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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When the Same Problems Repeat, It Is Not the People

By Garrett Wilson | December 29, 2025

By: Garrett Wilson Let’s face it. One of your core responsibilities as a leader is navigating people and business challenges at the same time. When the same problems show up month after month, the issue is no longer external. It is internal. This is not a workforce crisis. It is an operating model problem. Dentistry…

Limitations of Digital Dentistry: When Technology Falls Short

By Dr. Kelley Brummett, DMD | December 29, 2025

By: Kelley Brummett, DMD This Article Originally Appeared in PankeyGram.Org. Dr. Brummet granted permission for igniteDDS to share with our readers. As digital dentistry continues to revolutionize the way we practice dentistry, the functional capacity of the new tools, ease of use, and efficiency make them indispensable for modern practice workflows. However, even the most advanced technologies…

The Freedom Framework Week Three: The Power of Flow

By Candy Velez - CRDH, BSDH | December 29, 2025

Creating Freedom Through Structure, Alignment, and Leadership By: Candy Velez, CRDHIgniteDDS Dental Hygiene Coach Missed Week One or Two? Check them out here:Week One: Breaking the Invisible HandcuffsWeek Two: Releasing Money Blocks & Embracing Stewardship Once you’ve broken the invisible handcuffs and reframed your relationship with money, the next step is where everything comes together…

Meaningful Ways New Dentists Can Show Gratitude to Their Team During the Holidays

By Ronda Holman | December 22, 2025

…Without Spending Much Money By: Ronda Holman The holiday season is a perfect opportunity for new dentists to strengthen team culture and show appreciation—without stretching the budget. In a dental practice, genuine gestures speak louder than expensive gifts. Here are simple, memorable ways to express gratitude that your employees will truly appreciate. Write Personal, Handwritten…

Endo Made Simple Part 3: Obturation

By Michael Eid | December 22, 2025

By: Michael Eid Missed Parts 1 & 2? Check Them Out Here: Step 1: Final Canal Check High-Yield Tip: If a 10 doesn’t pass now, it won’t after obturation. Step 2: Dry the Canal High-Yield Tip: Moisture = weak sealer seal and post-op sensitivity. Step 3: Select the Master Cone High-Yield Tip: No tug-back = poor…

How Dentists Can Navigate Holiday Parties Without ‘Talking Teeth’ All Night

By Sable Muntean | December 22, 2025

By: Dr. Sable Muntean Holiday parties are supposed to be fun—good food, good music, good company. But if you’re a dentist, you know how it really goes: You walk in the door, grab a drink, and within five minutes someone is pointing at a molar and saying, “Since you’re here… can I ask you something?”…

The PPO Trap for Startups & Acquisitions: Moving into Ownership in 2026? This Is for You!

By Angela Holland | December 22, 2025

By: Angela Holland, Founder of Preferred Dental SolutionsInsurance Expert and Strategy Consultant for Dental PracticesPreferredDentalSolutions.com Insurance Decisions That Can Make or Break New Dental Practices If you’re launching or buying a dental practice, insurance decisions can make or break your first three years. Too many new owners sign onto every PPO “just to get patients…

Keeping Gingival Crevice Healthy

By David Rice | December 22, 2025

By: Pankey GramTopic Originally appeared on PankeyGram.org Gingival crevice is the space between the marginal gingiva and the tooth surface. Keeping it healthy, means knowing effective tooth preparation techniques that don’t block the passage of gingival crevice fluid with restoration materials. Many soft tissue inflammation, like gingivitis and periodontitis can occur as a result of…

The Practice Profitability Playbook: Part 3

By Dawn Patrick | December 22, 2025

Part 3: Clinical Control — Diagnose with Confidence, Present with Clarity By: Dawn Patrick, Business Strategy Coach, IgniteDDS Even the most profitable practice can struggle if patients don’t accept treatment consistently. Clinical Control ensures that your team delivers excellent care and communicates it effectively, so patients understand the value and say yes to recommended treatment….

How to Stay Sane During December’s Patient Rush: A Dentist’s Guide to Balance

By Sable Muntean | December 15, 2025

By: Dr. Sable Muntean December is a special kind of chaos for dental professionals. It’s the perfect storm: patients trying to use the last of their insurance benefits, parents squeezing in appointments before school break, and an endless stream of “Can you fit me in before the holidays?” messages. The pressure hits fast, and hard….