VDO increase: Definition, Uses, and Clinical Overview

Posted on February 27, 2026 | by drdental

Overview of VDO increase(What it is)

VDO increase means raising the vertical dimension of occlusion (VDO), which is the distance between the upper and lower jaws when the teeth are together.
It is a planned change in how “open” the bite is when the mouth closes into normal contact.
It is commonly used in full-mouth rehabilitation, treatment of tooth wear, and complex restorative planning.
It can be done temporarily (to test comfort and function) or as part of a long-term restorative solution.

Why VDO increase used (Purpose / benefits)

In dentistry, the bite is not only about how the teeth meet, but also about creating enough space for teeth and restorations to function without overloading them. A VDO increase is used when the existing bite position leaves insufficient restorative space or contributes to an unhealthy pattern of tooth contact.

Common goals and potential benefits include:

Creating restorative space: When teeth are heavily worn or the bite is very “closed,” there may be limited room to rebuild tooth shape with fillings, onlays, crowns, or dentures without making the teeth look bulky.
Re-establishing tooth length and form: Worn front teeth can look shorter and may lose guidance during chewing and speaking. Increasing VDO can help a clinician restore more natural contours.
Improving occlusal relationships: A VDO increase may help reposition contacts so biting forces distribute more evenly across teeth and restorations.
Supporting comprehensive treatment planning: For patients needing many restorations, a controlled bite opening can make it easier to sequence care (temporary phase first, then definitive restorations).
Allowing evaluation before final treatment: A reversible or provisional VDO increase (for example with a splint or provisional build-ups) can help test adaptation in daily life.

How much VDO can or should be increased, and what outcomes are realistic, varies by clinician and case.

Indications (When dentists use it)

Dentists may consider a VDO increase in situations such as:

Generalized tooth wear (erosion, attrition, abrasion) with loss of tooth height
A “collapsed” bite associated with missing back teeth and long-term bite changes
Deep bite situations where restorative space is limited (case-dependent)
Full-mouth rehabilitation requiring coordinated changes to tooth shape and bite contacts
Restoring multiple broken-down teeth where rebuilding at the existing bite would be thin or structurally compromised
Planning for crowns, onlays, veneers, or implant-supported restorations where space is needed for material thickness
Trial therapy using a bite splint or provisional restorations to evaluate comfort and function
Complex esthetic rehabilitation when tooth display and proportions must be re-established (case-dependent)

Contraindications / when it’s NOT ideal

A VDO increase may be less suitable, or may require extra caution and evaluation, in situations such as:

Significant, unresolved jaw joint (TMJ/TMD) pain or acute dysfunction where bite changes could complicate symptom interpretation
Uncontrolled bruxism (clenching/grinding) or heavy bite forces without a protective plan (risk varies by case)
Severe periodontal instability or tooth mobility that limits predictable bite support
Limited remaining tooth structure where adhesive build-ups would be unreliable without additional retention
Patients who have difficulty adapting to bite changes (adaptation varies widely)
Situations where a simpler approach (repairing localized wear or adjusting restorations without changing VDO) would address the problem
Poor plaque control or high caries risk that could reduce restoration longevity unless risk factors are addressed
Lack of posterior support where opening the bite without a stable plan could create uneven contacts

In practice, “not ideal” often means the approach needs modification (temporary phase first, different materials, or a different sequence), rather than being impossible.

How it works (Material / properties)

VDO increase is a treatment concept, not a single material. It describes a change in jaw separation at the bite. Because of that, properties like viscosity or filler content do not apply to “VDO” itself.

However, VDO increase is often achieved using restorative materials and appliances whose properties do matter, such as resin composites, provisional acrylics, or occlusal splints. When additive resin is used to open the bite, the following material concepts are commonly discussed:

Flow and viscosity:
Flowable composites have lower viscosity and can adapt well to tooth surfaces and molds (for example, in “injectable” workflows).
Packable (sculptable) composites are stiffer and may be easier to shape into occlusal anatomy by hand.
Choice often depends on how the bite is being opened (direct build-ups, mock-up transfer, indirect restorations) and the clinician’s technique.
Filler content:
In resin composites, higher filler content is generally associated with improved mechanical properties and reduced shrinkage compared with very low-filled resins, but performance depends on the specific formulation.
Flowable materials typically have lower filler than packable composites, though modern “high-fill flowables” exist. Details vary by manufacturer.
Strength and wear resistance:
For posterior bite build-ups used to maintain a new vertical dimension, clinicians often consider wear resistance and fracture resistance important, especially for patients with heavy biting forces.
The long-term behavior depends on the material, thickness, bonding approach, opposing tooth material, and the patient’s functional habits (for example, grinding).

If a VDO increase is accomplished with crowns/onlays (ceramic or metal-ceramic), the key properties shift toward restoration design, thickness requirements, bonding/cementation strategy, and material-specific wear interactions—again varying by material and manufacturer.

VDO increase Procedure overview (How it’s applied)

There are multiple ways to deliver a VDO increase. The workflow below describes a common additive, adhesive approach using resin materials (often used for a trial phase or as part of definitive treatment). Not every case uses every step in the same way.

Assessment and planning
Records may include photographs, scans or impressions, bite records, and an evaluation of wear patterns and existing restorations. The intended amount and distribution of VDO increase are planned.
Isolation
Teeth are kept clean and dry using methods such as cotton rolls, cheek retractors, or a rubber dam when appropriate. Good isolation supports predictable bonding.
Etch/bond
Enamel and/or dentin are conditioned following the selected adhesive system (for example, phosphoric acid etching when indicated), then primer/adhesive is applied according to instructions.
Place
Composite resin or another restorative material is added to selected teeth to create the planned bite opening. This may be done freehand, with a matrix, or through an injectable/mock-up transfer technique.
Cure
Light-cured materials are polymerized with a curing light in increments or as indicated for the product and thickness.
Finish/polish
The bite is checked and adjusted so contacts are balanced as intended. Restorations are refined, smoothed, and polished to reduce roughness and improve comfort.

In other approaches—such as occlusal splints, provisional restorations, or full-coverage crowns/onlays—the sequence differs (for example, no etch/bond step for a removable splint), but the overall idea remains: a controlled change in the bite is introduced, then refined and monitored.

Types / variations of VDO increase

VDO increase can be delivered in several clinical “formats,” often chosen based on whether the change is meant to be reversible, provisional, or definitive.

Reversible (trial) VDO increase
Occlusal splints (bite guards): A removable appliance can hold the bite at a new vertical dimension and help evaluate comfort and function.
Provisional restorations: Temporary crowns/bridges or provisional overlays can be used to test a planned increase before final restorations.
Additive direct restorations (commonly composite-based)
Posterior composite build-ups: Direct additions to back teeth can open the bite and create space to restore worn front teeth.
Anterior guidance build-ups: Additions to front teeth may be combined with posterior changes depending on the occlusal plan.
Indirect restorations (laboratory-fabricated)
Onlays/overlays: Often used to rebuild worn posterior teeth with controlled anatomy and thickness.
Crowns: Used when teeth require full-coverage restoration due to extensive breakdown or existing restorations.
Dentures or implant-supported restorations: In partially or fully edentulous cases, VDO can be established through prosthetic design.
Material variations when composite is used
Low vs high filler flowable composites: Higher-filled flowables may be considered when greater wear resistance is desired, though performance varies by manufacturer and case.
Bulk-fill flowable composites: Designed for thicker increments in some indications; whether it’s appropriate for occlusal build-ups depends on the product’s indications and clinician judgment.
Injectable composite techniques: Flowable composite is injected through a clear matrix derived from a diagnostic wax-up or digital design to transfer planned contours.

Pros and cons

Pros:

Can create space for restorations without aggressive tooth reduction in some cases
May allow a reversible or provisional test phase before definitive treatment
Can improve the ability to rebuild worn tooth anatomy and function
Often supports more organized full-arch treatment planning and sequencing
Additive approaches may be repairable and modifiable over time (material-dependent)
May help distribute contacts differently when the existing bite is unstable or heavily worn
Can be combined with multiple restorative options (direct, indirect, removable)

Cons:

Adaptation varies; some patients notice temporary changes in chewing, speech, or muscle fatigue
If done with composite build-ups, wear, chipping, or debonding can occur depending on forces and material choice
Requires careful planning of occlusal contacts; imbalanced contacts can lead to discomfort or restoration complications
May involve multiple appointments and monitoring, especially in full-mouth cases
Patients with bruxism may require additional protective strategies
Changing VDO can complicate existing bite patterns, and fine-tuning may be needed over time
Definitive restorations at a new VDO can be more complex and therefore more technique-sensitive

Aftercare & longevity

Longevity after a VDO increase depends on both the method (splint, composite, crowns/onlays, dentures) and the patient’s functional environment.

Key factors that commonly influence durability and comfort include:

Bite forces and habits: Heavy chewing forces, clenching, and grinding can accelerate wear or cause chipping, especially in additive resin phases.
Oral hygiene and caries risk: Plaque control and diet-related risk factors affect the margins and surfaces of restorations.
Regular follow-up: Bite adjustments and monitoring can matter because small high spots or shifting contacts may affect comfort and restoration stress.
Material selection and thickness: Different materials have different wear behavior and fracture resistance; outcomes vary by material and manufacturer.
Opposing teeth/materials: Wear patterns can change depending on what the restorations bite against (natural enamel, composite, ceramic, metal).
Periodontal support and tooth stability: Teeth with reduced support may respond differently to changes in occlusal loading.
Protective appliances (when indicated): Some patients are managed with an occlusal guard, particularly when grinding is present (use and benefit vary by case).

A practical expectation is that a VDO increase often involves an adaptation and refinement period, especially when it is introduced in a reversible or provisional way.

Alternatives / comparisons

Because VDO increase is a strategy rather than a single product, “alternatives” usually mean different ways to create space, restore wear, or manage the bite.

VDO increase vs restoring at the existing bite
Restoring at the current VDO may be possible in localized wear or limited restorative needs.
When space is insufficient, restoring without opening the bite can force restorations to be thin or over-contoured, which may affect function and cleansability.
Direct composite (flowable vs packable) for additive build-ups
Flowable composite: Often adapts well to matrices and small irregularities; may be used in injectable workflows. Wear resistance varies widely among products.
Packable/sculptable composite: Often preferred when hand-shaping occlusal anatomy; may feel more controllable for building cusps and ridges.
In practice, clinicians may layer or combine viscosities depending on the goal.
Glass ionomer (GI)
GI materials can chemically bond to tooth structure and release fluoride, which can be helpful in certain risk profiles.
Compared with resin composites, many conventional GI materials are generally considered less wear-resistant for heavy occlusal contacts, so their role in maintaining a long-term VDO increase may be limited (case-dependent).
Compomer (polyacid-modified resin composite)
Compomers sit between GI and composite in certain handling and fluoride-release characteristics.
They are more commonly discussed in specific restorative contexts (often pediatric or low-stress areas), and their suitability for occlusal VDO build-ups depends on product indications and clinician preference.
Indirect ceramic or metal-based restorations
Onlays/overlays and crowns can provide controlled anatomy and may offer different wear behavior than direct resin.
They are typically more involved in terms of preparation, lab steps, and cost structure, and reparability differs by material.
Occlusal splints as an alternative (reversible trial)
A splint can change the bite without permanently altering tooth surfaces.
It does not rebuild tooth shape the way restorations do, but it can be useful for evaluation and stabilization in selected cases.

Common questions (FAQ) of VDO increase

Q: What does VDO mean in dentistry?
VDO stands for vertical dimension of occlusion, the facial height when the teeth are in contact. It is one way clinicians describe how “open” or “closed” the bite is. It’s assessed alongside other factors like tooth wear, jaw position, and function.

Q: Is VDO increase the same as “opening the bite”?
In everyday language, yes—“opening the bite” is a common way to describe a VDO increase. Clinically, it means increasing the jaw separation at the bite in a controlled way. The amount and location (front vs back teeth) depend on the treatment plan.

Q: Does a VDO increase hurt?
Many people do not experience sharp pain from the bite change itself, but some may notice temporary muscle fatigue, chewing awkwardness, or sensitivity if restorations are involved. Comfort varies by individual and by how the change is introduced. Any persistent or worsening pain should be evaluated by a dental professional.

Q: How long does it take to get used to a VDO increase?
Adaptation time varies by clinician and case. Some patients adjust quickly, while others need a longer period with minor bite refinements. A provisional or reversible phase is sometimes used to observe tolerance before final restorations.

Q: How long does a VDO increase last?
The concept can be long-term, but the durability depends on the method used. A removable splint lasts as long as it is worn and maintained; composite build-ups or crowns have lifespans influenced by wear, bonding, hygiene, and bite forces. Longevity varies by material and manufacturer.

Q: Is VDO increase reversible?
Some approaches are largely reversible, such as an occlusal splint or provisional overlays. Other approaches—especially those involving tooth preparation for crowns—are not fully reversible. Many treatment plans intentionally start with a reversible or minimal-change phase.

Q: Will my speech or appearance change?
A change in bite position can affect how the teeth come together during speech, especially for “s” and “f” sounds, and it may change tooth display. Some changes are temporary as the tongue and muscles adapt. Visible changes depend on how much tooth length and contour are restored.

Q: Is VDO increase safe?
It is a commonly used concept in complex restorative dentistry, but outcomes and risks depend on diagnosis, planning, and execution. Adaptation and comfort vary, and there can be trade-offs such as restoration maintenance or the need for adjustments. Safety and suitability are case-dependent and should be evaluated clinically.

Q: How much does VDO increase cost?
Cost varies widely because a VDO increase can be achieved with anything from a removable appliance to comprehensive full-arch restorations. The number of teeth involved, materials, lab work, and appointment time all influence total cost. A dental office typically provides an estimate after records and planning.

Q: Do I always need crowns for a VDO increase?
Not always. Some cases use additive composite build-ups, onlays/overlays, dentures, or a splint-based trial before deciding on definitive restorations. The choice depends on tooth condition, esthetic goals, functional demands, and long-term maintenance considerations.