Citation Nr: 18148820 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-35 507 DATE: November 8, 2018 ORDER Entitlement to service connection for a dental disorder for compensation is denied. FINDING OF FACT The Veteran does not a have a dental disorder for which service-connected compensation is payable. CONCLUSION OF LAW The criteria for entitlement to service connection for a dental disorder for compensation purposes have not all been met. 38 U.S.C. §§ 1110, 1712, 5107 (2012); 38 C.F.R. §§ 3.303, 3.381, 4.150 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1967 to October 1973, November 1975 to October 1977, August 1978 to August 1982, and November 1986 to November 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). A claim for service connection for compensation for a dental condition is also considered a claim for VA outpatient dental treatment. Mays v. Brown, 5 Vet. App. 302, 306 (1993). In dental claims, the RO typically adjudicates the claim for service connection and the VA Medical Center adjudicates the claim for outpatient treatment. As this matter stems from an adverse determination by the RO, the appeal is limited to the issue of service connection for a dental disorder for compensation purposes. Therefore, the claim for service connection for a dental disorder for obtaining VA outpatient dental treatment is referred to the agency of original jurisdiction (AOJ) for adjudication or additional referral to the applicable VA medical facility, as appropriate. 38 C.F.R. § 19.9(b) (2017). Service connection for dental compensation Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). “To establish a right to compensation for a present disability, a Veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service”- the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran contends that he should receive compensation for his dental disorder, which he contends was caused by an in-service motorcycle accident. Under current VA regulations, compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, including conditions of the mandible, maxilla, ramus, condyloid process, coronoid process, hard palate, and loss of teeth due to loss of substance of the body of the maxilla or mandible. See 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. These conditions include loss of whole or part of the mandible, nonunion or malunion of the mandible, loss of whole or part of the ramus, loss of whole or part of the maxilla, nonunion or malunion of the maxilla, loss of the condyloid or coronoid process, or loss of any part of the hard palate. Compensation is also available for loss of teeth only if such is due to loss of substance of body of maxilla or mandible; bone loss through trauma or disease, such as osteomyelitis, must be shown for compensable purposes. The loss of the alveolar process as a result of periodontal disease is not considered disabling. See 38 C.F.R. § 4.150, Diagnostic Code 9913. Otherwise, a veteran may be entitled to service connection for dental conditions including treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease, for the sole purposes of receiving VA outpatient dental services and treatment, if certain criteria are met. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 17.161. As noted above, the matter of eligibility for VA dental treatment has been referred to the AOJ for appropriate consideration and is not the subject of the Board’s review. The Board will address whether the Veteran is entitled to service connection for VA compensation purposes. The Veteran reported on his VA Form 9 that his front teeth, numbers 7 and 8, were knocked out of their sockets during service due to a motorcycle accident that occurred in April 1987. He stated he was treated at Balboa Naval Hospital and his teeth were worked back into their sockets and his mouth was wired shut for 2 weeks. The Veteran reported that he was told that his teeth were dead and would turn darker and fall out over time. He stated that his teeth eventually did fall out, at which point he applied for service connection for his teeth. The Veteran’s service treatment records (STRs) confirm that he was involved in a motorcycle accident in 1987. Dental records indicate that teeth 7 and 8 were repositioned after the accident, and a root canal was performed on both teeth. The Veteran attended a VA dental examination in June 2014. The examiner found that the Veteran had a diagnosis of fractured teeth. The examiner acknowledged the Veteran’s in-service motorcycle accident and his subsequent root canals on teeth 7 and 8. The examiner did not identify any additional conditions affecting the mandible, maxilla, teeth, mouth, jaw, lips, tongue, or any evidence of osteomyelitis, tumors, or scars. The examiner indicated that diagnostic imaging was performed in June 2014, which showed two fractured teeth, but no loss of continuity to the maxilla or mandible. He stated that there was no evidence that linked the Veteran’s in-service facial trauma with his current fractured teeth. In addition, he noted that isolated tooth injury without loss of substance of the maxilla or mandible is not a service connectable condition for dental compensation. The Board finds that the Veteran does not have a dental disability on which a claim of compensation can be granted. As noted above, compensation is available for loss of teeth only if it is due to loss of substance of body of maxilla or mandible; bone loss through trauma or disease, such as osteomyelitis. See 38 C.F.R. § 4.150, Diagnostic Code 9913. There is no evidence in the record that the Veteran meets these requirements. The Veteran and his representative have not claimed that the Veteran has any compensable conditions of his mandible, maxilla, ramus, condyloid process, coronoid process, or hard palate throughout the appeal period; specifically, there is no indication of any loss of whole or part of the mandible, nonunion or malunion of the mandible, loss of whole or part of the ramus, loss of whole or part of the maxilla, nonunion or malunion of the maxilla, loss of the condyloid or coronoid process, or loss of any part of the hard palate. (CONTINUED ON NEXT PAGE)   As such, the Veteran does not have a dental disability for a claim of service connection for dental compensation. The Board therefore denies the Veteran’s claim for compensation for a dental disorder. There is no reasonable doubt to be resolved as to this issue. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. JAMES G. REINHART Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Norah Patrick, Associate Counsel