TEETH LOSS OF

Summary

The veteran served from July 1976 to August 1979. This case comes before the Board of Veterans' Appeals (Board) on appeal from a March 2021 decision by the Department of Veterans Affairs (VA) Regional Office (RO). The veteran sought a compensable rating for loss of teeth, specifically related to maxilla injury residuals and dental trauma, contending that his mouth and gums constantly hurt, making it difficult to eat, speak, and wear dentures. The Board reviewed multiple VA dental examinations from June 2019, October 2019, December 2019, and March 2021. These examinations indicated that while the veteran experienced tooth loss and issues with dentures, the loss of masticatory surface was less than 25 percent and replaceable by prosthesis. Examiners attributed some tooth loss to non-service-connected periodontal disease and post-accident home healthcare, while noting that only a portion of the lost teeth were service-related. The Board found that the evidence weighed against a claim for a compensable rating, as the loss was replaceable by prosthesis and limitations were largely due to non-service-connected conditions. The Board also considered a derivative claim for Total Disability based on Individual Unemployability (TDIU), raised by the veteran's representative in July 2025, in part due to his service-connected teeth disability. As this TDIU claim had not been initially adjudicated by the RO, the Board remanded the matter for adjudication of the TDIU claim.

Rationale

Loss of masticatory surface less than 25 percent and replaceable by prosthesis.; Non-service-connected gum disease and other teeth disabilities contributed to limitations.; Evidence weighs against claim for compensable rating.

Full Decision Text

Citation Nr: A26039868
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 210914-184981
DATE: April 29, 2026

ISSUES

Entitlement to a compensable rating for loss of teeth (previously evaluated as maxilla injury residuals, status post dental trauma).  

Entitlement to a total disability rating based on individual unemployability (TDIU).

ORDER

Entitlement to a compensable rating for loss of teeth (previously evaluated as maxilla injury residuals, status post dental trauma) is denied.

REMANDED

Entitlement to TDIU is remanded.

FINDINGS OF FACT

1. The Veteran's service-connected teeth disability, which impacts tooth #s 7,8,9 and 10 cause the loss of masticatory surface of less than 25 percent that can be restored by suitable prosthesis.

2. The Veteran's non-service connected teeth and gum disabilities cause difficulty with the Veteran properly wearing dentures.  

CONCLUSION OF LAW

The criteria for entitlement to a compensable rating evaluation of loss of maxilla have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.150, Diagnostic Code (DC) 9913.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran had active service from July 1976 to August 1979.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2021 decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). 

In the September 2021 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Hearing docket.  Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing.  38 C.F.R. §?20.302(a).

In April 2025, the Veteran, through written correspondence, withdrew his hearing request.  Therefore, the Board finds that there is no outstanding hearing request and will proceed with adjudication on the merits. 

In a July 2025 Representative's Brief, the Veteran's representative raised the issue of entitlement to TDIU, in part, due to his service-connected teeth disability.  See Rice v. Shinseki, 22 Vet. App. 447 (2009).  As the record now raises a question of whether the Veteran is unemployable due to his service-connected disabilities, a claim for entitlement to TDIU is properly before the Board.

The Board notes that the Veteran has filed 3 other VA Form 10182s (Docket Nos. 210914-185707; 211123-200288; and 221208-318652).  Those issues will be addressed in separate decisions. 

Entitlement to a compensable rating for loss of teeth (previously evaluated as maxilla injury residuals, status post dental trauma).  

The Veteran contends that he is entitled to a compensable rating for his teeth related disability because his entire mouth and gums constantly hurt and he is unable to properly wear dentures.  See May 2025 correspondence. He also contends that it is painful to eat and difficult to speak.  Id.  Finally, he contends that he is unable to eat properly and bridges won't fit due to loss of use.  See August and November 2019 VA Form 21-526 EZ. For the reasons explained below, the Board finds that a compensable rating is not warranted.

The Veteran is currently rated by analogy for his loss of teeth under Diagnostic Code 9913. 

Under Diagnostic Code 9913, which is for the loss of teeth due to loss of substance of body of maxilla or mandible without loss of continuity, a noncompensable rating is warranted for loss of teeth where the loss of masticatory surface can be restored by suitable prosthesis.  Where the loss of masticatory surface cannot be restored by suitable prosthesis, a 10 percent rating is assigned for loss of all upper and lower teeth on one side, all lower anterior teeth, or all upper anterior teeth.  A 20 percent rating is assigned for loss of all upper and lower anterior teeth, or all upper and lower posterior teeth.  A 30 percent rating is assigned for loss of all lower teeth or all upper teeth.  A 40 percent rating is assigned for loss of all teeth.  38 C.F.R. § 4.149, Diagnostic Code 991
ensable rating is warranted for loss of teeth where the loss of masticatory surface can be restored by suitable prosthesis.  Where the loss of masticatory surface cannot be restored by suitable prosthesis, a 10 percent rating is assigned for loss of all upper and lower teeth on one side, all lower anterior teeth, or all upper anterior teeth.  A 20 percent rating is assigned for loss of all upper and lower anterior teeth, or all upper and lower posterior teeth.  A 30 percent rating is assigned for loss of all lower teeth or all upper teeth.  A 40 percent rating is assigned for loss of all teeth.  38 C.F.R. § 4.149, Diagnostic Code 9913.

Diagnostic Code 9913 also provides a Note stating that the ratings apply only to bone loss through trauma or disease such as osteomyelitis and not to the loss of the alveolar process as a result of peridental disease, since such loss is not considered disabling.

Initially, the Veteran was granted service connection for residuals of a maxilla injury under Diagnostic Code 9915.  Under Diagnostic Code 9915, a noncompensable rating was warranted for loss of less than 25 percent of the maxilla, which is replaceable by prothesis.  Compensable ratings were available where there was evidence moderate malunion of nonunion of the maxilla or loss of less than 25 percent of the maxilla, which was not replaceable by prosthesis.  

VA treatment records indicate that the Veteran had multiple extractions of his teeth.  See October 2018 VA dentistry note.  

In June 2019, the Veteran was afforded a VA oral and dental conditions examination where the examiner noted that the Veteran suffered from periodontal disease and maxilla injury residuals, status post dental trauma.  The examiner did not indicate any mandible of maxilla condition.  The examiner also opined that the Veteran's masticatory surfaces could be restored by a suitable prosthesis.  "The restoration placed in 1978 had recurrent infections and the VA dental clinic extracted the remaining maxillary teeth and constructed a complete upper denture and lower partial denture."  The examiner explained that a portion of the Veteran's teeth (7,8,9,10) that were removed were service related.  However, another portion of his teeth (3,4,5,6,11,12) that were removed were not attributed to service.  Further, the examiner opined that the Veteran's periodontal condition was a result of plaque and tarter build up and was not service-connected. 

In October and December 2019, the Veteran was afforded VA examinations where the examiner noted gingival trauma due to ill-fitting denture and partial denture. The examiner noted similar findings to the June 2019 VA examination report, including that the Veteran's masticatory surfaces could be restored by a suitable prosthesis.  The examiner further noted that the Veteran needed, "either new upper complete denture and lower partial denture made or to have the current ones properly relines and adjusted."

The Veteran was most recently afforded a VA examination in March 2021 where the examiner noted a maxilla condition.  The examiner noted that the Veteran lost less than 25 percent of his maxilla, but noted that it was replaceable by prosthesis.  The examiner explained that 4 of the Veteran's teeth were lost in an in-service sports accident and were replaced by a bridge.  The examiner further explained that the Veteran lost additional teeth after the in-service accident which resulted in a minimal maxillary and mandibular alveolar ridge for a denture to work effectively.  The examiner differentiated the post-accident tooth loss and attributed it to the Veteran's home health care.  Finally, the examiner found that the Veteran's posterior teeth were not related to service. 

Based on the foregoing, the Board finds that the assigned noncompensable rating is the most appropriate rating.  In that regard, the Veteran assigns probative value to the VA examination reports which note the Veteran's complaints and limitations due to his service-connected teeth disability.  Of note, is the complexity of the Veteran's non-service-connected gum disease and other teeth disabilities.  The VA examiners addressed these complexities in their opinions.  The evidence indicates that the Veteran does not suffer from a loss of masticatory surface of more than 25 percent that cannot be restored by suitable prosthesis.  The examiners noted that the Veteran was fitted for dentures and at some point needed to have them relined.  The March 2021 examiner noted that due to the Veteran's non-service connected teeth loss, it was difficult for a denture to work properly.  The Veteran is not entitled to compensation for non-service connected symptoms. 

The Board also assigns
 limitations due to his service-connected teeth disability.  Of note, is the complexity of the Veteran's non-service-connected gum disease and other teeth disabilities.  The VA examiners addressed these complexities in their opinions.  The evidence indicates that the Veteran does not suffer from a loss of masticatory surface of more than 25 percent that cannot be restored by suitable prosthesis.  The examiners noted that the Veteran was fitted for dentures and at some point needed to have them relined.  The March 2021 examiner noted that due to the Veteran's non-service connected teeth loss, it was difficult for a denture to work properly.  The Veteran is not entitled to compensation for non-service connected symptoms. 

The Board also assigns probative value to the Veteran's statements regarding the symptoms he suffers.  However, as noted above, many of the Veteran's reported limitations are attributable to his non-service connected gum and teeth disability.  The limitations that are attributable to the service-connected teeth disability do not rise to the level of a compensable rating.  

For these reasons, the Board finds that the evidence weighs persuasively against the claim for a compensable rating for loss of maxilla as the loss is less than 25 percent and is replaceable by prosthesis. Because the evidence weighs substantially against the claim, the benefit of the doubt doctrine is not for application. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Accordingly, the claim for a compensable rating is denied.

REASONS FOR REMAND

Entitlement to TDIU

According to the Appeals Modernization Act (AMA) framework, the Board's jurisdiction to infer a TDIU claim under Rice v. Shinseki, 22 Vet. App. 447 (2009), is limited to when an increased-rating claim has been appealed and evidence of unemployability related to the appeal period is submitted during an eligible evidence-submission window.

As noted above, in July 2025, the Veteran, through his representative, raised the issue of entitlement to TDIU.  Thus, according to the holding in Rice, there is a derivative TDIU claim that has not been initially adjudicated by the RO. Therefore, the Board finds that there is a pre-decisional error that must be remanded.

The matters are REMANDED for the following action:

Adjudicate the claim for a TDIU.  See July 2025 correspondence where the representative raises the issue of entitlement to TDIU as part and parcel of the increased rating claim.

 

 

CHRISTOPHER A. WENDELL

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Baskerville, L.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.