Veterans experience a wide variety of dental conditions, but the VA does not rate many of them. Some service-connected dental disabilities are rated as high as 100%, but veterans can only get a 100% rating if they are missing part of their jaw or for malignant oral tumors. How well a veteran’s jaw functions typically determines a VA disability rating. While some dental issues can be directly service-connected, other common tooth problems can be rated as secondary conditions.
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In this article about VA dental disability benefits:
When people think of dental problems, they tend to think of cavities or root canals. But, there are not many VA disability ratings for teeth because many tooth problems are easily treated and are often unrelated to service. A veteran may be eligible for VA disability benefits if they have lost a part of their jaw or are missing specific groups of teeth and can not be fitted for replacements.
The VA only rates service-connected dental conditions that affect how well the mouth functions in the long term. For example, veterans who lose a significant part of their mandible (jaw bone) or maxilla (front part of the skull under the nose), might have difficulty speaking, and have to modify their food to eat. These veterans could qualify for a 100% rating. However, there are other service-connected disabilities that affect typical jaw function.
Tooth decay can be a secondary condition, but it cannot be directly service-connected. The VA will only rate conditions that have a lasting effect on veterans’ ability to chew or talk.
Service-connected jaw injuries
Most service-connected jaw injuries occur during combat or result from a collision. However, even a simple fall can cause jaw trauma.
Lower jaw (or mandibular) fractures are like any other fracture in the skeletal system–a bone will crack or break under extreme pressure or a forceful impact.
Mandibular fractures are treatable, but the injury can have lasting effects. Some veterans will develop an open bite after treatment. Depending on the severity of the misalignment, they might be able to receive up to a 20% rating.
Trauma to the jaw may also lead to temporomandibular joint dysfunction (TMJ), which is a condition affecting the joints and muscles that connect your jaw to your skull. TMJ often causes pain and reduces jaw movement.
You’ll find TMJ listed as TMD (diagnostic code 9905) in the Schedule of Ratings. A veteran can receive up to a 50% rating for a severe case. Ratings of 10%, 20%, 30%, and 40% are given depending on the degree the person can open his mouth and any dietary restrictions because of the limited ability to chew.
TMJ is also caused by excessive teeth grinding and jaw clenching. Veterans with post-traumatic stress disorder (PTSD) sometimes develop TMJ, which would be a secondary condition of PTSD.
How the VA rates oral conditions
To receive a 100% rating for a dental condition, veterans must have lost at least a portion of their mandible or maxilla (upper jaw) and be unable to use a prosthesis. Veterans can lose portions of their jaw during combat, in a collision, or as a result of surgery. For example, veterans who receive radiation therapy as treatment for a service-connected cancer can develop mandible osteoradionecrosis–a rare side effect that causes parts of the jaw bone to die. This condition often requires surgical intervention to remove dead skeletal tissue.
Dental disabilities are rated under diagnostic codes 9900 to 9918 in the Schedule of Ratings. Here are the ratings for lost sections of the jaw bone and when the jaw bone doesn’t heals in alignment (called a malunion):
| Description/Diagnostic Code | VA rating |
|---|---|
| Complete loss of mandible between angles (9901) | 100% |
| Partial loss of the mandible, impacting articulation (9902) Not replaceable by a prosthesis Replaceable by prosthesis | 70% 50% |
| Partial loss of mandible, not impacting articulation (9902) Not replaceable by a prosthesis Replaceable by prosthesis | 40% Loss of one-half or more 20% Loss of less than one-half 30% Loss of one-half or more 10% Loss of less than one-half |
| Malunion of the jaw (9904) Displacement, causing severe open bite Displacement, causing moderate open bite | 20% 10% |
Veterans can also receive a 100% rating for a malignant (cancerous) oral mass, called a neoplasm. Six months after treatment, the veteran will attend a mandatory examination and be given a new rating. The VA will decide if there has been permanent damage to the veteran’s oral anatomy that further qualifies for VA disability.
Why dental problems are typically secondary conditions
While common teeth problems, like tooth decay, are rarely considered service-connected dental disabilities, they can be a secondary condition to a variety of medical problems.
A veteran can receive a secondary disability rating for any health condition caused by a service-connected disability. This means you will need medical evidence to prove that your dental problem stems from your service-connected condition.
Tooth decay secondary to cancer
There are many cancers that the VA recognizes as service-connected, and cancer treatments may negatively impact your oral health. Chemotherapy and radiation therapy can have a harmful effect on salivary glands. This can make your mouth dry and upset your healthy balance of oral bacteria which can lead to tooth decay.
Tooth decay secondary to asthma
Treatments for asthma can also cause tooth decay. Asthma is an inflammatory condition that constricts airways and causes an overproduction of mucus, restricting breathing. Medication for asthma combats the condition by reducing inflammation and signaling the body to create less mucus. This can cause dry mouth, so those who use an inhaler are at an increased risk for oral problems.
Tooth decay secondary to bulimia nervosa
Bulimia nervosa, often called simply “bulimia,” is another service-connected condition that puts you at risk for oral complications. Bulimia is an eating disorder where people often self-induce vomiting after eating. Eating disorders are very common among service members. A 2014 study found that 33.6% of active-duty women were at risk for eating disorders. Unlike other eating disorders, bulimia is directly linked to a multitude of dental problems. People with bulimia frequently induce vomiting after periods of binge eating. Vomiting exposes your teeth to corrosive stomach acid that can erode the protective layers of your teeth, resulting in cavities and tooth decay. Frequent vomiting may also reduce saliva production and change the acidity of saliva. People with severe bulimia can erode their teeth beyond repair.
Dental benefits for veterans
Getting your dental issues service-connected will help you win VA disability compensation, but it can also help you get access to dental care through the VA. The VA has an outpatient dental program that will pay for a wide variety of dental procedures. Some veterans will qualify for extensive procedures while others will only qualify for limited procedures and many do not qualify at all. Eligibility for certain procedures depends on your particular circumstance.
You may be eligible for some level of dental care through the VA if you:
- Have a service-connected dental disability or condition
- Apply for dental care within 180 days of discharge or release (under conditions other than dishonorable)
- Are enrolled in a qualifying VA-sponsored homeless residential rehabilitation program for at least 60 days
- Are a former POW
- Have a dental condition clinically determined by VA to be aggravating a service-connected medical condition
- Have a 100% VA disability rating
- Are receiving TDIU benefits
- Are enrolled in a Chapter 31 vocational rehabilitation program
- Are receiving VA care and require dental treatments
VA dental insurance
The VA Dental Insurance Program (VADIP) also offers discounted private dental insurance for qualifying veterans and their family members. If you are enrolled in VA health care or enrolled in the Civilian Health and Medical Program of the VA (CHAMPVA), you are most likely eligible. This program will not cover all dental procedures and does not provide free dental care.
Woods and Woods can help you receive benefits
Proving service connection for dental disabilities is complicated. If you feel your dental condition resulted from your service, contact Woods and Woods. We can help you file an initial claim or appeal a rating decision. Consultations are free, and you only pay us if we win.
Talk to Us About Your Claim: (812) 426-7200
FREQUENTLY ASKED QUESTIONS
There are not many VA disability ratings for teeth because dental problems are easily treated and are often unrelated to service. Although veterans who are missing teeth due to partial loss of the lower (mandible) or upper (maxilla) jaw could qualify for benefits. Also, veterans might be eligible for benefits if missing specific groups of teeth that can’t be replaced by prosthetics. Tooth decay can be secondary to another service-connected condition.
While teeth problems are rarely considered service-connected dental disabilities, they can be a secondary condition to a variety of medical problems. A veteran can receive a secondary disability rating for any health condition that is related to a service-connected disability. Cancer, PTSD, asthma, and bulimia nervosa are a few service-connected disabilities that are linked to oral complications.
Neil Woods
VA disability attorney
Woods & Woods
Neil Woods is the firm’s owner and president. He received his law degree from Western Michigan University.
