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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How Dental Practices Can WIN December Instead of Surviving It

By Dawn Patrick | December 1, 2025

By: Dawn Patrick, Business Strategy Coach, IgniteDDS December can feel like the ultimate scramble. Patients rushing to use insurance, team members juggling time off, and a push to hit year-end goals. But the most successful dental practices don’t just get through December. They leverage it, to finish strong, increase treatment acceptance, and prepare the schedule so…

Early Intervention in Pediatric Dentistry for Better Sleep and Growth

By Dr. Mark Murphy, DDS | December 1, 2025

By: Mark T. Murphy, DDSThis topic originally appeared on PankeyGram.org. Dr. Murphy granted permission for igniteDDS to share with our readers. Sleep is the foundation of a child’s health and development, yet many children struggle with undiagnosed sleep disorders. One of the most overlooked conditions is pediatric sleep apnea, a disorder that can have serious consequences…

The Practice Profitability Playbook: Part 2

By Dawn Patrick | December 1, 2025

Part 2: Financial Control — Show Me the Money in Your Dental Practice By: Dawn Patrick, Business Strategy Coach, IgniteDDS Money makes a practice run, but too often, practices struggle to collect what they earn. Without strong financial control, even busy offices can leave revenue on the table. Financial Control is the system that ensures…

Did Your Dental Assistant Give You Expired Anesthetic Again?

By Ronda Holman | November 24, 2025

If So, Here’s What We Need to Do By: Ronda Holman There’s nothing that sinks a dentist’s stomach faster than spotting an expired anesthetic carpule during a procedure. It’s frustrating, embarrassing, and it instantly breaks the flow of the appointment. But when expired anesthetic shows up repeatedly, it’s rarely because your dental assistant is careless;…

Endo Made Simple Part 1: Caries, Locating Canals, & Initial Access

By Michael Eid | November 24, 2025

By: Michael Eid Before you can shape and clean, you have to get the tooth ready, find the canals, and remove the pulp. Here’s a step-by-step guide for students. Step 1: Remove Caries & Build a Safe Access 🦷 High-Yield Tip: Always think “containment”. Your irrigant must stay inside the chamber. Isolation is the key…

What We’re Really Thankful For: A Note to the Dental Community

By Sable Muntean | November 24, 2025

By: Dr. Sable Muntean As we head into Thanksgiving week, we wanted to pause and offer something simple, but genuine: Thank you. Not in a passing, casual way,  but from a place of true understanding of what this profession asks of you every single day. To the Dentists You are leaders, healers, problem-solvers, and steady…

Fee Negotiation Myths That Keep Dentists Underpaid

By Angela Holland | November 24, 2025

By: Angela Holland, Founder of Preferred Dental SolutionsInsurance Expert and Strategy Consultant for Dental PracticesPreferredDentalSolutions.com There’s a long-standing myth in dentistry that PPO fees are fixed. That’s what you’re paid and it’s what you’re stuck with. Let me be clear: that’s simply not true. Every week, we help dental practices negotiate substantial increases, sometimes 20%,…

Digital Dentistry Workflow: Superior Esthetics and Functionality

By John Cranham, DDS | November 24, 2025

By: John C. Cranham, DDS This article originally appeared on PankeyGram.Org. Dr. Cranham granted permission for igniteDDS to share with our readers. Managing complex esthetic and functional dental cases requires precision, efficiency, and a thorough understanding of occlusion. Traditional analog workflows have served dentistry well, but digital workflows now allow for greater accuracy, predictability, and efficiency….

From Clinician To CEO: Part 2

By David Rice | November 24, 2025

Part 2. Systems Control – Turning Chaos Into Consistency By: Dr. David Rice When a dentist shares they’d like more money and more time off, my first thought is, of course. My second thought is what I know they’re really after: freedom. When most new practice owners feel overwhelmed, it’s rarely because they’re bad at…

How to Actually Unplug This Holiday Season & Why You Should

By Sable Muntean | November 17, 2025

By: Dr. Sable Muntean The holidays are supposed to be the season of peace, rest, and connection, yet for many dental professionals, it ends up being one of the most stressful times of the year. Schedules fill up, year-end production goals loom, and even when the office finally closes for a few days, your mind…