Altering the Vertical Dimension Discussing occlusion with a focus on best practices by Dr. John C. Cranham Dr. John C. Cranham is the clinical director of The Dawson Academy, where he teaches many of the lectures and hands-on courses. He also works full time as a dentist within an aesthetic-oriented practice in Chesapeake, Virginia. Cranham is an internationally recognized speaker with 25 years of experience teaching courses and presenting continuing education sessions to dental professionals. He's been the clinical director of the academy for 10 years and a faculty member for 14 years. 70 The vertical dimension of occlusion (VDO) is a concept that dentists learn about in dental school, but remains one of the most misunderstood and controversial subjects in all of dentistry. Some say it cannot be altered for any reason, others say they do it routinely, and most dentists are probably slightly bothered by the debate, so they simply stay away from thinking about it. This article should help readers understand the critical occlusal goals that will be required should they open the vertical; illustrate the cases when altering the VDO can be helpful; and identify the cases when altering the VDO could increase the probability of instability and ultimately dysfunction. Before that discussion, let's review the critical occlusal goals that must be established on any case that alters the VDO. APRIL 2020 // dentaltown.com DT0420_Cranham_VDO_AG.indd 70 3/19/20 3:20 PMhttp://www.dentaltown.com