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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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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How Dentists Can Save Lives Through Dental Sleep & Airway Education, Emphasizing Oral Systemic Health

How Dentists Can Save Lives Through Dental Sleep & Airway Education, Emphasizing Oral Systemic Health

By Dr. DeWitt Wilkerson, DMD | December 27, 2024

By: DeWitt Wilkerson, DMDThe Article Originally Appeared on TheDawsonAcademy.com. Dr. Wilkerson granted permission for igniteDDS to share with our readers. Dental professionals have long known that the mouth is a gateway to overall health – what happens within the oral cavity can have a direct impact on the rest of the body. And as oral health…

dental fuel

Navigating the Unpredictable Path of Early Dental Practice Ownership with Dr. Gabriela Flores

By Dr. Gabriela Flores | December 26, 2024

Host: Dr. Tanya Sue MaestasGuest: Dr. Gabriela FloresEdited By: Candy Velez CRDH The journey into dental practice ownership is as daunting as it is rewarding, particularly for those stepping into it soon after dental school. Dr. Gabriela Flores shares her experience of navigating this complex landscape, offering invaluable insights that resonate with dental professionals and…

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Help! My Dental Assistant Is Always Missing When I Need Them

By Ronda Holman | December 24, 2024

By: Ronda Holman It’s a familiar and frustrating scenario: You, the Dentist, are ready to seat the next patient but your dental assistant is missing. Time ticks away, the schedule begins to fall apart, and frustration grows—only to find the assistant casually chatting in the lab or taking an unscheduled break. This situation not only…

dentists reaching financial freedom and growth

The Practice Profit Plan: Steps to Achieve Financial Freedom & Growth

By Dawn Patrick | December 23, 2024

By: Dawn Patrick, Dental Coach and Director of Operations, IgniteDDS Managing a dental practice is more than providing quality patient care. To achieve long-term success, dentists must also focus on financial health—both within their practice and personally. This roadmap offers actionable steps to maximize profitability while maintaining balance in life and business.  Step 1: Set…

The index technique

The Index Technique: New No-Prep Approach for Worn Dentition

By Riccardo Ammannato, DDS | December 20, 2024

By: Riccardo Ammannato, DDSThis Topic Originally Appeared on PankeyGram.Org. Dr. Ammannato granted permission for igniteDDS to share with our readers. The goal of treating severely worn teeth is to improve the smile appearance and extend the function of the teeth. To ensure patient comfort and health, achieving stable posterior occlusion and efficient anterior guidance is…

dental fuel

Lifelong Learning and Work-Life Balance in Dentistry: Insights from Chad Duplantis

By Chad Duplantis, D.D.S, F.A.G.D | December 18, 2024

Host: Dr. Tanya Sue MaestasGuest:  Dr. Chad DuplantisEdited By: Candy Velez CRDH The world of dentistry is ceaselessly evolving, demanding continuous education and an acute awareness of work-life balance. Chad Duplantis, a seasoned dental professional, shares vital wisdom that transcends the operatory. Duplantis’s dialogue with Tanya Sue Maestas offers a holistic approach necessary for a…

ecosite one

Ecosite One by DMG Review – with Dr. David Rice

By David Rice | December 17, 2024

By: Dr. David Rice Ecosite One by DMG, guys, this is a very cool composite I just reviewed. Watch my quick video below or read on for more details. Key Takeaways: Ecosite One is ideal for class ones, twos, and fives. It’s also pretty versatile, meaning we can use it for very conservative preps, all…

dental office manager tracking kpis

Essential KPIs for Start-Up Dental Practices

By Dawn Patrick | December 16, 2024

By: Dawn Patrick, Dental Coach and Director of Operations, IgniteDDS Tracking and measuring KPIs in your dental practice isn’t just a nice-to-have; it’s essential for growth and sustainability. By focusing on key metrics like new patient acquisition, retention rates, and production efficiency, you can identify areas for improvement and drive your practice toward success. Let…

benefits of using desensitizers before tooth prep

4 Main Reasons I Always Use Desensitizers Before Tooth Prep

By Dr. Lee Ann Brady | December 13, 2024

By: Lee Ann Brady DMDTopic Originally Appeared on PankeyGram.Org. Dr. Brady granted permission for igniteDDS to share with our readers. One of the most common questions I get is about the use of a category of materials we refer to as desensitizers, prep scrubs, or prep wetting agents.  The question is usually do they actually…

dental fuel

Crafting Cohesion: The Crucial Elements of Team Building in Dentistry with Dr. Chad Duplantis

By Chad Duplantis, D.D.S, F.A.G.D | December 11, 2024

Host: Dr. Tanya Sue MaestasGuest:  Dr. Chad DuplantisEdited By: Candy Velez CRDH Building a successful dental practice extends beyond clinical excellence; it thrives on cultivating a cohesive team that fully embraces the practice’s vision and culture. In a podcast with Dr. Chad Duplantis, he shares his experiences and insights on team dynamics, highlighting the challenges…