Molar-incisor hypomineralization (MIH) is a developmental enamel hypomineralized condition characteristically involving the first permanent molars and sometimes also the incisors. The affected teeth are predisposed to tooth surface loss (TSL) which may not only compromise the esthetics and function but also endanger the pulp and longevity of the teeth. This report describes the management of a patient with MIH complicated with localized TSL and lack of occlusal clearance due to dentoalveolar compensation. The atypical TSL pattern involved all anterior teeth and required the placement of Dahl appliances on both arches. Keywords: Dahl concept, erosion, minor axial tooth movement, molar-incisor hypomineralization, tooth surface loss, tooth wear