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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Preparing Your Patients for Removable Prosthodontics

By Ronda Holman | March 16, 2026

By: Ronda Holman For many patients, transitioning to removable prosthodontics, whether partial dentures or full dentures, can feel intimidating. As dental professionals, one of our most valuable roles is helping patients understand what to expect and guiding them through the adjustment period with clear explanations and supportive coaching. When patients are properly prepared, their confidence…

Hope Isn’t on the Menu: Planning a Profitable Dental Year

By Dawn Patrick | March 16, 2026

By: Dawn Patrick, COO and Dental Business Strategy Coach, IgniteDDS It’s almost the end of the first quarter of 2026. How’s “hope” working for you? At this point, you’ve either planned a successful year and had an amazing first few months, or you are winging it and hoping for the best each month. Think about…

Going From Conventional to Digital Denture Fabrication

By Lee Culp, CDT | March 9, 2026

By: Lee Culp, CDTThis article originally appeared on PankeyGram.org. igniteDDS was granted permission to share with our readers. For years, creating dentures was a time-consuming process, requiring multiple patient visits, manual wax-ups, and trial-and-error adjustments. However, the rise of digital dentistry has revolutionized denture fabrication. From AI-assisted design to dental 3D printing, digital workflows have…

6 Strategies to Lead an Old Team as a New Dentist

By David Rice | March 9, 2026

By: Dr. David Rice Imagine this … or maybe you don’t need to because you’re already living it … you’re a new dentist … passionate … skilled … and ready to crush it in practice. But the team that’s been there for 10… 15… 20 years … they know the patients … the systems (or…

Why Dental Photography Is Essential in Modern Dental Practice

By James Wanamaker | March 2, 2026

By: James Wanamaker, DDS – IgniteDDS Clinical Coach In my private practice centered on esthetics and function, dentistry is never just about restoring teeth. It’s about restoring confidence, improving function, and creating harmony between the teeth, lips, and face. When you approach dentistry at that level, one tool that becomes absolutely indispensable is dental photography….

Stop Choosing Sides: The Secret Ingredient for Next-Gen Dentistry Is Fusion

By Candy Velez - CRDH, BSDH | March 2, 2026

By: Candy Velez, CRDH, BSDH, IgniteDDS Dental Hygiene Coach For a long time, dentistry has lived in two very different worlds. On one end, you have corporate dentistry — highly structured, efficient, protocol-driven, and focused on numbers. On the other end, you have private practice — often rooted in relationships, autonomy, and heart, but sometimes…

Advancing Implant Dentistry Through Digital Precision

By Lee Culp, CDT | February 23, 2026

By: Lee Culp, CDTThis article originally appeared on PankeyGram.org. igniteDDS was granted permission to share with our readers. The advancements in digital dentistry have redefined implantology, making it faster, more predictable, and highly precise. Traditional workflows relied heavily on physical impressions, wax-ups, and manual adjustments, often requiring multiple appointments and increasing the risk of inaccuracies….

Why the Money Isn’t Showing Up: Part 3

By Dawn Patrick | February 23, 2026

Building Financial Accountability Without MicromanagingDid you miss Part 2? Catch up on Why the Money Isn’t Showing Up, Part 2 By: Dawn Patrick, COO and Dental Business Strategy Coach, IgniteDDS Here’s the balance every dentist wants: “I want accountability — not hovering.” Good systems do exactly that. 1. Ownership vs. Delegation You can delegate tasks….

The Tip Of The Iceberg

By Dr. Eric Recker | February 22, 2026

By: Eric Recker You get that call. Again. Lately, it feels like it’s every week. Your hygienist isn’t coming in because of a migraine, a sick kid, another illness, a family emergency, a last-minute appointment they forgot to tell you about, or some other vague reason. You look at your schedule and realize you have…

How Dentistry Affects the People You Love: Part 3

By Sable Muntean | February 16, 2026

The Guilt Dental Professionals Feel Toward Their Partners and Families By: Dr. Sable Muntean Guilt is a common, yet often unspoken, challenge for dental professionals. It creeps in when you miss family events, work long hours, or feel emotionally unavailable at home. Over time, this guilt can quietly affect your mental health and strain your…