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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3 Things Dentists Should Stop Saying

By Savanah Craig | June 3, 2024

By: Dr. Savanah Craig The language we choose to use is incredibly important. Unfortunately, if your dental school was anything like mine, you spend years learning all the technical parts of treatment planning and diagnosis but were never taught how to properly share that information with your patients. Unless we are fortunate enough to have…

Dentist Education: How Do I Predictably Prep Second Molars?

By Dr. Leonard Hess, DDS | May 31, 2024

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyArticle originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to share with our readers. When delivering a single crown, probably the toughest tooth we can prep for is the second molar. Things to be Aware of When Prepping Second Molars 1. Limited Opening One, usually, there’s…

Questions to Ask When Hiring a Financial Advisor

By Todd Doobrow, CFP | May 29, 2024

By: Todd Doobrow, CFP As we head into summer, we are finding many dentists “finally” prioritizing the business generated by their own two hands. Whether you’re planning for retirement, baffled by student loans, saving for your children’s education, or investing for long-term growth, finding the right financial planner can make a significant difference in your…

Help…My Dental Assistant is Messy!

By Ronda Holman | May 27, 2024

By: Ronda Holman In a bustling dental clinic in a small town, a young dental assistant named Lisa had just joined the team. Eager to learn and help, Lisa had one glaring flaw—she was an incredibly messy dental assistant. She didn’t organize the instruments properly, neglected sterilization throughout the day, and left rooms in disarray…

Post-Orthodontic Questions for Retainers 

By Dr. Lee Ann Brady | May 24, 2024

By: Lee Ann Brady DMDTopic originally appeared on Pankey.org: Dr. Brady allowed permission for igniteDDS to share with our readers As the orthodontic treatment comes to an end, patients can’t wait to remove their braces or Invisalign. Tired of keeping braces and the intricacies of caring for teeth that come with them, they tend to…

The Intersection of Dental Passion & Entrepreneurship: A Deep Dive into the World of Restorative Dental Hygiene with Irene Iancu RRDH

By Irene Iancu | May 22, 2024

Host: Dr. Tanya Sue MaestasGuest: Irene Iancu RRDHEdited By: Candy Velez CRDH In an enlightening episode of Dental Fuel, Tanya Sue Maestas engages with Irene Iancu, RRDH, a trailblazer in the field of restorative dental hygiene. Based in Toronto, Canada, Iancu’s journey from a passionate dental hygienist to the entrepreneurial owner of her own dental…

The Importance of Coaching with Dr. William Chen

By Dr. William E. Chen, DMD | May 20, 2024

We chatted with Dr. William Chen, who shared his expertise and insights onmistakes, challenges, and the importance of coaching in the dental profession. Host: Dr. Tanya Sue MaestasGuest: Dr. William ChenEdited By: Candy Velez CRDH Trust but Verify: The Power of Coaching in Dentistry Dr. Chen emphasizes the need to trust but verify and highlights…

Predictable Veneers: The Art of Shrink Wrap Provisionals

By Dr. Lee Ann Brady | May 17, 2024

By: Lee Ann Brady DMDTopic originally appeared on Pankey.org: Dr. Brady allowed permission for igniteDDS to share with our readers Of all the methods commonly used for veneer provisionalization, my favorite has to be the shrink wrap technique. I love it and use it all the time because in my opinion, it is the easiest…

Building a Successful Dental Team: Insights from Dr. William Chen

By Dr. William E. Chen, DMD | May 15, 2024

Today, Dr. William Chen, a seasoned dentist and entrepreneur, shares his insights and experiences in scaling his dental practice and building a successful dental team. Host: Dr. Tanya Sue MaestasGuest: Dr. William ChenEdited By: Candy Velez CRDH Let’s explore the challenges of building a successful dental practice and the mistakes that can occur along the…

Financial Mistakes Dentists Should Avoid: Insights from Dr. William Chen

By Dr. William E. Chen, DMD | May 13, 2024

Host: Dr. Tanya Sue MaestasGuest: Dr. William ChenEdited By: Candy Velez CRDH Today, we continue our conversation with Dr. William Chen, exploring the realm of digital dentistry and discussing a significant financial mistake he made in his career. Dr. Chen shares valuable insights and advice for dentists, shedding light on avoiding financial pitfalls. Let’s dive…