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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patient history

Co-Discovering Oral Diseases Through Medical History 

By Mary Osborne RDH | June 16, 2025

By: Mary Osborne, RDHThis topic originally appeared on PankeyGram.Org. Dr. Osborne granted permission for igniteDDS to share with our readers. Take Your Time For Detailed Medical History  The earliest but yet the most powerful tool toward accurate diagnosis is detailed patient’s medical history. But to get the desired information that we need from patients for diagnosing…

submitting claims to dental insurance so its not fraudulant

Why Submitting Claims to Dental Insurance Under a Provider Not Rendering Treatment is Insurance Fraud

By Angela Holland | June 16, 2025

By: Angela Holland In the world of dental insurance, accuracy isn’t just important, it’s essential. When it comes to submitting dental claims, one of the most critical pieces of information is the rendering provider, the licensed dentist who actually performed the service. Whether you’re a single-practice office or part of a larger dental network, it…

drawing the line in the sand on performance

Draw the Line: How to Hold Your Team Accountable Without the Drama

By Dawn Patrick | June 10, 2025

By: Dawn Patrick, Dental Practice Coach + Director of Operations IgniteDDS  As a dental practice owner or manager, you work hard to create a positive, high-performing team culture. But what happens when a team member continuously falls short of expectations? Allowing poor performance to persist damages morale, impacts patient care, and affects profitability. That’s why…

the importance of taking time to take time off of work

The Importance of Making Time for Time Off from Work

By Louis Kaufman DDS, FAGD, MBA | June 10, 2025

By: Dr. Kaufman One of the most important lessons I can share with my colleagues is taking time off from the hustle and bustle of modern life. While this might seem like an indulgence it is an essential component of a healthy lifestyle. Rest serves as a catalyst for increased productivity. Dentistry is mentally and…

Class II cavity preparation and restoration

Class II Preparation and Restoration: High-Yield Guide for D1 Students 

By Michael Eid | June 9, 2025

By: Michael Eid Class II preparation and restoration are where things get real. You’re now dealing with proximal surfaces, tight contacts, and matrix systems. This guide simplifies it all for you. What Is a Class II Cavity?  Location: Proximal surfaces (mesial/distal) of posterior teeth  Class II Preparation Steps  Occlusal Portion  Proximal Box  Matrix & Wedge Tips …

Breathing and Airway Support in Pediatric Dentistry

Breathing and Airway Support in Pediatric Dentistry

By Steve Carstensen, DDS | June 9, 2025

By: Steve Carstensen DDSThis Topic Originally Appeared on PankeyGram.Org. Dr. Carstensen granted permission for igniteDDS to share with our readers. I want to share a clear example of how bad sleep directly affects the anatomical structures dentists pay a lot of attention to—the mandibular condyles.   Sleep Disruption Disrupts Jaw Bone Regeneration  We’ve all seen on X-rays…

a-dec operatory

First Practice? Get Savings, Support for a ‘Smart Start’

By David Rice | June 9, 2025

By: A-decTopic originally appeared on DentalProductShopper.com, they granted permission for igniteDDS to share with our readers. A-dec program offers equipment savings, expert guidance, and complimentary services to ensurefirst-time practice owners get off to a smooth start Struggling with a lengthy wish list of equipment for your first practice? For many dentists, it’s an experience that likely…

Your new team member wants to succeed—your onboarding plan helps them do it.

Stop the Revolving Door: Rethink Your Onboarding Strategy 

By Dawn Patrick | June 2, 2025

By: Dawn Patrick, Dental Practice Coach + Director of Operations IgniteDDS  In a busy dental practice, it’s easy to assume a new hire will “figure things out” after a few shadowing shifts. But that’s a fast track to burnout—for the new team member and for the team trying to train them on the fly. Onboarding…

relationship based dentistry

Relationship-Based Dental Practices: Avoiding Judgmental Stories About Patients

By Michael Rogers, DDS | June 2, 2025

By: Michael Rogers, DDSThis Topic Originally Appeared on PankeyGram.Org. Dr. Rogers granted ignitedds permission to share with our readers. Near my dental office, there’s a small strip center that includes a realty group and a small church that creates a significant daily line of cars that go through a drive-through window. Cars line up waiting…

pros and cons of dental insurance tpas

Understanding Dental Insurance Third-Party Administrators: How They Benefit and Hinder Your Practice

By Angela Holland | June 2, 2025

By: Angela Holland Dental insurance third-party administrators (TPAs) play a significant role in managing insurance claims and processing reimbursements between dental practices and insurance companies. TPAs are third-party entities hired by insurance companies, employers, or health plans to manage dental insurance plans and the claims process. Their goal is to streamline the administrative side of…