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.

How to Master a Complete Dental Examination

October 4, 2024 |

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?

August 23, 2024 |

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

July 12, 2024 |

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?

June 21, 2024 |

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?

May 31, 2024 |

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?

April 26, 2024 |

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

April 12, 2024 |

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

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occlusal muscle

How to Discover Occlusal Muscle Disorders

March 29, 2024 |

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

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Fixed-Implant-Bridge

Considerations of Treatment Planning a Maxillary Implant Prosthesis

March 15, 2024 |

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

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stabilize the joints

How to Stabilize the Joints

March 8, 2024 |

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

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How to Master a Complete Dental Examination

By Dr. Leonard Hess, DDS | October 4, 2024

By: Dr. Leonard A. Hess, DDS, Clinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to share with our readers. The key to offering complete dentistry starts with a thorough complete dental examination, but the order and how each Dentist explains this to patients can vary. 4 Steps to a…

strong dental team culture

Building a Strong Culture with Your Dental Team: The Foundation of a Thriving Practice 

By Dawn Patrick | October 2, 2024

By: Dawn Patrick, Dental Coach + Director of Operations IgniteDDS  In the ever-evolving world of dentistry, clinical skills and patient care are paramount. However, the success of a dental practice isn’t driven by technical expertise alone. Behind every flourishing practice is a unified, motivated, and engaged dental team that works seamlessly together. The key to…

sedation dentistry

Improving Efficiency in Dental Treatment Room Turnover

By Ronda Holman | September 30, 2024

By: Ronda Holman One of the common frustrations in a dental practice is when treatment room turnover takes longer than necessary. This delay can create bottlenecks, lead to patient dissatisfaction, and disrupt the schedule. Teaching a dental assistant to clean and set up a treatment room efficiently is essential for maintaining a smooth workflow. 5…

locus of control

Shifting ‘The Locus of Control’ Towards a True Partnership

By Dr. Brad Weiss | September 27, 2024

By: Brad WeissThis topic originally appeared on Pankey.org. Dr. Weiss granted permission for igniteDDS to share with our readers. As a maximizer, I’m always tweaking processes to try to make things a little better. A few years back on the advice of a wise mentor, I made a small change to the last question I…

cultivate leadership in your dental practice team

Building & Maintaining a Strong, Committed Dental Team: A Comprehensive Guide for Long-Term Success 

By Dawn Patrick | September 25, 2024

By: Dawn Patrick, Dental Coach + Director of Operations IgniteDDS  The success of any dental practice is rooted in the strength of its team. As a dentist and business owner, the challenge of managing a team while balancing clinical duties can feel overwhelming. However, creating a culture of engagement, accountability, and commitment is crucial for…

image of dr. bolamperti with his new solea dental laser technology

Solea Dental Laser Transformation

By Dr. Anthony Bolamperti, DDS | September 23, 2024

By: Dr. Anthony Bolamperti, DDSThis topic originally appeared on ConvergentDental.com. Dr. Bolamperit granted permission for igniteDDS to share with our readers. Every doctor who invests in a Solea dental laser has a transformation. Every transformation may be a little different, but they all have common threads that tie us together. My transformation began earlier than…

personal patient care

Individualized Patient Details for Lifelong Relationships

By Dr. DeAnne Blazek, DDS | September 20, 2024

By: DeAnne Blazek DDSThis topic originally appeared on Pankey.org. Dr. Blazek granted permission for igniteDDS to share with our readers. We see many patients daily and, it’s hard to remember all of them. You may remember their dental concerns or recall your work once you examined but not the people themselves. Keeping an individualized notebook…

dental fuel

Embracing Balance in Dentistry: Dr. Naved Fatmi on Avoiding Burnout

By Dr. Naved Fatmi | September 18, 2024

Host: Dr. Tanya Sue MaestasGuest: Dr. Naved FatmiEdited By: Candy Velez CRDH In the fast-paced world of dentistry, balancing practice demands with personal well-being can often feel like walking a tightrope. Burnout, a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, looms as a serious risk. Fortunately, Dr. Naved Fatmi’s…

exceeding patient expectations by having advanced technology for a better dental experience

Exceeding Dental Patient Expectations

By Dr. Timothy Anderson, DDS | September 16, 2024

A Practice of Exceeding Dental Patient Expectation By: Timothy Anderson, DDSThis topic originally appeared on ConvergentDental.com. Dr. Anderson granted permission for igniteDDS to share with our readers. Patient-Centered, Technology-Driven Culture A few years ago, I did the crazy thing of starting a dental practice from scratch. Naturally, there were some hurdles and struggles, specifically doing…

function and aesthetics in dentistry

What is Function and Aesthetics in Dentistry?

By Dr. Neeraj Khanna, DDS | September 13, 2024

By: Dr. Neeraj KhannaTopic originally appeared on TheDawsonAcademy.com. Dr. Khanna granted permission for igniteDDS to share with our readers. Let’s face it – it’s an image-conscious world we live in. Patients often walk into dental offices with a single goal: achieving that perfect smile (while treating other underlying issues.) However, this focus on aesthetics can…