Citation Nr: 18141794
Decision Date: 10/11/18	Archive Date: 10/11/18

DOCKET NO. 14-31 214A
DATE:	October 11, 2018
REMANDED
Entitlement to service connection for loss of teeth, to include as secondary to service-connected acquired absence of maxillary incisors, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from February 1976 to February 1977.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
In June 2018, the Veteran and his wife testified before the undersigned.
1. Entitlement to service connection for loss of teeth, to include as secondary to service-connected acquired absence of maxillary incisors is remanded.
The Veteran asserts that his loss of teeth is related to his May 1976 in-service dental trauma, or in the alternative is related to the treatment for his service-connected absence of maxillary incisors.  See June 2018 Board Hearing at 4-5, 10.  Specifically, he states that the partial plate used to treat his maxillary incisors caused his other teeth to decay and fall out.  Id.  The February 2011 and May 2012 VA examiner opined that the Veteran’s loss of teeth is not related to the in-service trauma but is the result of advanced cavities.  The Board finds that the VA examiner did not address the service treatment record notation of intrusion of #10 and #11 and pain in #7 and discomfort in #10.  Additionally, the examiner did not address whether the Veteran’s current loss of teeth is caused or aggravated by his service-connected absence of maxillary incisors.  Thus, a remand is necessary for an addendum opinion.  
Additionally, the Veteran testified that he obtained a partial plate shortly after his separation from service from the Perry Point VA Medical Center (VAMC).  In November 2010, the Perry Point VAMC indicated that medical records were not found for the Veteran.  As the Board is remanding the claim, the RO is afforded another opportunity to obtain any outstanding VA treatment records, to include outpatient dental records from Perry Point VAMC.   
The matter is REMANDED for the following actions:
1. Obtain any outstanding VA treatment records, to include outpatient dental records from Perry Point VAMC dated from 1977.  If any records are unavailable, notify the Veteran pursuant to 38 C.F.R. § 3.159(e).
2. Then obtain an addendum opinion regarding the etiology of the Veteran’s loss of teeth.  After a review of the claims file, the examiner is requested to provide a specific opinion as to:
a)  Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s loss of teeth is related to service, to include his May 1976 dental trauma.  The examiner must specifically address the in-service notation of intrusion of #10 and #11 and pain in #7 and discomfort in #10. 
b)  Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s loss of teeth is proximately due to his service-connected absence of maxillary incisors.
c)  Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s loss of teeth is aggravated (worsened beyond natural progression) by his service-connected absence of maxillary incisors.
In rendering the requested opinions, the clinician must consider the Veteran’s June 2018 testimony that the partial plate used to treat his service-connected maxillary incisors led to decay and other tooth loss.
A complete rationale must be provided.  
 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Forde, Counsel