Citation Nr: 21011251 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 17-12 041 DATE: March 1, 2021 REMANDED Entitlement to service connection for a dental disorder, to include gum disease and jaw clicking, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1966 to November 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from April 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded by the Board in February 2019 and March 2020 for additional administrative and evidentiary development. Most recently, in September 2020, the matter was remand to the Agency of Original Jurisdiction (AOJ) for a VA examination. Unfortunately, the Board finds that an additional remand is necessary to comply with the September 2020 remand order. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to service connection for a dental disorder, to include gum disease and jaw clicking, is remanded. The Veteran is claiming service connection for a dental disorder, to include gum disease and jaw clicking. The Board remanded the Veteran’s claim in September 2020 for a VA examination to ascertain the nature and etiology of any dental condition, to include gum disease and jaw clicking. The examiner was to ascertain whether the Veteran suffers from loss of teeth, and if so, comment on whether this is due to loss of substance of the body of the maxilla or mandible due to trauma or disease such as osteomyelitis or is a result of periodontal disease. In October 2020, the Veteran underwent a VA examination. During the examination, the Veteran reported a history of jaw clicking. The examiner diagnosed recurrent tooth decay, and declined to diagnosis a temporomandibular joint condition (TMJD). Upon pantographic imaging, the Veteran was shown to have loss of teeth, mandible or maxilla. The examiner opined that the Veteran’s oral condition was less likely than not incurred in or caused by service. The rationale stated that the Veteran does not have TMJD and thus is not related to his active duty service. The examiner noted that the Veteran did have a fractured jaw in 1967, and a cyst removal however these conditions have completely healed. The Board finds that the AOJ did not substantially comply with the Board’s remand directives in the October 2020 VA examination as the VA examiner failed to address whether the Veteran’s diagnosed tooth decay is related to his in-service fractured jaw in 1967, or his in-service cyst removal. Further, the examiner failed to address whether the Veteran’s missing teeth are due to loss of substance of the body of the maxilla or mandible due to trauma or disease. A remand is required to have a dentist examine the Veteran to determine if the Veteran’s tooth decay is related to his in-service fractured jaw, or in-service cyst removal, and whether the Veteran’s missing teeth are due to trauma such as a fractured jaw, or disease. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any dental condition, to include tooth decay and jaw clicking. (a.) The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, to include a fractured jaw in 1967, and a cyst removal. (b.) Please comment on whether the Veteran’s loss of teeth is due to loss of substance of the body of the maxilla or mandible due to trauma or disease such as a fractured jaw or periodontal disease. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Russell, Tangela 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.