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 Many Days Have You Missed?

By Dr. Eric Recker | November 3, 2025

By: Dr. Eric Recker This past weekend, I got sick. I will spare you the details, but let’s just say that sometimes you go to sleep at night with a high level of confidence that your stomach contents will be leaving before morning. That was my Saturday night. Sunday was followed by serious chills until about…

Professional Development that Actually Works

By Garrett Wilson | November 3, 2025

By: Garrett Wilson Professional development is one of the top five benefits dental professionals are looking for from their employers, according to our research, which surveyed over 1,000 dental professionals across the country. But there’s a catch: development cannot be forced. As a leader, you can’t care about someone’s development more than them. The best…

Achieve Superior Provisionals with Matrix1

By Dr. Kelley Brummett, DMD | November 3, 2025

By: Kelley Brummett, DMD This topic originally appeared on PankeyGram.org. Dr. Brummett granted permission for igniteDDS to share with our readers. When it comes to delivering provisional molds, precision is paramount. A well-made dental provisional not only ensures patient comfort but also sets the stage for a seamless crown preparation. In my practice, I’ve found that the material used…

Deep Marginal Elevation: What It Is, Why It Matters, & How to Learn the Basics

By Michael Eid | October 27, 2025

By: Michael Eid Your first deep marginal elevation (DME) will test every bit of patience you have. The matrix won’t seal, saliva will creep in, and you’ll start questioning why a class 2 is becoming this difficult. But once you understand why you’re doing it and how to do it right, DME becomes one of the…

Gratitude in the Operatory: Finding Joy in the Everyday Practice

By Sable Muntean | October 27, 2025

By: Dr. Sable Muntean As November rolls in and the holiday season approaches, many of us in the dental profession find ourselves reflecting on what we’re thankful for, in life and in practice. Dentistry can be fast-paced and demanding, but it’s also a career filled with opportunities to touch lives in meaningful ways.  Discovering Joy…

Blessing or Curse? The 4 O’Clock Dilemma

By Ronda Holman | October 27, 2025

By: Ronda Holman It’s 3:55 p.m. on a Thursday. The 4 o’clock patient just canceled. You can almost hear the sighs of relief ripple through the back office—until the dentist pops their head in and says, “Let’s fill that spot with a root canal!” For the doctor, this is a victory. The schedule stays full, production…

Correcting Patients’ F & V Sounds During Restorative Dental Treatment

By Dr. Lee Ann Brady | October 27, 2025

By: Lee Ann Brady, DMDThis topic originally appeared on PankeyGram.Org. Dr. Brady granted igniteDDS permission to share with our readers. Following on the last article about correcting the S sound, I want to take a look at two other phonetically similar sounds, F and V, that affect our restorative dental treatment results. The good news is that…

From Scramble to Strategy: Making Q4 Your Most Profitable Quarter

By Dawn Patrick | October 27, 2025

By: Dawn Patrick, Dental Business Coach and Director of Operations, IgniteDDS  Every fall, dental practices face the same challenge: by the time they remember that October through December holds the highest patient demand, half the opportunity is gone. With September behind us, now is the moment to get intentional. Why? Because Q4 is where patient momentum…

🦷🎃 Spooktacular Smiles: Fun Ways to Celebrate Halloween in the Office

By Sable Muntean | October 20, 2025

By: Dr. Sable Muntean Costume ideas, decorating tips, and candy alternatives to keep it dental-friendly! Halloween is a favorite time of year for patients and dental teams alike, a perfect excuse to add a little fun (and maybe a few cobwebs) to your workday! Between the costumes, décor, and community spirit, this spooky season is…

Correcting Patients’ S Sound During Restorative Dental Treatment

By Dr. Lee Ann Brady | October 20, 2025

By: Lee Ann Brady, DMDThis topic originally appeared on PankeyGram.org. Dr. Brady granted permission for igniteDDS to share with our readers. Patients produce the S sound by creating a small airspace between their upper and lower incisors, and there are three common ways this happens:  In each case, the ideal space for producing the S…