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…

Read More
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…

Read More
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…

Read More

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….

Read More
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…

Read More
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…

Read More
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…

Read More
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…

Read More
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…

Read More
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…

Read More

Back to the basics….What is Dental Insurance Credentialing?

By Angela Holland | March 25, 2025

By: Angela Holland If you’re a dentist or dental practice owner, you’ve likely encountered the term “insurance credentialing” at some point. While this process may seem daunting, understanding dental insurance credentialing is crucial for your practice’s financial success and the quality of care you provide to your patients. Whether you are just starting your practice,…

The Big Bad Board of Dentistry: What Power Do They Really Have?

By Candy Velez - CRDH, BSDH | March 24, 2025

Understanding the Authority of the Florida Board of Dentistry By: Candy Velez – CRDH, BSDH For many dental professionals, the Florida Board of Dentistry feels like a looming presence, often associated with disciplinary actions, complaints, and investigations. The very mention of an inquiry can strike fear into even the most diligent practitioners. But what authority…

Are All Dental Whitening The Same? 

By David Rice | March 19, 2025

By: Dr. David Rice As a young dentist, hygienist or assistant, it’s easy to be overwhelmed with teeth whitening today. We have:  So, are they all the same? Which delivery system is best? As a dental pro, how do I make the best recommendations to my patients?  Future Dentists Take on Teeth Whitening Options Have…

No Prep Veneers: Minimal Intervention, Maximum Impact

By Michael Eid | March 19, 2025

By: Michael Eid As dentists, preserving natural tooth structure is a top priority. No Prep Veneers offer a way to enhance smiles without sacrificing precious enamel. In this blog, I’ll share insights on how this innovative approach can help achieve the dream smile while keeping your natural teeth intact.  What Are No Prep Veneers?  No…

Compensation Doesn’t Have to Be Complicated

By Garrett Wilson | March 18, 2025

By: Garrett Wilson You’re trying to set competitive pay for your staff, but finding accurate compensation data is a challenge. So, you call a few peers at other dental offices to compare notes. The problem? Not only is this approach unreliable, it’s also illegal. Employers cannot legally collaborate to set wages, so relying on peer…

Are You Just a Bare Minimum Dentist? The Truth About the Standards You’re Held To

By Candy Velez - CRDH, BSDH | March 17, 2025

Upholding the Standard of Care in Dentistry By: Candy Velez – CRDH, BSDH As dental professionals, we are responsible for our patients’ health and well-being. However, demanding schedules, high patient volumes, and ingrained habits can create unintended gaps in care. Dentists may go years without scrutiny—until a reported incident places every aspect of a patient’s…

Efficiency of Chlorhexidine Varnish for Tissue Management

By Dr. Lee Ann Brady | March 12, 2025

By: Lee Ann Brady DMDTopic originally appeared on PankeyGram.org. Dr. Brady granted permission for igniteDDS to share with our readers. Chlorhexidine has had a wide range of uses in dentistry for many years, including maintaining tissue health during periodontal therapy, reducing the risk of caries, and minimizing sensitivity.  Along with the positive effects it has,…

Dental Insurance Fee Negotiation Process & Why Hire an Expert

By Angela Holland | March 11, 2025

By: Angela Holland Negotiating PPO fees is a crucial yet often overlooked step in maximizing your dental practice’s financial success. Done correctly, PPO fee negotiations can significantly increase insurance collections—without requiring more patients, additional treatments, or increased marketing costs. While the process can take anywhere from 9 to 18 months, the results are well worth…

You’re A Practice Owner…How Should You Hire an Associate?

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

By: Dr. Kaufman I have had at least one associate sometimes two over the last 16 years. I was an associate and that was almost 30 years ago. Here is my take, if you are the practice owner you need to be comfortable sharing your practice.  Why Not Have An Associate? Some docs I know…

Dental Microscope: When We See Better, We Can Do Better

By Dr. Michelle Lee, DDS | March 5, 2025

By: Michelle Lee, DDSTopic originally appeared on PankeyGram.Org. Dr. Lee granted permission for igniteDDS to share with our readers. Today, we have an abundance of restorative materials at our fingertips. Accurate case planning involves realizing the potential of digital design and precision-based dentistry to efficiently provide the best possible restorative care. My attitude to dentistry…