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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3 Simple PPO Revenue Optimization Tips Every Practice Should Know

By Angela Holland | October 20, 2025

By: Angela Holland, Founder of Preferred Dental SolutionsInsurance Expert and Strategy Consultant for Dental PracticesPreferredDentalSolutions.com Dentistry is a business of both skill and strategy. Delivering excellent care is non-negotiable, but maximizing what you’re paid for that care requires an intentional approach to PPO management.  Here are three powerful ways to optimize your revenue from a…

Tofflemire vs. Palodent: Why Your Contacts Will Suck…at First

By Michael Eid | October 13, 2025

By: Michael Eid Your first few Class II restorations will probably have open contacts, flat contours, or a ridge you’ll want to cry over. That’s normal. Getting good proximal contacts isn’t just about packing composite; it’s about mastering your matrix system. Here’s what I learned the hard way.  1. Tofflemire Feels Safe: But It Lies to…

Seasonal Nutrition for Busy Dental Teams

By Sable Muntean | October 13, 2025

By: Dr. Sable Muntean Fueling Long Clinic Days with Fall Flavors The fall season invites cozy sweaters, crunchy leaves, and pumpkin‐spiced treats. For dental professionals juggling back-to-back appointments, administrative tasks, and patient care, it’s all too easy to let nutrition slip. But fueling your body well is one of the best investments you can make,…

Ergonomic Loupes: Improve Vision and Extend Your Dental Career 

By Dr. Lee Ann Brady | October 13, 2025

By: Lee Ann Brady, DMDThis topic originally appeared on PankeyGram.org. Dr. Brady granted permission for igniteDDS to share with our readers. As a dentist, I’ve always been dedicated to providing the best possible care for my patients. But over the years, I realized that I needed to prioritize my own well-being as well. One area…

Paying Off Student Loans Early vs. Investing: A Smart Strategy

By Todd Doobrow, CFP | October 13, 2025

By: Todd Doobrow, CFP As a dentist, you’ve likely emerged from dental school with some amount of student loan burden. According to the ADA, the average dental school graduate owes over $290,000 in student loans. Faced with this debt, many dentists debate taking one of two actions, often based solely on the actions their peers…

Fall Into Balance: How Dentists Can Recharge This Season

By Sable Muntean | October 6, 2025

By: Dr. Sable Muntean As the air turns crisp and the leaves begin to change, fall brings a gentle reminder that it’s okay to slow down. For dentists, who often spend long hours focusing on precision, patient care, and practice demands, the idea of slowing down can feel foreign, or even impossible. But just as…

Increasing Case Acceptance Through Hygienist-Led Conversations

By Dr. Clayton Davis, DMD | October 6, 2025

By: Clayton Davis, DDSThis topic originally appeared on PankeyGram.org. Dr. Davis granted permission for igniteDDS to share with our readers. What if your hygiene team could help patients commit to treatment—before you even walk into the room?15 years ago, while visiting New York City, I dropped by a high-performing dental practice I’d heard a lot…

Why Having an Insurance Expert on Speed Dial Is No Longer a Luxury… It’s a Necessity for 2026

By Angela Holland | October 6, 2025

By: Angela Holland, Founder of Preferred Dental SolutionsInsurance Expert and Strategy Consultant for Dental PracticesPreferredDentalSolutions.com The dental insurance landscape is constantly changing: carrier consolidations, new shared agreements, and ever-shifting reimbursement models. Managing it all while running a practice is like trying to fix a car engine while driving down the highway. It’s no wonder more…

How To Win at Work & at Home 

By Dr. Eric Recker | September 30, 2025

By: Dr. Eric Recker Check out this scenario. You have had a day. Again. They seem to be happening more frequently, and it is getting harder to keep them to yourself. You are starting to realize you are at least a little bit fried, and you aren’t quite sure what to do about it. You…

Guiding Patients with Empathy & Purpose: Your Blueprint for Leadership in Dentistry

By Dr. Paul Henny, DDS | September 29, 2025

By: Paul Henny, DDSThis topic originally appeared on PankeyGram.org. Dr. Henny granted permission for igniteDDS to share with our readers. Effective leadership in dentistry isn’t just about clinical excellence—it’s also about empathy, adaptability, assertiveness, and clear communication. That’s a powerful (and sometimes challenging) combination. In the pressure of a busy practice, it’s easy to default…