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…

Read More
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…

Read More
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…

Read More

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….

Read More
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…

Read More
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…

Read More
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…

Read More
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…

Read More
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…

Read More
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…

Read More

Dental Fuel Episode 7: Team Mistake with Dr. Emma Guzman-Vizcarrondo

By Tanya Sue Maestas, DDS | July 14, 2023

Growing your team can be challenging as a new dentist. On Dental Fuel Episode 7, Dr. Emma Guzman shares her experience in making a mistake when working in a team and how it shaped her growth! Dr. Emma Guzman is a General and Cosmetic Dentist, practicing in New York City. She completed her Doctor of…

Crown Wars: Lithium Disilicate vs Zirconia

By David Rice | July 11, 2023

By: Dr. David Rice Lithium Disilicate vs Zirconia? When it comes to selecting the best material for your patient’s crown, you have options. The question is, which option is best, when, and why. Lithium Disilicate: Advantages 👍 Strength At 550 MPa and excellent fracture toughness, Lithium Disilicate weighs in well. Although I prefer to bond…

Dental School Graduate: Now What!?

By Dr. Bri Torgerson | July 10, 2023

By: Dr. Bri Torgerson So, you’ve just graduated from dental school, now what? First, of all, congratulations, you have done it; you’ve graduated dental school or maybe you’ve graduated and you have your final clinical boards to pass. Regardless, you did it, which is a feat in and of itself! Taking Your Final Clinical Boards…

Dental Fuel Episode 6: Financial Mistake with Dr. Emma Guzman-Vizcarrondo

By Tanya Sue Maestas, DDS | July 7, 2023

On Dental Fuel episode 6, Dr. Emma Guzman speaks FACTS, sharing a financial mistake she has made and a reminder to know your worth! Very insightful and a lesson that we can all learn from! Dr. Emma Guzman is a General and Cosmetic Dentist, practicing in New York City. She completed her Doctor of Dental…

Dear New Resident: Tips to Transitioning from Dental School to Residency

By Savanah Craig | July 3, 2023

By: Savannah Craig Deciding to pursue a residency program is a big decision and there are a lot of reasons why someone would choose to pursue a residency program. Spending a year as a resident was truly the best decision I’ve ever made, but like anything, there are ups and downs.  The Transition from Dental…

Dental Fuel Episode 5: Clinical Mistake with Dr. Emma Guzman-Vizcarrondo

By Tanya Sue Maestas, DDS | June 30, 2023

On Dental Fuel episode 5, we are pleased to welcome Dr. Emma Guzman-Vizcarrondo! Dr. Emma Guzman is a General and Cosmetic Dentist, practicing in New York City. She completed her Doctor of Dental Surgery degree at the University at Buffalo School of Dental Medicine and was a general practice resident at Bronx Care in the…

Dental SEO: Your Guide to Conquering Google

By Sean Hamel | June 27, 2023

By: Sean Hamel What is Dental SEO? Dental SEO, or dental search engine optimization, is the process of optimizing your dental practice’s website to improve its visibility in search engine results pages (SERPs). By implementing effective SEO strategies, you can ensure that your website ranks higher in search results when potential patients search for dental…

Dental Patient Communication: Tips for a Successful Outcome

By Dawn Patrick | June 26, 2023

By: Dawn Patrick In the realm of dental care, effective communication between dental teams and patients plays a pivotal role in establishing trust, improving treatment outcomes, and fostering a positive dental experience. Beyond technical expertise, the ability to communicate with empathy, clarity, and transparency is essential for creating a comfortable and supportive environment for patients….

Knowledge of Operating a Dental Practice: Job Options Abound

By Bruce Bryen | June 20, 2023

By: Bruce Bryen Dental school is over as is the training as an associate dentist working for a local, single-owner office. Was the education as an associate enough to take on the responsibilities of being the top person at a dental practice where you are the owner? Think about what you have absorbed and what…

Consider the Freedom of a Dental House Call Practice

By Ashleigh Robinson | June 19, 2023

By: Ashleigh Robinson Before you start or acquire a traditional dental practice, consider an alternative practice model designed to meet the needs of patients who struggle to receive care by making dental house calls. This model could offer major benefits to you as well. If you have been looking to delve into practice ownership, you…