Citation Nr: 21023770 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 19-01 296 DATE: April 21, 2021 ORDER Entitlement to service connection a dental disability for compensation purposes, claimed as bone loss due to early extraction of teeth, is denied. FINDING OF FACT The Veteran does not have a dental disability that is causally or etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a dental disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.381, 4.150. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1954 to February 1957. He appeals a September 2017 rating decision denying entitlement to service connection for a dental disability. The Veteran requested a Board hearing via live videoconference when perfecting his appeal. In March 2020, the Veteran withdrew his hearing request in writing and asked that the claim be decided based on the evidence on file. The Board notes that a claim for service connection for a dental condition is also considered to be a claim for VA outpatient dental treatment. Mays v. Brown, 5 Vet. App. 302, 306 (1993). The regulation relating to service connection of dental conditions for treatment purposes was amended, effective February 29, 2012, in order to clarify existing regulatory provisions and to reflect the respective responsibilities of the Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA) in determinations concerning eligibility for dental treatment. See Proposed Rules, Dental Conditions, 76 Fed. Reg. 14,600 (Mar. 17, 2011); Final Rule, Dental Conditions, 77 Fed. Reg. 4469 (Jan. 30, 2012). The amended version of 38 C.F.R. § 3.381 now clarifies that VBA will adjudicate a claim for service connection of a dental condition for treatment purposes after VHA determines that a Veteran meets the basic eligibility requirements of 38 C.F.R. § 17.161 and requests that VBA make a determination on relevant questions. 38 C.F.R. § 3.381 (a). Significantly, treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may nevertheless be service connected solely for the purpose of establishing eligibility for outpatient dental treatment as provided in 38 C.F.R. § 17.161. See 38 C.F.R. § 3.381. Here, the record indicates that the Veteran’s claim may have been referred to determine his eligibility for dental treatment, however, it is unclear whether that issue has been fully adjudicated and whether the Veteran has been informed of any adjudication. See May 2016 VA treatment note. This matter is REFERRED to the AOJ for any action deemed appropriate. Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303(a), 3.304, 3.307, 3.309, 3.310. Generally, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). Service connection for compensation purposes can be established only for the specific 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 the body of the maxilla or mandible. See Simmington v. West, 11 Vet. App. 41 (1998). For loss of teeth, bone loss through trauma or disease such as due to osteomyelitis must be shown for purposes of compensability. The loss of the alveolar process as a result of periodontal disease is not considered disabling. See Note to Diagnostic Code 9913, 38 C.F.R.§ 4.150. A claim for service connection for a dental disability is also a claim for VA outpatient dental treatment under 38 C.F.R. § 3.381. Mays v. Brown, 5 Vet. App. 302 (1993). Service connection for purposes of outpatient dental treatment may be granted for a dental condition of any tooth and/or and periodontal tissue shown by the evidence to have been incurred in or aggravated by service, so long as the veteran falls under one of a number of specific classifications, to include those having a service-connected compensable dental disability or condition. 38 C.F.R. § 3.381(a)(2). Entitlement to service connection for a dental disability. The Veteran contends that he suffers from mandibular and/or maxillary bone loss due to multiple tooth extractions in service. After review of the evidence, the Board finds that service connection is not warranted. Service connection for compensation purposes As an initial matter, the Board notes that correspondence from the National Personnel Records Center confirms that the Veteran’s personnel and medical records were destroyed in the fire at the National Archives and Records Administration on July 12, 1973. However, the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). In a letter dated September 2019, the Veteran’s private dentist confirmed that he currently suffers from moderate upper and severe lower ridge bone loss. Accordingly, the threshold requirement of a current disability has been met. The Board finds the Veteran’s statements that he had over a dozen teeth pulled during service to be credible. Also, the Veteran’s dentist opined that his kind of bone loss is typically due to being without teeth for many years, usually decades. The Board also acknowledges that the Veteran’s service treatment records are unavailable for review. However, per the Veteran’s own statements, he had multiple teeth removed in-service as a part of routine dental procedures rather than due to any specific trauma or disease. To be sure, the removal of as many teeth is undoubtedly unpleasant. But such a procedure does not qualify as trauma for the purposes of entitlement to service connection. VA’s General Counsel has held that dental treatment of teeth, even extractions, during service does not constitute dental trauma. See VAOPGCPREC 5-97, 62 Fed. Reg. 15,566 (1997). Unfortunately, the evidence does not otherwise show an in-service event or injury for which service connected may be awarded. The Board is sensitive to the Veteran’s difficult situation; however, although the Board concedes that the Veteran had multiple in-service extractions, the evidence does not show that his current bone loss is due to tooth extraction that occurred due to trauma or disease. The Veteran does not have a loss of teeth due to loss of substance of the body of maxilla or mandible due to bone loss through trauma or any other condition on which service connection for compensation purposes could be allowed. The Board notes the Veteran’s general reports of ongoing dental pain due to his in-service dental treatment. However, there is no evidence of an injury to the mandible or maxilla, and the Veteran has not alleged such. Although the Veteran is entitled to the benefit of the doubt where the evidence is in approximate balance, the benefit of the doubt doctrine is inapplicable where, as here, the preponderance of the evidence is against service connection for a dental disability. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. L. ANDERSEN Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Daniel Ballinger, Associate Counsel