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

Navigating Post-Graduation: Strategies for Preventing Burnout in Dentistry

By Savanah Craig | August 12, 2024

The journey beyond graduation can be fraught with challenges and pressures, such as burnout, especially for young professionals like Dr. Savanah Craig and Dr. Ronnetta Sartor. In their conversation, they tackle the crucial topic of burnout in dentistry—a pervasive issue facing many in their field. Sharing their personal experiences and proactive measures highlights the importance…

HPV and Oral Cancer: Early Detection and Prevention

By Dr. Lee Ann Brady | August 9, 2024

By: Lee Ann Brady DMDThis topic originally appeared on Pankey.org. Dr. Brady granted permission for igniteDDS to share with our readers. Human papillomavirus (HPV) is a virus that can cause cancer later in life. Infection with this virus is very common, and almost everyone with get this virus at some point in life.  Most of…

The Crucial Role of Psychology in Financial Planning

By Todd Doobrow, CFP | August 7, 2024

By: Todd Doobrow, CFP Financial planning isn’t just about numbers and spreadsheets; it’s equally about understanding how human behaviors influence our financial decisions. Psychology plays a pivotal role in shaping how individuals perceive, prioritize, and manage their finances, ultimately impacting their financial well-being and long-term goals. We this play out in six different ways; how…

Lessons I Learned in My First Year of Dentistry

By Savanah Craig | August 5, 2024

By: Dr. Savanah Craig Each year feels like it moves faster than the one before it. In the blink of an eye, 52 weeks have passed and it can be easy to miss how far you have come – unless you take the time to reflect. This year has been the first year of my…

Tongue Ties, Restricted Fascia, and Mouth Breathing

By Dr. Soroush Zaghi, MD | August 2, 2024

By: Dr. Soroush Zaghi, MDThis topic originally appeared on TheDawsonAcademy.com. Dr. Zaghi granted permission for igniteDDS to share with our readers. The consequences of tongue ties, restricted fascia, and mouth breathing, are explained by a leading expert, physician, and researcher in nasal obstruction, snoring, and sleep-disordered breathing. Conversation with Dr. Zaghi on Tongue Ties, Restricted…

Ready or Not: How to Know When It’s Time to Buy a Dental Practice 

By Dr. Hannah Crowell | July 31, 2024

By: Dr. Hannah Crowell Buying a dental practice is a significant milestone in your career as a dentist. It represents not only a financial investment but also a commitment to managing a business and caring for a patient base. Deciding when you’re ready to take this step requires careful consideration of several key factors. 7…

Help…My Dental Assistant Won’t Restock the Treatment Rooms

By Ronda Holman | July 29, 2024

By: Ronda Holman My name is Ronda Holman and I have been sitting across from a dentist for a living for the last 25 years. I thought it might be time to make some written confessions about what I have been guilty of over the years and how my dentist effectively molded me into their…

Maximizing Team Member Engagement

By Dr. Mark Kleive DDS | July 26, 2024

By: Mark Kleive DDSThis article originally appeared on Pankey.org. Dr. Kleive granted permission for igniteDDS to share it with our readers. Keeping your team members motivated and actively participating throughout the year is no small feat. Without a solid communication-based framework,  things can easily fall apart, undermining the cohesion and productivity of your practice. During…

Cultivating Team Synergy in Dental Practice Management: Insights from the Trenches

By Savanah Craig | July 24, 2024

Dentistry, while rooted in medical science, is profoundly shaped by the personalities at play within a practice. The realm of managing a dental team extends beyond clinical skills, delving into the nuanced art of fostering a positive workplace culture that ultimately reflects in patient satisfaction. Join Dr. Savanah Craig and Dr. Ronnetta Sartor as they…

Quick Take: Elevating Common Dental  Procedures with the Solea

By David Rice | July 22, 2024

By: David Rice, DDS The Solea® All-Tissue Dental Laser from Convergent Dental is a breakthrough dental technology that enables dentists to perform a wide range of anesthesia-free, blood-free, and pain-free procedures in hard- and soft-tissue. Those who have an interest in lasers understand that Solea’s unique 9.3-micron CO2 technology makes it superior in handling anesthesia-free…