

• Identify the muscle referral patterns of the head and neck
• Understand the rationale behind trigger point injections and Botox for therapeutic use
• Learn why most TMJ pain is not related to the joint or occlusion

8:00am–9:30am • 1.5 CEU, 20%
Kondo Your Clinic… NOW!
Kelly Giannetti, DMD
Spark joy in your 9–5. Do you wonder what patients feel when they enter your office? Does your office reflect your work ethic and personality? Get passionate about creating an environment that reflects the quality of work you provide!
Course objectives:

• Understand strategies for removing clutter and looking at your office from the patient’s perspective
• Learn how to address your digital workflow and a truly paperless office
• Learn about clinical options for a big impact on waste production

8:00am–9:30am • 1.5 CEU, Core
Vaping: Just the Facts!
Jo-Anne Jones, RDH
There is hardly a day that goes by without ‘vaping’ making headline news. We are just beginning to learn about the potential long-term risks of vaping. Vaping-related pulmonary illness, alteration of adolescent brain development, nicotine addiction, accidental injuries and several reported deaths are a few of the risks that are coming to light with the use of vaping products. What is our messaging to our dental patients and how may we best educate them on the potential risks of this growing trend?
Course objectives:

• Learn how to identify vaping incidence and prevalence in the U.S.
• Understand the science behind vaping – and what has led to its growing popularity and addictive properties
• Learn how to recognize the impact of vaping on oral and systemic health

10:00am–11:30am • 1.5 CEU, 20%
Collect with Confidence
Lisa Greer, Dental Benefits Analyst, and Matthew Nelson, Practice Analyst; CDA Practice Support Center
The front office sets the stage for managing patient collections and strong billing practices. When a practice has clear, defined, and implemented patient collection and billing systems, the day runs efficiently, and patients understand the payment expectations. But, managing collections takes confidence, and confidence comes with knowledge. This course will help you administer your practice’s billing and collections system with confidence.
Course objectives:

• Learn how to become a confident collections and billing expert
• Learn to navigate through the most difficult patient billing and collections scenarios
• Understand the billing tools that will make your job easier
• Learn how to strengthen your current coding knowledge
• Learn the consequences for not billing correctly

10:00am–12:00pm • 2 CEU, 20%
Patient First. What About Me?
Kelli Jaecks, MA, RDH (Sponsored by Leyton)
Dental professionals who care for the health and well-being of others are especially susceptible to burnout. Everyone else’s needs come before our own, both at work and at home. The adage of “patient first” has unintentionally created an environment in health care that places the practitioner last. What if we spin this practice on its head? Practitioner first. My own physical and mental well-being first. Why? Because Self-Care is Healthcare. When we focus on strengthening the practitioner, we are better equipped to serve the patient.
Course Objectives:

• Discover why self-care needs to be a non-negotiable in a healthy practitioner
• Understand the principles of Patient First
• Learn how to investigate simple, positive changes to address burnout and increase personal wellness and have fun doing it!

10:00am–12:00pm • 2 CEU, Core
Comprehensive Care Utilizing Advanced Digital and Direct Restoration Material
Payam Ataii, DMD (Sponsored by Shofu Dental)
Dr. Ataii will share current “GIOMER” and bioactive restorative techniques and product choices for the clinician and dental team seeking to advance their skills while completing procedures in a minimal amount of time. Learn how to enhance your team’s skill set, improve, and simplify your everyday dentistry, plus gain more patient acceptance by communicating with your restorative patients by utilizing digital imaging.
Course objectives:

• Learn how to diagnose and plan treatment of failed restorations
• Learn material options for long-term restorative success
• Learn case presentations for patient acceptance using digital photography
• Learn about finishing, polishing, and consistent delivery for ideal margins

10:00am–12:00pm • 2 CEU, Core
HIPAA Training: Complete Your 2022 Requirement!
Terry McDonald, Director of Compliance Solutions; PCIHIPAA (Sponsored by PCIHIPAA – SDDS Vendor Member)
2020 and 2021 were unprecedented years for dental providers. Forced to adapt to ever-changing circumstances, practices across the nation scrambled to put together a response plan to ensure compliance with new HIPAA guidance. What do you need to do now to protect your practice? Drawing on his experience as a leader in cyber-security and compliance, Mr. Broudy will address the lessons learned and implications for the future of healthcare compliance.
Course objectives:

• Learn about evolving COVID-19 cyber threats, including ransomware attacks
• Learn tips to keep your patients, employees and practice safe and secure
• Learn about enforcement trends for HIPAA violations
• This course will complete your 2022 HIPAA Risk Assessment requirement!

10:00am–12:30pm • 2.5 CEU, Core
Hindsight is 20/20: Missing the Oral/Oropharyngeal Cancer Diagnosis
Jo-Anne Jones, RDH (Sponsored by VELscope and Orascoptic)
The ability to save a life through earlier diagnosis is a gratification that may not be compared to anything we do in dentistry. Conversely, when we ‘miss’ a diagnosis, the sorrow that ensues is challenging to overcome. Through a guided visual journey of inspiring and moving oral cancer stories of survivors and those who have lost their lives, learn the subtle life-saving symptoms and critical screening techniques that will increase our opportunity to save a life! This is a presentation you will never forget.
Course objectives:

• Recognize the incidence and five-year survival rates of current oral and oropharyngeal cancer
• Learn and explore the critical components and palpation techniques of today’s oral cancer screening exam
• Understand the role adjunctive screening devices, play in enhancing our assessment capabilities

10:30am–12:00pm • 1.5 CEU, Core
Splints Gone Wrong
Kelly Giannetti, DMD (Sponsored by Align Technology)
All of us prescribe various forms of night guards to help our patients. But…they are NOT without risks. This lecture will discuss iatrogenic tooth movement and how to predict it.
Course objectives:

• Learn about commonly used splints and their side effects
• Learn about the common side effects and predictable treatment
• Learn how to correct unwanted movement with aligners

1:30pm–4:00pm • 2.5 CEU, 20%
Scheduling Frustrations Solved—20 Step Plan to Take Control of Your Day!
Jennifer de St. Georges (Sponsored by CareCredit)
Scheduling Situations Solved…enjoy reduced stress, increased production and happy patients. Today’s busy patients are rarely tolerant of a dental practice consistently ‘running late’ and they have no problem discussing their frustrations on the internet! This program delivers the tools and communication skills needed to solve eight of the top time management problems.
Course objectives:

• Learn to run on time, reduce team stress, protect productivity and increase patient/practice communication and customer service
• Learn the rules to manage emergencies, scheduling bottlenecks, and late arrivals
• Learn the tips and tricks to solve a Hit List of issues and frustrations

1:30pm–4:00pm • 2.5 CEU, Core
Recession: To Treat or Not to Treat, THAT is the Question
Theresa Worsham, DMD (Sponsored by Geistlich Biomaterials)
This course dives in to the different types of recession defects. We will discuss the etiology of the different recession defects and focus on the proper treatment of these defects. Cases will be discussed throughout the course to develop a solid foundation.
Course objectives:

• Learn to recognize the different types of recession
• Learn the proper treatment planning for even the most challenging cases
• Learn case presentations of different recession defects

1:30pm–4:00pm • 2.5 CEU, 20%
Martinis, Millennials, Motherhood & Menopause: Considerations in Women’s Health for You,
Your Dental Team and Your Patients
Kelli Jaecks, MA, RDH (Sponsored by Leyton)
With over 50% of graduating dentists and over 90% of dental hygienists being female, our industry needs a clear focus on women’s health. According to the US Census, there are over 126 million women in the U.S. today. As our population ages, women will outnumber men two-to-one. How do we best care for ourselves and our patients in this growing reality? Whether we are dealing with periods and PMS, pregnancy, or perimenopause, hormones impact multiple bodily systems, including oral health. This presentation will examine multiple systems within the female body that are affected as we age. Women can be proactive in making lifestyle choices to get healthier and live longer. As healthcare providers, we can educate and empower our patients in positive habits for disease prevention and longevity.
Course Objectives

• Understand how hormones impact multiple bodily systems, including oral health
• Learn to identify risk factors and prevention strategies for oral, breast, and bone health
• Understand and explore simple strategies in mental and physical wellness to beat the hormone groan at any age
• Understand the role of the health care professional in understanding, supporting and educating patients

1:30pm–4:30pm • 3 CEU, Core
Annual OSHA Training and Infection Control – Are We Safe “Enough?”
Nancy Dewhirst, RDH, BS (Sponsored by PCIHIPAA – SDDS Vendor Member)
This course reviews the science of disease transmission and many dental safety recommendations considering COVID-19 and beyond. Standard and Transmission-based Precautions will be explained in the context of CDC and ADA Guidelines and OSHA & Dental Board regulations (meets Infection Control and OSHA CE requirements). Safety strategies and actions are ranked by effectiveness and include new technology, how to optimize indoor air safety, PPE, and other prevention controls.
Course objectives:

• Learn to recognize and manage bloodborne, contact, droplet and airborne diseases
• Understand and identify best practices for providing dental care while considering COVID-19
• Learn how to make sense of evolving recommendations as applied to changing infection risk

1:45pm–4:15pm • 2.5 CEU, Core
New Era in Patient Care with Clear Aligners
Payam Ataii, DMD (Sponsored by SmileDirectClub)
This lecture will review the clinical efficacy of the hybrid aligner model and discuss clinical cases for doctors and dental team members. Key area of focus include patient case selection, office integration, and practice growth. Clinical cases with a key objective of understanding the types of cases that are ideal for the hybrid model and others that fit the traditional aligner workflow will be reviewed.
Course objectives:

• Understand the influences of aligner treatment options on practice management and revenue
• Learn clinical guidelines to identify patients that are ideal for the hybrid aligner model
• Learn how to create a superior dental experience for every patient within the practice

2:00pm–4:00pm • 2 CEU, Core
What’s in Your Oral Cancer Screening Toolkit? Workshop Format
Jo-Anne Jones, RDH (Sponsored by VELscope and Orascoptic)
An interactive workshop designed to equip today’s dental clinician with the skill set to recognize and identify the earliest warning signs of HPV and non-HPV oral and oropharyngeal cancer. A demonstration of a live examination using an adjunctive screening device will be provided as well as the review of techniques both extraoral and intraorally. The integration of Teledentistry will also be demonstrated highlighting the ability to assess, capture, annotate and manage findings providing your practice and dental patients with the best possible opportunity for earlier discovery of oral cancer.
Course objectives:

• Learn how to perform a systematic extraoral and intraoral examination with attention to high-risk anatomical areas related both to HPV and non-HPV oral and oropharyngeal cancer
• Learn and recognize the subtle, life-saving signs and symptoms that may accompany HPV-positive oropharyngeal cancer
• Integrate clinical resources that will aid in assessment, documentation and management pathways of an abnormal finding

 

Friday, February 11, 2022

 
7:30am–9:00am • 1.5 CEU, 20%
Ergonomics: It’s a Balancing Act
Nancy Dewhirst, RDH, BS
Wear comfortable clothes for stretching! Enjoy a long dental career and improve clinical precision while avoiding injury and pain! Pathogenesis, causes and prevention of various cumulative trauma disorders are discussed, focusing on upper extremity, spinal and joint pathologies. Evaluate preventive strategies, including equipment design, body positioning and conditioning. Practice stretching and strengthening exercises to reduce pain, preserve range of motion and optimize personal career excellence and longevity.
Course objectives:

• Learn how to evaluate physical signs and symptoms of cumulative trauma disorders commonly found in dental workers
• Understand the physiology of representative cumulative trauma disorders
• Understand how to practice and evaluate stretching and strengthening exercises and compare ergonomic features of dental equipment that benefit workers and patients

7:30am–9:30am • 2 CEU, Core
Be SMART: Silver Modified Atraumatic Restorative Treatment
Jeannette MacLean, DDS (Sponsored by Elevate Oral Care and GC America)
Learn how to treat and restore cavities in an efficient, effective, and painless way using Silver Diamine Fluoride (SDF) and Glass Ionomer Cement (GIC), known as Silver Modified Atraumatic Restorative Treatment (SMART). SDF can arrest caries and desensitize dentin with little more than a microbrush, while expanding access to care and improving outcomes. Review how bioactive materials like GIC can not only restore, but also further arrest and remineralize carious lesions while conserving tooth structure. Find out how offering minimally-invasive options like SMART, can attract new patients, improve patient satisfaction, and increase internal marketing and word of mouth referrals to your practice.
Course objectives:

• Learn the principles of case selection, informed consent, treatment planning, and a clinical protocol for SDF
• Learn and review the evidence for atraumatic restorative treatment to manage dental caries
• Describe the case selection, materials, and clinical protocol for SMART

8:00am–9:30am • 1.5 CEU, 20%
Communication Skills to Instill Patient Confidence and Trust: The Foundation of the Referral Practice
Jennifer de St. Georges (Sponsored by CareCredit)
“Inform before you perform, no surprises” is the key to building confidence and trust between practice and patient. A strong interactive Doctor/Team communication allows everyone to speak with one voice; never underestimate the power of a unified approach with patients. Enjoy increased patient acceptance when patients know “what’s in it for them!”
Course objectives:

• Learn the guidelines, tools and techniques to elevate communication skills
• Learn how to enhance patient customer service and outcomes
• Understand and create a master plan to make implementation stress-free, fun and productive

8:00am–10:00am • 2 CEU, Core
Inflammatory Diseases: It’s Not Just Perio Anymore
Lory Laughter, RDH, MS (Sponsored by FADE)
This program presents information on the oral effects of inflammatory diseases, chronic pain, and related medications; what to look for in the health history; how to gently care for sufferers; and when to consider a medical referral. It also recommends resources and educational materials as well as methods clinicians can use to treat people with these issues.
Course objectives:

• Learn to recognize oral manifestations associated with inflammatory diseases
• Understand how the brain and body respond to chronic pain
• Learn how to identify strategies to provide comfortable dental treatment for patients with chronic pain

8:00am–11:00am • 3 CEU, Core
Let’s Destroy the Misconceptions of Minimally Invasive Implants: Travel a Personal Journey of Understanding So You Can Use Them Too
Michael Miyasaki, DDS (Sponsored by IBS Implant and Academy of Minimally Invasive Implantology – SDDS Vendor Member)
Patients are seeking out dental implants more now than in the past 30 years! This course will help clinicians determine if implants are a service they want to add to their practice or, for those placing implants already, if a minimally invasive approach can be incorporated into what they do already. With a system designed with minimally invasive implant placement in mind, there is less morbidity; it can save you and your patient’s time and money and, most importantly, can increase your implant’s longevity. Treatment alternatives that offer us predictability and conserve the maximum amount of bone and tissue will be discussed. Join me on my personal journey through challenges, such as failure to integrate and peri-implantitis, what I have come to learn, and so much more.
Course objectives:

• Learn why dental implants should be offered to patients, how to talk to patients, and how the team can support their integration
• Understand the core principles of minimally invasive implantology
• Understand protocols for minimally invasive implantology will be illustrated and explained
• Understand how to grow your practice by offering implant services

9:30am–11:30am • 2 CEU, Core
Gotta Love Infection Control
Marcella Oster, RDA
Get back to loving your infection control by updating techniques, risks and standard operating procedures that can help you be in compliance. Since COVID, there is SO much more to review…and so much more to “embrace!” This course meets the two-hour infection control for license renewal.
Course objectives:

• Learn how to outline standard operating procedures for all areas of the dental office
• Learn how to analyze risks for potential modes of transmission/pathogens
• Understand the measures for effective and implemented environmental control
• Learn to identify steps to protect and educate staff/patients from Covid-19

10:00am–12:00pm • 2 CEU, Core
Less is More: Minimally Invasive Cosmetic Treatment Options for Enamel Defects
Jeannette MacLean, DDS (Sponsored by Elevate Oral Care, GC America and DMG America)
Unsightly congenital enamel defects and acquired white spot lesions can be troublesome for many patients. Historically, these blemishes have been treated with invasive and costly resin bondings and veneers. Dealing with enamel defects can prove particularly troublesome for young patients, which when left untreated, often become a source of embarrassment for the patient. Or worse, some lesions may progress to cavitations, particularly post-orthodontic white spot lesions. This course will review three simple and painless options to manage enamel defects. MI Paste, ICON Resin Infiltration, and Etch/Bleach/Seal can improve or even completely reverse the appearance of congenital enamel defects and white spot lesions while preserving tooth structure and repairing the patient’s natural enamel.
Course objectives:

• Learn how to recognize evidence for using MI Paste, ICON Resin Infiltration, and Etch/Bleach/Seal
• Understand case selection, materials, and clinical protocol for each procedure
• Understand the pros and cons for each technique

10:00am–12:00pm • 2 CEU, 20%
Financial Patient Communication-7-Point Plan to Eliminate Financial Surprises
Jennifer de St. Georges (Sponsored by CareCredit)
It is harder to collect money from patients with dental insurance than patients without coverage! This program delivers tools, techniques and communication skills to educate patients on their financial responsibilities…learn to LOVE talking money and payments with patients!
Course objectives:

• Learn how to increase cash flow, lower AR, reduce patients confusion re 3rd party involvement
• Understand positive patient consultation tips for successful collections, including phone “shoppers”
• Learn clear financial policies and proactive and informative communication tools

10:30am–12:30pm • 2 CEU, Core
The Science of Products and Technology: Old, New, Tried and True
Lory Laughter, RDH, MS (Sponsored by GC America)
This course reviews commercial and professional products; some new and exciting, and some established favorites. Participants will also learn research tips and receive hands on evaluation of select products. The content will help practitioners develop customized prevention programs that go far beyond teaching people how to brush and floss while building strong disease prevention programs.
Course objectives:

• Learn about research on commercial and professional products that can make practice more effective and easier for patients and practitioners
• Learn how to develop a prevention program using tests, technologies, and products that fit a practice philosophy and style
• Understand and identify resources with additional information and demonstrations

11:30am–12:30pm • 1 CEU, 20%
The Great Resignation and Rehiring: Dentistry’s Changing Workforce Composition
and the Age of Digital Transformation
Christine Sison, CEO; Swiss Monkey (SDDS Vendor Member)
With the recent pandemic, pre and post, dentists have learned that the “old ways” of practice management may have other options, that may be better options. The past two years have challenged dentists to find alternate work modes and solutions for what used to be “the normal and standard” ways. Attend this presentation to learn what is new and innovative and what may work for your practice.
Course objectives:

• Learn about the rise of the remote workers, the changing workforce composition in dentistry and the use of hybrid models (in-office and off-site)
• Learn the new recruiting mindset for employers
• Understand the impact of new technology and business intelligence tools and what that means for practice operations, the patient experience and staffing

1:30pm–3:30pm • 2 CEU, Core
Is My Patient Crazy or Do They Actually Have Pain? Solving the Puzzle of Treating Invisible Pain
Rich Hirschinger, DDS, MBA (Sponsored by gentle jaw)
In the past, if a doctor could not account for the source of a patient’s pain, treatment was provided including root canals and/or extractions. If the pain did not resolve even after an extraction, it was assumed the patient was crazy or the pain was not related to the scope of dentistry, and the patient was referred to a physician or they just continued to live with their pain. During Dr. Hirschinger’s presentation, you will see videos of patients that had invisible pain that was not accounted for clinically or radiographically. You will hear about patients that had dental treatment that did not to relieve their pain since the pain was not odontogenic.
Course objectives:

• Learn how to recognize the signs and symptoms of trigeminal neuralgia, glossopharyngeal neuralgia, and nervus intermedius neuralgia
• Understand how to localize pain and be more certain of a diagnosis before irreversible dental treatment is rendered
• Learn how to recognize various headaches according to the International Headache Society criteria

1:30pm–3:30pm • 2 CEU, Core
An Endless Love for California Dental Practice Act
Marcella Oster, RDA
Face it, we all have a love/hate relationship with ever-changing laws, managing employees and being in compliance. This two-hour course meets license renewal requirements for CDPA.
Course objectives:

• Understand and review the scope of practice, standards, and law/ethics
• Understand mandated reporting, identifying victims of violence or neglect, outlining responses and procedures
• Learn the laws governing prescription drugs
• Understand the definition of Law and Ethics in dentistry
• Understand the On the Job Training (OTJT) responsibilities and fines

1:30pm–3:30pm • 2 CEU, 20%
Love and Processing: 10 Steps to Keeping your Patients Happy and your AR Low
Sara Baker, CEO; SD Reliance (SDDS Vendor Member)
What’s love got to do with it? (“It” being claims processing, of course!) The answer is…everything! Maintaining a loving relationship with your insurance AR is key to your entire collections process. Your insurance claims submission and aging process can be efficient, cost-effective, and – amazingly – easy! Ms. Baker will walk through the claims process designed to keep claims processing painless and healthy.
Course objectives:

• Understand how to set the stage for effective claims processing
• Learn how to create a successful insurance AR system
• Understand what defines “lack of dental necessity” – common claim issues and how to avoid them

1:30pm–3:30pm • 2 CEU, 20%
Reducing Your Practice Risk: Effective Risk Management Strategies, Tips, and Resources
Jessica Saetern and Shelli Macaluso, Risk Management Analysts; TDIC (SDDS Vendor Member)
Dentistry is a career that can be immensely rewarding if well protected. Part of that protection includes steps you can take to avoid common risks faced by dentists. Through case presentation, this course reveals how you can identify and minimize potential risks through implementation of proven risk management techniques and incorporation of trusted resources. Topics that will be covered include informed consent, patient dismissal, refunds, and employment issues.
Course objectives:

• Learn how to launch a comprehensive informed consent protocol
• Learn when and how to refund or dismiss a patient
• Learn how to implement protocols to protect your practice

1:45pm–3:45pm • 2 CEU, Core
Ice Age: Pathology, Physiology, and Destructive Aftermath of Methamphetamine Abuse
Mitchell Goodis, DDS and Jennifer Berry, MS, LMFT
Young victims of Methamphetamine addiction suffer Adverse Childhood Experiences (ACEs). Understand how meth affects both mind and body, why it is so addictive, how it is cooked and distributed, and what happens when CPS is called. Dentists and their staff are mandatory reporters of child abuse and neglect. Meet a former meth addict who lost her children to foster care due to drug use, and a Child Protective Services therapist who makes tough decisions to remove children from bad situations.
Course objectives:

• Understand how Methamphetamine is manufactured, shipped, and distributed to addict the American consumer
• Understand clearly the allure of Methamphetamine, how it affects the brain, and why recidivism is common
• Learn the “behind the scenes” events that occur when a dental office calls CPS to report child abuse