Medicine:Dahl appliance

A Dahl appliance is a dental appliance that includes a flat anterior bite plane that causes a planned posterior disclusion. The Dahl appliance causes Dahl effect dental adaptation; posterior overeruption and mild intrusion of the anterior teeth, creating anterior interocclusal space which may be desired for either orthodontics, restorative dentistry such as restoring non-carious tooth surface loss, or for fixed prosthodontics.

When first described the Dahl appliance was a removable appliance, but fixed cobalt-chrome castings and gold castings have also been used. More recently direct bonded dental composite has been used, especially in when restoring anterior tooth wear.

In patients who have lost their Vertical Dimension of Occlusion (VDO) due to attrition, it is more difficult for the selected teeth to intrude and extrude because their periodontium is so strong.

Patients with known history of temporomandibular disorders (TMDs), periodontal disease, missing molar occlusal units or those previously treated with Dahl's appliance are not good candidates for this sort of treatment modality.

It is very important in patients who have lost their VDO due to any underlying disorder like stress, anxiety, depression or parafunctional habits. It is very important to treat the underlying pathology first and then the symptoms. If the underlying pathology is not treated, then the problem may arise again which can lead to more severe problems.

Recent advancements in this type of treatment modality i.e. fixed dahl's appliance has given the operator remarkable control over the movements of the teeth.

The other method for increasing VDO is provision of the Onlay crown, restorative management i.e. with dental composite.

Due to the increase level of stresses in the paedetric population that will lead to the loss of VDO, so in the paedetric patient, Dahl's appliance treatment is not the treatment of choice because that appliance might interfere with the growth resulting into the growth retardation.