Citation Nr: 21006926 Decision Date: 02/05/21 Archive Date: 02/05/21 DOCKET NO. 15-01 328 DATE: February 5, 2021 ORDER Service connection for a mouth wound to include a cracked tooth is denied. FINDING OF FACT In-service soft tissue injury to the Veteran's mouth/lip resolved, with no evidence of current residual disability or functional impairment of earning capacity as a result of such. As for hard tissue injury, including to one or more teeth, while it appears that he cracked an upper tooth in service, he is not shown to have a current dental disability due to loss of substance of body of maxilla or mandible from trauma or disease such as osteomyelitis, to permit compensation. CONCLUSION OF LAW The criteria for service connection for a mouth wound to include a cracked tooth have not been met. 38 U.S.C. §§ 1131, 1712, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.381, 4.150, 17.161. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1980 to June 1984. The Board thanks him for his service. He appeals from a December 2013 rating decision which denied service connection for a mouth wound to include a cracked tooth, based on a claim filed in February 2013. The appeal was remanded in June 2018 and February 2020. Thereafter, his claim for service connection for bilateral pes planus which had also been remanded, was granted in August 2020. Establishing service connection generally requires medical or, in certain circumstances, lay evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed.Cir.2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed.Cir.1996) (table). Under VA law, compensation is only available for certain types of dental and oral conditions, which are rated under 38 C.F.R. § 4.150, Diagnostic Codes 9900-16. Diagnostic Code 9913 applies to dental service connection claims involving teeth. Compensation is only paid for loss of teeth due to loss of substance of the body of maxilla or mandible without loss of continuity (as a result of trauma) or disease such as osteomyelitis, and not the loss of alveolar process (the ridge on the surfaces of the upper (maxilla) and lower (mandible) jaws containing the tooth sockets) as a result of periodontal disease, since such loss is not considered disabling. See Note, 38 C.F.R. § 4.150, Diagnostic Code 9913. VA regulations distinguish between "replaceable missing teeth" or periodontal disease and teeth lost as a result of "loss of substance of body of maxilla or mandible." Simington v. West, 11 Vet. App. 41 (1998); 38 C.F.R. § 3.381. Replaceable missing teeth may be considered service connected solely for the purpose of determining entitlement to dental examinations or outpatient dental treatment, but only the loss of teeth involving the loss of substance of body of either the maxilla or mandible (as described in 38 C.F.R. § 3.381) is considered compensable, and may be rated under the appropriate diagnostic codes. Thus, to warrant compensation for a dental disability, as opposed to treatment only, the evidence must show not only that there was a dental trauma or disease (such as osteomyelitis, but not periodontal disease), but that the trauma or disease caused a loss of substance of the body of the maxilla or mandible resulting in a loss of teeth. Based on the evidence, the Board concludes that service connection is not warranted for residuals of a mouth injury to include a cracked tooth. With regard to soft tissue injury, service treatment records confirm an injury to the soft tissue of the Veteran's mouth in service, with March 1982 service treatment records showing that it was of the top lip with swelling and abrasion, and showing that he was given a stitch for it. However, there is no competent evidence of any current disability, such as a scar or other residuals, from this soft tissue injury, or of any functional impairment of earning capacity as a result of any such disability from the soft tissue injury. To the contrary, the October 2013 VA examination report is exemplary evidence indicating that no mouth scar or other impairment is present. In the absence of a current disability or functional impairment of earning capacity as a result of any such disability, service connection cannot be granted. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143-144 (1992); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). As for the hard tissue (dental) aspects of the Veteran's claim, the Veteran is seeking compensation for a cracked tooth or teeth, requesting a 10 percent rating for it in December 2014. As reported above, compensation is only payable for loss of teeth due to loss of substance of the body of maxilla or mandible without loss of continuity (as a result of trauma) or disease such as osteomyelitis, and not the loss of alveolar process (the ridge on the surfaces of the upper (maxilla) and lower (mandible) jaws containing the tooth sockets) as a result of periodontal disease, since such loss is not considered disabling. See Note, 38 C.F.R. § 4.150, Diagnostic Code 9913. In the Veteran's case, the evidence shows that he had 1 cracked tooth which was successfully repaired in service, but does not show the loss of 1 or more teeth through loss of substance of the body of the maxilla or mandible, as the regulation requires. In fact, the VA examiner with whom the Veteran met in October 2013 indicated the Veteran did not have a mandible or maxilla condition. In sum, the evidence of record demonstrates that the Veteran has no current compensable dental disability as defined under VA law. While service treatment records show that the Veteran sustained a cracked tooth, the evidence of record indicates that such trauma did not cause loss of substance of the body of the maxilla or mandible resulting in the loss of any teeth. Further, the May 2020 VA medical opinion of record indicates that the Veteran's current tooth problems are unrelated to any aspect of service, the examiner confirming that service treatment records confirm that “[in-service] trauma to the upper lip and cracked tooth…heal[ed] within normal limits [with] no noted pain” on in-service follow-up evaluation. The Veteran has not otherwise presented any evidence or assertion that he currently has loss of substance of the body of the maxilla or mandible caused by the injury that cracked his tooth in service, and a cracked, repaired tooth which is what is shown to have occurred in service is not compensable. (Continued on the next page)   The preponderance of the evidence is against the claim and there is no reasonable doubt to be resolved in the Veteran's favor concerning it. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1991). Z. SAHRAIE Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Lawson 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.