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

December 6, 2024 |

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

November 15, 2024 |

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

October 25, 2024 |

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

October 4, 2024 |

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?

August 23, 2024 |

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

July 12, 2024 |

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?

June 21, 2024 |

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?

May 31, 2024 |

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?

April 26, 2024 |

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

April 12, 2024 |

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThe Article Originally Appeared on TheDawsonAcademy.com Question: What…

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Know Your Patients: One of the Keys to Successful Treatment

By Dr. Mike Crete, DDS | July 19, 2024

By: Mike Crete DDSThis topic originally appeared on Pankey.org. Dr. Crete granted permission for it to be shared with igniteDDS readers. Have you ever found yourself explaining a treatment plan to a patient, only to be met with a blank stare and silence for a minute? It’s a common scenario indicating that while the patient…

Redefining Success: Insights from Dental Professionals on Career Fulfillment

By Savanah Craig | July 17, 2024

In a world where the definition of success is often blurred by societal expectations and personal aspirations, two rising dental professionals engage in a candid conversation that demystifies the concept of success. Dr. Craig and Dr. Sartor delve into what it means to achieve success in both personal and professional spheres, particularly in the field…

Innovative Dental Technology Increases Efficiency & Production

By Michael T. Kelly, DMD | July 15, 2024

By: Michael T. Kelly, DMDThis topic originally appeared on ConvergentDental.com. Dr. Kelly granted permission for it to be shared with igniteDDS readers. Michael T. Kelly, DMD of Aesthetic Dentistry of Scottsdale is committed to dental excellence and strives to teach others about advancing dental techniques. He and his team successfully utilize innovative dental technology to…

TMJ 101: The Best TMD Treatment Options For Dentists

By Dr. Leonard Hess, DDS | July 12, 2024

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to share with our readers. Temporomandibular joint (TMJ) disorders, commonly referred to as TMD, are a set of conditions affecting the jaw joint and surrounding muscles. With an estimated prevalence of 5-12% in the general population,…

Navigating Patient Expectations: Insights for Early-Career Dentists

By Savanah Craig | July 10, 2024

Dentistry isn’t just about the technical handling of teeth; it involves the complex task of navigating patient expectations, often overshadowed by immediate clinical challenges. The journey of newly graduated dentists Dr. Savanah Craig and Dr. Ronnetta Sartor offers a lens into the intricate balancing act of managing patient desires and maintaining professional integrity. This article…

Breaking Barriers to Care: Innovation in Special Needs Dentistry

By Dr. Laura B. Holena, DDS | July 8, 2024

By: Laura B. Holena, DDSThis topic originally appeared on ConvergentDental.com. Dr. Holena granted permission for this content to be shared with igniteDDS readers. There is a crisis in special needs dental care, with patients in some cases waiting years and often having to travel long distances to see a dentist who can accommodate them. For…

Interdental Papilla: Esthetic Considerations 

By Dr. Lee Ann Brady | July 5, 2024

By: Lee Ann Brady DMDTopic originally appeared on Pankey.org: Dr. Brady allowed permission for igniteDDS to share with our readers Interdental papilla is the part of the gingiva that fills the space between teeth. It has a triangular shape in the anterior region and a concave col in the posterior region of the tooth, which…

DMG DentaMile Desk MC System

By David Rice | July 3, 2024

By: DMG-Connect.com DMG Connect allowed igniteDDS permission to share this video with our readers.

Referrals: What Dentists Wish Patients Knew

By Savanah Craig | July 1, 2024

By: Dr. Savanah Craig In the age of Amazon Prime and grocery pick-up, convenience is becoming a higher priority for patients. Our society prizes one-stop shopping above all else and general dentists are working hard to fit this model. More and more dentist are becoming “Super GPS” and taking courses to add more advanced procedures…

Handling Patient’s Denials in Your Practice

By Mary Osborne RDH | June 28, 2024

By: Mary Osborne, RDHThis topic originally appeared on Pankey.org. IgniteDDS was permitted to share it with our readers. Helping patients move past denial over their dental health is no easy feat. In your dental practice, you have likely encountered this situation many times.    Resolving denials within a dental practice requires a delicate balance of empathy, patience,…