Citation Nr: 20007355 Decision Date: 01/29/20 Archive Date: 01/28/20 DOCKET NO. 19-25 960 121265DATE: January 29, 2020 ORDER Entitlement to service connection for a dental disability for compensation purposes is denied. REFERRED Entitlement to service connection for dental disability for purposes of eligibility for outpatient dental treatment is referred. FINDING OF FACT The preponderance of the evidence does not show a compensable dental disability that was the result of loss of substance of the body of the maxilla or mandible due to in-service dental trauma or bone disease. CONCLUSION OF LAW The criteria for service connection for a dental disability have not been met. 38 U.S.C. §§ 101, 1110, 1131, 5107; 38 C.F.R. §§ 3.6, 3.303, 3.381, 4.150, 17.161. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from March 1970 to October 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for a dental disability is denied. Legal Background A claim for service connection for a dental disability is also considered a claim for outpatient dental treatment. Mays v. Brown, 5 Vet. App. 302, 306 (1993). In dental claims, the Regional Office (RO) adjudicates the claim for service connection and the VA Medical Center (VAMC) adjudicates the claim for outpatient treatment. Because the current issue of entitlement to service connection for a dental disability stems from an adverse determination by the RO, the dental issue addressed herein must be limited to service connection for compensation purposes. Therefore, the issue of entitlement to outpatient dental treatment is referred to the Agency of Original Jurisdiction (AOJ) for further referral to the appropriate VAMC for adjudication. See 38 C.F.R. § 17.161. As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see also Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996). Under current VA regulations, compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. Compensation is available for loss of teeth only if due to loss of substance of body of maxilla or mandible due to trauma or disease such as osteomyelitis, but not periodontal disease. Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not considered disabling conditions and may be considered service connected solely for establishing eligibility for outpatient dental treatment. See 38 C.F.R. § 3.381(a). In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to service connection for a dental disability for compensation purposes. Factual Background The Veteran asserts that his teeth were extracted when he was in boot camp training and asks that the VA help him in whatever way they can to restore the five or six teeth that were removed while in service as this would make it easier for him to eat. The Veteran also states that he was able to obtain records from the San Juan VAMC which show that his teeth were removed while in service. The Board notes that the records that the Veteran references are included in his file and have been reviewed and considered in the Board’s determination of this matter. See April 2019 Notice of Disagreement (NOD). The Board notes that in May 2018 a formal request was made for VA to furnish complete medical/dental records, service treatment records (STRs), and the entire personnel file for the Veteran. See Request for Information dated May 2018. VA made a formal finding that the Veteran’s records for the San Juan, VAMC from 01/01/1970 through 08/27/1997 and from 09/17/1997 through 01/08/2018 were unavailable and all attempts to retrieve the records have been completed and no additional evidence was received. As such, the Board finds that further attempts to obtain the records would be futile. See Report of General Information VA Form 21-0820 filed August 2018. The Board notes however, that some of the Veteran’s dental records were found in the STRs of record. In a STR dated April 1970, dental records reflect that six of the Veteran’s teeth are missing. Another STR dated October 1970 reflects that 8 of the Veteran’s teeth are missing. The STRs contain no notes with respect to why these teeth were missing and the reasons for extraction, nor do the STRs contain specific diagnosis associated with the removal of the Veteran’s teeth or abnormalities that the Veteran experienced. Post-service evidence of record shows several negative notes for dental disease and any disease related to the Veteran’s mouth or throat. The post-service treatment records show no diagnosis of any type of dental disability, or treatment for a dental disability, no evidence of tooth decay, gingivitis, or any disease that is associated with a dental disability. (Continued on the next page)   Analysis Service connection for a dental disorder for compensation purposes is not warranted in this case, as the evidence does not show a compensable dental disability that was the result of loss of substance of the body of the maxilla or mandible due to in-service dental trauma or bone disease. While the Board finds the Veteran competent and credible to report losing teeth after having them extracted in boot camp, the Veteran is not competent to determine whether his loss of teeth was due to loss of substance of body of maxilla or mandible due to trauma or disease. The Federal Circuit Court defines “service trauma” as “an injury or wound produced by an external physical force during the service member’s performance of military duties.” Nielson v. Shinseki, 23 Vet. App. 56, 60 (2009); see also VAOPGCPREC 5-97. VA’s General Counsel held that dental treatment of teeth, even extractions, during service do not constitute dental trauma. See VAOPGCPREC 5-97. The Board finds the Veteran losing teeth after having them extracted in boot camp does not amount to dental trauma. There is no competent evidence to suggest that the Veteran’s dental disability was due to loss of substance of body of maxilla or mandible due to in-service trauma or disease. Thus, service connection for a dental disorder is not established under 38 C.F.R. § 4.150. In making this determination, the Board notes that the decision is limited to whether service connection is warranted for compensation purposes. The issue of entitlement to service connection for a dental treatment has been referred for appropriate action. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Dorsey-Kwansa, Associate Counsel 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.