Reverse Dahl Technique for Localised Posterior Tooth Surface Loss – PDP235

Can you apply the Dahl technique to localised POSTERIOR wear?

Spoiler alert: hell yeah!

How can the Dahl Technique help when there is posterior wear and NO space to restore?

How predictable is building up posterior teeth (rather than the usual worn anteriors)?

In this episode, Jaz dives into the ‘Reverse Dahl Technique’, a twist on the classic method typically used for localized anterior wear. Dr. Hans Kristian Ognedal from Norway shares his insights, explaining how building up posterior teeth with composite can lead to occlusion magic! 

If you’re curious about this technique and want to see a real-life case study, this episode breaks it all down, with a special visual breakdown for those watching on YouTube or Protrusive Guidance.

Protrusive Dental Pearl: Jaz shares insights from Hold On to Your Kids by Dr. Gordon Neufeld & Dr. Gabor Maté, emphasizing how modern children lose parental attachment too soon, turning to peers for guidance. This shift can lead to anxiety and emotional disconnection. 

Takeaway: Kids thrive when their primary attachment remains with parents, not peers. Strengthening this bond is crucial for healthy development. 

Key Takeaways

• The traditional Dahl principle focuses on creating occlusal space for anterior crowns.
• The reverse Dahl technique is a direct method for treating worn POSTERIOR teeth.
• Diet plays a significant role in tooth wear and dental health.
• Taking photographs of patients’ teeth can help track wear over time.
• Understanding the etiology of tooth wear is crucial for effective treatment.
• Building up dental anatomy is essential for successful restorations.
• Occlusion should be viewed as a dynamic system rather than a static one. 
• Patients can adapt well to this treatment modality
• “Patients that wear their teeth, they don’t usually have TMJ problems.”

Highlights of this episode:

• 02:22  Protrusive Dental Pearl
• 04:50 Guest Introduction: Dr. Hans Kristian Ognedal
• 07:06 Understanding the Original Dahl Concept
• 09:31 Exploring Reverse Dahl Technique
• 13:30 Etiology and Patterns of Tooth Wear
• 23:46 Facial Patterns and Occlusal Traits Linked to Wear
• 24:44 Clinical Approach to Posterior Wear
• 30:26 Patient Comfort and Staging Treatments
• 32:11 Cuspal Planes and Guidance
• 34:21 Review Schedule and Observations
• 38:44 Longevity of Treatments
• 44:04 Contraindications and Patient Selection 
• 45:24 Case Studies and Practical Tips
• 49:30 Night Guard Use
• 53:06 Final Thoughts and Education Opportunities

If you want to learn more about Dahl Technique, be sure to listen/watch:

• Why do some Dentists find Dahl Distasteful? – PDP016
• Dahl Part 2 (The Spicy Bit) – PDP017
• Dahl Technique and ‘Maryland Bridges’ – GF001

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes B and C.

AGD Subject Code: 180 OCCLUSION (Occlusal functional concepts)

Aim: To explore and understand the Reverse Dahl Technique, focusing on its application for patients with localized posterior tooth wear. This technique provides a solution when posterior teeth are worn, and there is insufficient space for proper restoration.

Dentists will be able to –

1. Understand the principles behind the Reverse Dahl Technique and how it differs from the traditional Dahl Technique.

2. Identify the clinical scenarios where the Reverse Dahl Technique can be applied.

3. Comprehend the role of composite build-up in restoring posterior wear and its impact on occlusal reestablishment.