Focus: VA Rating on Teeth and Gums

Focus: VA Rating on Teeth and Gums

At the end of 2021, the American Institute of Dental Public Health (AIDPH) and the National Health and Nutrition Examination Survey (NHANES) issued a study that highlighted that Veterans suffer from tooth decay, gum diseases and need restorative dental care much more often than the non-Veteran population.

42% of Veterans admitted that they experienced bone loss around their teeth or received gum treatment. That is nearly twice as many as among non-Veterans.

While Veterans indeed suffer from a wide variety of dental conditions, the VA often does not rate them as service-related disabilities. Cavities and tooth loss, especially if they are a result of natural aging-related conditions, are easily manageable, and can be treated through VA dental care. 

However, if we are talking about examples like the loss of a part of your jaw, which resulted from a  service-connected injury or condition, you may be eligible for a 100% disability. As a rule, the VA rates teeth and gum conditions that affect your ability to speak or may affect your diet. But there are some exceptions and specifications every Veteran should know to get the maximum VA disability benefits.

Today we’ll cover:

    • How the VA rates oral conditions
    • Why teeth and gums problems are more likely to be rated as secondary conditions
    • Everything you need to know about VA dental benefits

VA rates for Oral Conditions

The VA rates dental and oral conditions under diagnostic codes 9900 to 9918 in the Schedule for Rating Disabilities.  

The rates range between 0 and 100%, depending on the severity of the condition and its effect on a Veteran’s life. 

There are lots of scenarios when your teeth and gums might get affected by the conditions of your military service, a particular accident or injury, or even as a result of treatment for another service-connected disability. 

The VA developed a classification of teeth and gum conditions that can make you eligible for VA disability benefits:

    • Periodontitis
      Periodontitis is the most common condition that develops when the tissues that hold your teeth in place get infected. Periodontitis is usually a result of poor oral hygiene. For example, if the conditions of your military service prevent you from brushing and flossing your teeth regularly, the buildup of plaque may lead to service-connected periodontitis. Depending on the severity of its symptoms, such as tooth mobility or loss and gum recession, you can receive a 0 to 20% VA rate.

    • Loss of Teeth
      If you lost your teeth in combat, due to an accident while in service, or as a result of another service-connected disability and/or its treatment, you will also be eligible for the VA disability rate. And while VA rates for loss of teeth are pretty low—0 to 10%—in certain scenarios, each lost tooth can be rated individually, giving you a combined rate in the end.

      In you lose all of your teeth for service-connected reasons and they cannot be replaced by a prosthesis or false teeth, you can receive a 40% VA disability rate. Loss of all upper or all lower teeth may get you up to a 30% rate.

    • Dental Caries 
      This is a chronic infection that leads to tooth decay and may cause serious discomfort or pain that in different stages may affect your ability to eat or even speak. Once this condition is service-connected and affects your overall health, function, and employability, you may receive up to 20% disability rate.

    • Temporomandibular joint (TMJ) Disorders
      There are about 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. Depending on the functional and movement impairment on the jaw as well as the severity of other symptoms, TMJ can get you up to a 30% disability rate.

    • Oral Cancer
      If the conditions of your military service lead to the development of a malignant (cancerous) oral mass, called a neoplasm, you are eligible for VA disability benefits. Depending on the location and extent of the disease, the efficiency of treatment, and their effect on your physical and mental health, you can receive a 100% VA disability rate.

    • Loss of Mandible/Maxilla
      Partial or complete loss of mandible (lower jaw) and/or maxilla (upper jaw) bones can happen in combat, due to an accident or as a result of treatment for another service-connected condition (ex. Radiation therapy.) It is another scenario when a Veteran can receive a 100% VA disability rate if the damage is permanent and prevents them from using a prosthesis. 

As you see, most of the oral conditions are hardly rated more than 30%. Also, the most common ones like dental caries and periodontitis are rarely acknowledged as service-connected. However, there is some good news: Almost any of your dental problems may be qualified as a secondary condition to a wide range of medical conditions.

Oral Disease as a Secondary Condition 

If you can prove that your dental problems come from any service-connected condition or its treatment, you can receive a secondary disability rating.

Technically, there are four most common scenarios when oral disease becomes a secondary condition:

    1. Asthma
      Statistically, Veterans are 25% more prone to the development of asthma (Code 6602) than non-Veterans. This common service-connected condition constricts airways and restricts breathing. Medication used in the inhaler for the treatment of asthma often causes dry mouth and may have other side effects. They can lead to dental problems, which can be rated as secondary conditions.

    1. Cancer
      VA recognizes a wide range of cancers as presumed service-connected disabilities. The disease itself and its treatment are known to cause dental problems. Dry mouth, tooth decay, and other dental problems are common side effects of chemotherapy and radiation therapy and can be rated as secondary conditions.

    1. Mental Health Conditions
      Mental health issues such as depression, anxiety, or post-traumatic stress disorder (PTSD) can lead to neglect of dental care, which usually causes secondary dental problems such as periodontal disease or dental caries.

    1. Eating Disorders
      Eating disorders, especially bulimia nervosa (code 9521) are very common among military personnel. When these conditions cause or lead to self-inflicted vomiting, teeth get exposed to stomach acid. It is an extremely corrosive substance that can lead to severe tooth damage. Once you have a service-connected eating disorder, you can claim dental problems as a secondary condition.

Dental Benefits for Veterans

Except for VA disability benefits, your service-connected oral conditions can make you eligible for the VA dental care program.

However, different Veterans may qualify for different levels of VA dental benefits. Some may automatically be eligible for any required dental care, while others can receive dental treatment only once or only for a particular condition.

To apply for the VA dental care program you need to enroll in VA health care using VA Form 10-10EZ and apply for the VA Dental care evaluation. The VA will examine your military service history, current health, and living situation and determine which of the 10 classes you belong to:

 

Another thing every Veteran should remember is the VA Dental Insurance Program (VADIP), which provides discounted private dental insurance for Veterans and their family members.

To become eligible for VADIP, you need to be:

    • A Veteran enrolled in the VA Healthcare Program

In Conclusion 

If you believe that your dental problems were caused directly by your military service, don’t hesitate to file your VA disability claim. These conditions are overwhelmingly common among Veterans and with qualified assistance, you will be able to provide all the necessary evidence and claim your VA disability benefits.

Here at VCU, we have almost a decade of experience helping Veterans and their families seek and claim all the VA benefits they are entitled to. We have developed a straightforward procedure and a wide network of independent medical professionals to help you at any stage, from filing your claim to appealing it.

Book your free 30-minute call with a Veterans Specialist today and claim VA disability benefits that you are entitled to legally, medically, and ethically.

Leave a Comment

Your email address will not be published. Required fields are marked *