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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Importance of Communication & Respect in Dental Teams: From the Perspective of a Dental Assistant

By Ronda Holman | January 15, 2024

Interviewer: Tanya Sue Maestas, DDSInterviewee: Ronda HolmanEdited By: Candy Velez – CRDH, BSDH Today, we explore the vital role played by dental assistants, shedding light on the often-unnoticed significance of effective communication and respect within dental teams. Our guest, Ronda Holman, shares her experiences and insights, emphasizing the impact these factors can have on the…

Why am I Experiencing Clinical Failures?

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

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThe Article Originally Appeared on TheDawsonAcademy.com If we’ve been practicing for any length of time at all, we’re going to see some clinical failures. I think sometimes the perception is if we’re faculty at The Dawson Academy, that it never happens, and you should know that…

Navigating Professional Boundaries & Fair Compensation with Dental Assistant, Ronda Holman

By Ronda Holman | January 10, 2024

In the intricate dance of professional boundaries & fair compensation,dental assistants often find themselves walking a tightrope. Interviewer: Tanya Sue Maestas, DDSInterviewee: Ronda HolmanEdited By: Candy Velez – CRDH, BSDH Today we explore the financial mistakes that dental assistants can make and the valuable lessons we can all learn from them. Ronda Holman shares her…

5 Best Practices to Retain the Patients in Your New Acquisition

By David Rice | January 8, 2024

Implementing best practices can make a substantial difference in helping retain the patients in your new acquisition and existing team loyalty and trust throughout the transition. By: Dr. David Rice Buying a dental practice is the biggest financial decision you’ll make as a young dentist. Do it well, and it will fuel your future. Buy…

What Script Do I Need To Order an MRI for a Patient?

By Dr. Leonard Hess, DDS | January 5, 2024

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyArticle Originally Appeared on TheDawsonAcademy.com So what script do we need if we order an MRI on our patient? Now, it used to be, several years ago, that MRI was kind of the gold standard for us to look inside the joint. That is not the…

Dental Assistants: The Unsung Heroes of Dentistry

By Ronda Holman | January 4, 2024

Today, we shine a spotlight on the often-overlooked heroes of dental care: dental assistants. Interviewer: Tanya Sue Maestas, DDSInterviewee: Ronda HolmanEdited By: Candy Velez – CRDH, BSDH Through the eyes of Ronda Holman, a seasoned dental assistant with 24+ years of experience, we explore the challenges, triumphs, and invaluable roles these professionals play in dentistry….

Sedation Dentistry in a General Dental Practice 

By Savanah Craig | January 2, 2024

By: Savannah Craig In a world full of dental phobia, sedation has become an increasingly popular option for dentists to offer their patients. There are many options for types of sedation that can be offered to patients, and each is carefully regulated by state dental boards. I hope to educate patients about what options are…

Vertical Dimension Confusion

By Dr. Leonard Hess, DDS | December 29, 2023

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson Academy There is no topic more confusing and more provoking than changing vertical dimension of occlusion. The reason is that every dentist has seen cases where it did not go very well, for the patient or the dentist. Broken crowns, chipped incisal edges, new TMJ issues,…

Unmasking the Middle of Dentistry: Advice from Dr. Pamela Maragliano-Muniz

By Dr. Pamela Maragliano-Muniz | December 27, 2023

Interviewer: Tanya Sue Maestas, DDSInterviewee: Dr. Pamela Maragliano-MunizEdited By: Candy Velez – CRDH, BSDH We had the pleasure of speaking with Dr. Pamela Maragliano-Muniz, a renowned dentist and educator. Throughout our conversation, Dr. Maragliano-Muniz shared valuable insights and advice for dentists at all stages of their careers. In this article, we will explore the key…

Embracing Clinical Mistakes, Excellence, and Growth in the Dental World with Dr. Pamela Maragliano-Muniz

By Dr. Pamela Maragliano-Muniz | December 26, 2023

Interviewer: Tanya Sue Maestas, DDSInterviewee: Dr. Pamela Maragliano-MunizEdited By: Candy Velez – CRDH, BSDH We had the pleasure of speaking with Dr. Pamela Maragliano-Muniz, a board-certified prosthodontist with a dental practice located in Salem, Massachusetts  Dr. Maragliano-Muniz shares her journey from dental hygiene to prosthodontics and discusses the clinical mistakes she has made and how…