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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Help! My Dental Assistant Talks Too Much

By Ronda Holman | December 22, 2023

Talking too much can inadvertently cause discomfort to some patients and the schedule.Embrace the challenge of becoming a better listener. By: Ronda Holman Hi dear reader, 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…

Why Staying An Associate Is A Big Financial Loss

By David Rice | December 19, 2023

In the realm of personal finance, understanding the nuances of take-home pay is crucial for individuals striving to maximize their earnings, manage their financial well-being, and avoid a big financial loss. By: Dr. David Rice This article delves into the significant differences between the take-home pay of a W-2 employed dental associate earning $200,000 annually…

So You’ve Been Waitlisted, Now What?

By Dr. Bri Torgerson | December 18, 2023

“The reality is, that not everyone will get into dental school, some will be waitlisted,but that doesn’t mean it will NEVER happen.” By: Dr. Bri Torgerson Hi friends! I’m Dr. Bri Torgerson and I’m a General Dentist living and practicing in Saint Louis, Missouri. I’ve had a pretty unique journey into, through, and after graduating dental…

Splint Therapy: Time Is On Our Side

By Dr. Will Kelly | December 15, 2023

By: Will Kelly DMDArticle Originally Appeared on PankeyGram.org My experience with splint therapy was like most dentists prior to developing the skills taught at Pankey. In fact, my appliance was not really therapy at all. Perhaps just a shot in the dark “helmet” that protected teeth against collisions with very little intention. Throughout the years…

5 Red Flags that Prevent New Dentists from Getting their First Practice Loan

By David Rice | December 13, 2023

Navigating Your Path to Practice: Most Common Red Flags that Prevent New Dentists from Getting their First Practice Loan By: Dr. David Rice You woke up today, and you’ve decided you’re finally ready to trade your associate handpiece for your owner handpiece! The key now is to make sure you’re the strongest borrower you can…

A Dentist’s Insight into Oil Pulling and Contemporary Dentistry

By David Rice | December 11, 2023

Navigating the Buzz: A Dentist’s Take on Contemporary Dentistry & Oil Pulling By: Dr. David Rice  It’s not uncommon for us to encounter TikTok trends that capture public attention. Lately, one such topic that has resurfaced and re-sparked interest is oil pulling—an ancient tradition with wild claims of modern-day oral health benefits. As professionals dedicated…

Adult Growth of the Dental Arch

By Dr. Roger Solow, DDS | December 8, 2023

A comprehensive understanding of the complex interplay between all of these changesin the dental arch is essential to restorative dentistry. By: Dr. Roger Solow DDSArticle Originally Appeared on PankeyGram.org Successful restorative dentistry now hinges on an understanding that physiological changes occur over a lifetime. It’s detrimental to treat the dynamic relationship between dental occlusion and…

Transforming Financial Challenges into Triumphs: Lessons from Dr. Maragliano-Muniz’s Journey

By Dr. Pamela Maragliano-Muniz | December 6, 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, who shared a personal financial mistake she made and how it shaped her approach to dentistry. Dr. Maragliano-Muniz’s story serves as a valuable lesson for all dental professionals, highlighting the importance…

First Day of Private Practice

By Savanah Craig | December 4, 2023

By: Savannah Craig The night before my first day of private practice felt a lot like the first day of school. I laid out my new scrubs, packed my lunch box, and double-checked my alarm was set ten times before I finally went to sleep. Of course, I woke up before my alarm with those…

Do Patients Parafunction In Centric Relation?

By Dr. Lee Ann Brady | December 1, 2023

By: Lee Ann Brady DMDArticle Originally Appeared on PankeyGram.org Seated Condylar Position I know even the mention of the words centric relation probably has some readers bristling, as this is a much argued-over topic. With that said the research by Lundeen and Gibbs at the University of Florida shows that we do seat our condyles…