Dr. Leonard Hess, DDS

Dr. Leonard Hess, DDS

Dr. Leonard Hess began teaching continuing education courses in 2005, and the topics include occlusion, smile design, treatment planning, preparation design, and practice integration of complete dentistry.

He’s taught full-day continuing education courses at the American Academy of Cosmetic Dentistry’s national meeting, The Greater New York Dental Meeting, AACD National Meeting, Pacific Dental Conference, Ontario Dental Association meeting, and The Yankee Dental Conference.

Dr. Hess also has taught courses in Japan, Germany, Poland, China, and Canada.

Dr. Hess is currently serving as the Senior Clinical Director at The Dawson Academy. He also owns Union County Center for Comprehensive Dentistry in Charlotte, North Carolina.

dawson academy complete dental examinations

Complete Examinations in Dentistry

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThe Article Originally Appeared on TheDawsonAcademy.com. Dr. Hess…

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how to track key dental practice performance metrics

How To Track Key Dental Practice Performance Metrics

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThe Article Originally Appeared on TheDawsonAcademy.com Measure What’s…

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phone greeting tips for dental offices

Top Phone Greeting Tips for Dental Practices

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThe Article Originally Appeared on TheDawsonAcademy.com In today’s…

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How to Master a Complete Dental Examination

By: Dr. Leonard A. Hess, DDS, Clinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr….

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How Do You Know If You Achieved Centric Relation? By: Dr. Leonard A. Hess, DDS Clinical Director, The Dawson Academy This article originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to share with our readers. When we talk about utilizing bimanual manipulation as a way to get centric relation, one of the biggest misunderstandings we see is the tendency for dentists to think CR is achieved by forcing the jaw back to seat the condyles. When we are in a situation where we have a tight patient, or patients that are resisting, the worst thing we can do is force it. Bimanual manipulation provides verification of: The correctness of the physiologic position The alignment of the condyle-disk assembly The integrity of the articular surfaces Steps to Achieving Centric Relation Recline the patient so your arms are parallel to the floor and their chin is pointing up. Stabilize the patient’s head by cradling it between your rib cage and forearm. It is essential that the head be stabilized with a firm grip so it will not move when the mandible is being manipulated. Lift the patient’s chin to slightly stretch the neck, keeping your forearms parallel to the floor. Gently position the four fingers of each hand on the lower border of the mandible. The little finger should be slightly behind the angle of the mandible. The pads of your fingers should align with the bone and stay together as if you were going to lift the head. Bring the thumbs together to form a C with each hand. The thumbs should fit in the notch above the symphysis. Remember, NO PRESSURE should be applied. With a gentle touch, and with almost zero pressure from your hands, have the patient slowly hinge open and closed in rotation (an arc of 1-2mm is acceptable), never letting the teeth touch. Do not jiggle or load the joint at this point. The whole idea here is to let the condyles go to where they physiologically want to be – properly seated in each fossa. When the hinge movement is consistent, the mandible will retrude automatically and you should feel the jaw go back. At that point, hold the jaw firmly on that hinge point. With proper hand placement, there is a torque effect from the thumbs and fingers that loads the joints in an upward and forward direction. This allows upward pressure to be maintained through the condyles while still allowing them to rotate freely. Load the joint by applying firm (but gentle) pressure UP with the fingers on the back half of the mandible and DOWN with the thumbs in the notch above the symphysis (keeping the teeth separated). Note: Sudden heavy loading can injure retrodiskal tissue and cause considerable pain. Ask the patient, Do you feel any tension or tenderness in either joint? If yes, stop and determine the cause. If no, continue. Increase to moderate pressure, then firm pressure. With each increment of loading, ask the patient, “Do you feel ANY tension or tenderness in either joint?”. If tension or tenderness is experienced at any load interval, stop and determine the cause. The dense vascular connected tissue that makes up the disk will be able to handle enormous pressure through it without any sort of tenderness if you have a properly aligned condyle-disk assembly, and that condyle is completely seated. And if the condyle is seated completely, such that the medial aspect of the condyle is engaged with the medial aspect of the glenoid fossa with a properly inter-closed disk, then there can’t be any stretching of the muscle. What It Looks Like When the Condyle is Not Completely Seated in Centric When you load test, there will be a tension on that lateral pterygoid, and they will feel some tightness or fullness or a pull. Because of this feeling, they’ll have awareness in that joint. If there’s pathology in the joint or an intracapsular problem, they’re likely to have some sort of discomfort or tenderness. But also, remember that as we assess the joint, we’re relying on the totality of the exam; the questions that we ask, the palpation of the muscles, the load testing, the range of motion, doppler analysis, all these things that we do, to develop a visual picture of what’s going on there. But the short answer to, how do you know if you’ve achieved centric relation, is by load testing; by load testing in three pressure increments and making sure there is no tension or tenderness in either joint. If a Patient Has Had a Lower Block, You Can Still Put Them in Centric Relation Anesthesia locking the trigeminal nerve really doesn’t have any effect whatsoever on whether you can achieve centric or not. Those are sensory nerves and we’re not really messing with the motor. The fact is, we’re going to take bilateral manipulation to achieve centric relation, whether they’re numb or not. And the technique is going to be exactly the same. You can actually achieve centric relation even if the patient is asleep. We’ve done a number of bite records while the patients were under Pentathol. It’s exactly the same as when they’re awake. Just remember, when you’re putting a patient in centric relation, it’s the natural physiological hinge of the joint you’re looking for. If you’ve previously taken Core 2: Examination & Records with us, I encourage you to review all the principles in the book (Chapter 9: Determining Centric Relation) and in the manual, as well as what we taught in class. If you haven’t taken the Examination & Records course, we spend a day and a half doing load testing, so that students get very comfortable with the hand position and how to get repeatable precise results.

How Do You Know If You Achieved Centric Relation?

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr. Hess…

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tmj patient

TMJ 101: The Best TMD Treatment Options For Dentists

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr. Hess…

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dentist checking patient for fremitus

What is Fremitus and Why Should You Check For It?

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to…

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prepping second molars

Dentist Education: How Do I Predictably Prep Second Molars?

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyArticle originally appeared on TheDawsonAcademy.com, Dr. Hess allowed…

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Sequencing a Full-Mouth Rehab: Anterior or Posteriors First?

Sequencing a Full-Mouth Rehab: Anterior or Posteriors First?

The correct sequence to begin a full-mouth rehab is tobegin with the anterior teeth first, particularly the…

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patients who have more pain after wearing a b-splint

Q&A with Dr. Hess: Patients Who Have More Pain After Wearing a B-Splint

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThe Article Originally Appeared on TheDawsonAcademy.com Question: What…

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Incisal Edge Position

By James Wanamaker | April 20, 2026

By: Dr. James Wanamaker With every case I plan, I take the same set of twenty-one photos because each image gives me a different piece of the puzzle, and together they guide one of the most critical parameters in smile design.  In an esthetic-driven practice, few decisions are more important or more misunderstood than where…

The Start-Up Ownership Illusion: Part 2

By David Rice | April 20, 2026

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If They Understand It, They’ll Accept It

By Ronda Holman | April 13, 2026

By: Ronda Holman You’re standing in the operatory. You just walked your patient through what you’re seeing, what needs to be done, and why. Then they look at you and ask: “Why does this cost so much? Can you just give me the cheapest option?” And just like that, you feel it. That slight tension….

Media Release: Ivoclar’s Complete CAD/CAM Block Portfolio for CEREC is Now Available Through Benco Dental

By David Rice | April 13, 2026

By: Ivoclar Expanded Dealer Partnership Gives CEREC® Users Access to Ivoclar’s Full CAD/CAM Block Line, Including IPS e.max® Ivoclar, a global leader in integrated dental solutions, and Benco Dental, the nation’s largest family-owned dental distributor, have expanded their longstanding partnership to offer Ivoclar’s complete CAD/CAM block portfolio for the Dentsply Sirona CEREC system through Benco…

Everyone Is a Human Being: Choosing to Create Better Workplace Culture

By Candy Velez - CRDH, BSDH | April 13, 2026

We All Have the Superpower of CHOICE By: Candy Velez, CRDH, BSDH, IGNITEDDS Dental Hygiene Coach When the Hardest Part of Work Isn’t the Work In many professional environments, the most difficult part of the job is not always the workload, the schedule, or the pressure. Sometimes, it is the way people treat each other….

Fluoride Varnish: A Valuable Tool for Caries Prevention

By Dr. Lee Ann Brady | April 6, 2026

By: Lee Ann Brady, DMDThis topic originally appeared on PankeyGram.org. Dr. Brady granted permission for igniteDDS to share with our readers. Fluoride varnish is one of the most effective ways to prevent caries, yet many dental professionals and patients underestimate its power. If you’re still using fluoride gel or foam, it’s time for an upgrade….

The Evolution of Excellence: Introducing the NSK Ti-Max Z99L

By David Rice | April 6, 2026

By: NSK NSK’s newest electric handpiece, the Ti-Max Z99L, is designed to provide more torque, better ergonomics, and unmatched durability. 1. Optimized for Power: The New Gear & Chuck System The Z99L introduces the DURAPOWER CHUCK, a next-generation mechanism that provides a significantly stronger bur grip, reducing the risk of slippage even when cutting through…

From Chaos to Coordination: Building a Michelin-Star Dental Team

By Dawn Patrick | April 6, 2026

By: Dawn Patrick, COO and Dental Business Strategy Coach, IGNITEDDS What Does a High-Performing Dental Team Actually Look Like? In high-performing dental practices, success isn’t about everyone doing everything. It’s about everyone doing their part, exceptionally well. Think about a fine dining restaurant. Yet every guest experiences seamless service, which leads to a 5-star experience….

Enhancing Doctor & Dental Lab Communication in the Digital Age

By Lee Culp, CDT | March 31, 2026

By: Lee Culp, CDTThis article originally appeared on PankeyGram.org. Dr. Culp granted permission for igniteDDS to share with our readers. The collaboration between doctors and dental labs has undergone a seismic shift with the rise of digital dentistry. Historically, communication between these two essential players in restorative dentistry was limited—often reduced to written instructions and…

Link AI for A-dec+™: A Smarter Way to Manage Your Future Dental Practice

By David Rice | March 31, 2026

By: A-dec® Thinking about your future practice? With all the decisions ahead, here’s an easy one. Your Focus Right Now vs. Your Future Practice Right now, your focus is on clinics, competencies, labs, and exams. When you imagine owning a practice someday, you’re probably excited about: What you may not be so excited about is…