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Are you confident when increasing the vertical dimension?
How do you plan, stage, and sequence a full-mouth case safely?
What’s the right deprogramming method—leaf gauge, Kois appliance, or something else?
Dr. David Bloom joins Jaz in this powerhouse episode to demystify the real-world process of increasing vertical dimension. With decades of experience in comprehensive dentistry, David shares how he approaches diagnosis, bite records, temporization, and final restorations—with predictability and confidence.
Protrusive Dental Pearl: Pick one occlusal philosophy and stick with it until you understand it well through real cases. Once you’re confident, stay open to other approaches—hearing different views will make you smarter, more flexible, and a better dentist.
If you are looking to get started with the foundations of Occlusion, check out our comprehensive Online Occlusion Course.
Need to Read it? Check out the Full Episode Transcript below!
Highlights of this episode:
- 00:00 Trailer
- 00:55 Introduction
- 04:43 Guest Introduction: Dr. David Bloom
- 10:25 Equilibration Techniques Explained
- 11:18 Interjection #1
- 15:50 Opening Vertical Dimension vs. Orthodontics
- 18:06 Interjection #2
- 23:05 Whitening and Restorative Solutions
- 25:27 Guidelines for Raising Vertical Dimension
- 25:52 Interjection #3
- 29:28 Midroll
- 32:49 Guidelines for Raising Vertical Dimension
- 36:06 Visual Try-In and Adapting Vertical Dimension
- 40:16 Case Planning and Execution
- 41:16 Interjection #4
- 43:42 Case Planning and Execution
- 50:23 Material Preference for Provisionals
- 52:00 Bite Registration and Final Adjustments
- 55:06 Do’s and Don’ts for Clinicians
- 57:15 Conclusion and Resources
- 58:59 Outro
Key Takeaways
- Vertical Dimension and Adaptation: Opening the vertical dimension in dentistry can be challenging, especially for edentulous patients who lack proprioception. However, with proper planning and understanding of occlusion, the human body can adapt remarkably well.
- Occlusal Philosophy: It’s important to learn one occlusal philosophy well, whether it’s Kois, Dawson, or another. Understanding different approaches can make you a more rounded clinician, as different patients may benefit from different methods.
- Equilibration and Deprogramming: Equilibration is crucial for idealizing occlusion by eliminating interferences. Deprogramming helps in achieving centric relation, a stable and repeatable position for the condyles, which is essential for successful equilibration.
- Orthodontics vs. Vertical Dimension: Deciding between orthodontics and opening the vertical dimension depends on the specific case. For example, pre-aligning patients with orthodontics might be necessary to address a restricted envelope of function.
- Testing and Adaptation: Testing the vertical dimension with transitional materials like composite can help patients adapt before moving to definitive restorations. Experienced clinicians may sometimes proceed directly to final restorations based on their judgment and diagnostic steps.
Get CE/CPD for this episode only on the Protrusive Guidance App.
🖥️ A new website is launching soon by Dr. David Bloom — ppcontinuum.com
Also, Dr. David Bloom’s hands-on courses on veneers and minimally invasive dentistry
If you found this episode valuable, you’ll definitely want to watch PDP197: Vertical Dimension – Don’t Be Scared!, part of Occlusion Month.
#PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry
This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcomes B and C.
AGD Subject Code: 180 OCCLUSION (Occlusal therapy)
Aim:
To provide clinicians with a comprehensive understanding of how to safely and predictably increase the vertical dimension of occlusion (VDO) for restorative cases, using a diagnostic-driven, conservative, and patient-centred approach.
Dentists will be able to:
- Describe the indications and contraindications for increasing VDO.
- Differentiate between conformative and reorganized approaches to occlusal rehabilitation.
- Identify the steps involved in diagnostic planning, including CR bite records, wax-ups, and visual try-ins.
