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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Choosing to Acquire a Dental Practice & Not Start One

By Bruce Bryen | September 19, 2023

Here are the top things to keep in mind after choosing to Acquire a Dental Practice & Not Start One By: Bruce Bryen So you finally decided to acquire an existing dental practice. There were likely many reasons why you made this decision. The answer to whether to buy an existing dental practice or start…

Buyer Beware: 7 Warnings You’re Looking at the Wrong Practice to Buy

By David Rice | September 12, 2023

Here’s Why You Should Not Ignore the Red Flags By: Dr. David Rice So you want to buy a dental practice and you’re worried you’re looking at the wrong practice. 7 Red Flags You’re Looking at the Wrong Practice to Buy 1. How Many Active Patients Are There? Talk to ten people and you’ll get…

Starting a Dental Practice vs Buying an Existing Practice

By Bruce Bryen | September 11, 2023

By: Bruce Bryen Considering starting a dental practice vs buying an existing practice? Whoever said that it was going to be easy had no idea what had to be done to start up a dental practice from the ground up. This is in comparison to acquiring an existing dental practice through a dental practice broker…

Dental Fuel Episode 15: Ronda Holman: Team Mistake

By Ronda Holman | September 8, 2023

This week, on Dental Fuel Episode 15, we’re diving deep into the art of building better communicators within dental teams. Communication is our SUPERPOWER, and it all starts with understanding the human aspect of what we do. Ronda specializes in helping to create the ideal DDS-DA relationship. Empowering dental assistants to continue their education so…

Dental Partnerships: The Good and The Bad!

By Bruce Bryen | September 6, 2023

By: Bruce Bryen Now the potential for more income, exposure to the community, and the recognition deserved by the graduate may be about to occur. The learning curve has been completed after the hiring as an associate, the purchase of a dental practice, and the reputation being built where the name of the dentist is…

Is Strength Training the Key to Your Dental Career Longevity?

By Savanah Craig | September 5, 2023

By: Savannah Craig One of the many things associated with a career in dentistry is back and neck pain. Finding ways to protect yourself is crucial to being able to have a long career. Since dental school, I’ve been trying to find solutions for managing and preventing back pain. I’ve tried stretching, massage therapy, and…

Dental Fuel Episode 14: Ronda Holman: Financial Mistake

By Ronda Holman | September 1, 2023

This week on Dental Fuel Episode 14, Ronda Holman, a seasoned dental assistant with over 24 years of experience, exposes a critical financial mistake – PEOPLE.   Join us as Ronda explains how your team can be the ultimate asset or the ultimate demise  of a dental practice. Your dream dental office flourishes when your team…

Cultivate Leadership within Your Dental Team

By Dawn Patrick | August 28, 2023

Cultivating Leadership in Your Dental Team: Empowerment Strategies for Practice Success By: Dawn Patrick A successful dental practice is built upon more than just clinical expertise; it thrives when every member of the team embraces leadership qualities. Transforming your dental team into a group of empowered leaders can foster a dynamic environment, enhance patient experiences,…

Dental Fuel Episode 13: Clinical Mistake with Ronda Holman

By Ronda Holman | August 25, 2023

This week on Dental Fuel Episode 13, Ronda Holman, a passionate dental assistant unleashes 24 years of wisdom and shares her insights on not letting feelings fester within your dental team. In the ever-changing world of dentistry addressing clinical mishaps promptly is key to creating a collaborative environment. Ronda specializes in helping to create the…

Choosing the Right Color Palette for Your Dental Office

By David Rice | August 22, 2023

By: A-dec With design, we surround ourselves with color that affects mood, energy, and mindfulness. And design trends continually transform. In 2023, we see a return to moody tones that represent strength, earthiness, positivity, and biophilic design, which brings the awe of our planet into our spaces and connects us with the natural environment. Biophilic…