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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Preventing Burnout: How to Maintain Engagement & Discipline in Your Dental Team

By Dawn Patrick | October 21, 2024

By: Dawn Patrick, Dental Coach and Director of Operations, IgniteDDS  In today’s demanding dental environment, burnout among dental professionals is increasingly common. As a dental leader, your team’s well-being is essential to the long-term success of your practice. Burnout impacts not only productivity but also patient care, team morale, and retention. Maintaining engagement and discipline…

Active Listening Tips For Patient-Centered Care

By Dr. Bill Gregg, DDS | October 18, 2024

By: Dr. Bill Gregg DDSThis topic originally appeared on Pankey.org. Dr. Gregg granted permission for igniteDDS to share with our readers. The first step towards becoming a great clinician, who can diagnose and treat diseases is becoming an active listener. Usually, the most important things you need to know for an effective treatment come from…

The Art of Listening: Clinical Mistakes with Dr. Chad Duplantis on Dental Fuel

By Chad Duplantis, D.D.S, F.A.G.D | October 16, 2024

Host: Dr. Tanya Sue MaestasGuest:  Dr. Chad DuplantisEdited By: Candy Velez CRDH In this episode of Dental Fuel, our host, Dr. Tanya-Sue Maestas, sits down with Dr. Chad Duplantis, a seasoned restorative dentist based in Fort Worth, Texas. With decades of experience and a passion for technology in dentistry, Dr. Duplantis shares invaluable insights for…

Building Self-Esteem & Long-Term Commitment: How to Show Appreciation to Your Dental Team 

By Dawn Patrick | October 14, 2024

By: Dawn Patrick, Dental Coach + Director of Operations, IgniteDDS  In any dental practice, the team is its core. When they feel appreciated, their self-esteem rises, confidence grows, and they’re more likely to stay long-term. Showing consistent and genuine appreciation is not just a gesture—it’s an ongoing strategy to build a committed, high-performing team. This…

A Challenging Hybrid Overdenture Case

By Dr. Lee Ann Brady | October 11, 2024

By: Dr. Lee Ann Brady, DMDThis topic originally appeared on Pankey.org. Dr. Brady granted permission for igniteDDS to share with our readers. Dentistry is a life-learning career, and everyone encounters some cases through their career that challenge their clinical skills. That’s a positive thing, it motivates us to explore more and advance our skills further,…

When to Change Financial Advisors

By Todd Doobrow, CFP | October 9, 2024

By: Todd Doobrow, CFP Break-ups are rarely ever fun but are often necessary to help us keep moving forward.  Whether firing a difficult patient or moving on from a significant other, closing one door hopefully leads to another opening. This is no different when thinking about your relationship with your financial advisor. As your needs…

Challenges & Benefits of Working in Healthcare

By Savanah Craig | October 7, 2024

By: Dr. Savanah Craig Working in healthcare is challenging for many reasons. I would bet that most people in healthcare are high-achieving and have a strong desire to help others. This makes people susceptible to burnout. Dentists, however, have the added level of patient fear, distrust, and isolation to contend with. Spend enough time with…

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…

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…

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…