Citation Nr: 21040282 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 15-38 022 DATE: July 3, 2021 ORDER Entitlement to service connection for a dental condition is denied. REFERRED The issue of entitlement to service connection for a dental condition for treatment purposes is referred to the Agency of Original Jurisdiction. FINDING OF FACT The Veteran does not have a dental condition for which compensation may be granted. CONCLUSION OF LAW The criteria for service connection for a dental disorder for purposes of compensation have not been satisfied. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.303, 3.310, 3.381, 4.150. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from September 1985 to January 2000; and from March 2000 to February 2007. For his meritorious service, the Veteran was awarded (among numerous other decorations) the Meritorious Service Medal, the Air Force Commendation and Achievement Medals, and the Southwest Asia Service Medal. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in September 2012 by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared for a hearing before the undersigned Veterans Law Judge in June 2019. A transcript of the hearing is of record. This matter was remanded by the Board in July 2020 for additional development; specifically, the Board sought a new VA examination, which has been completed. Thus, the Board finds substantial compliance with its remand instructions. 1. Entitlement to service connection for a dental condition The Veteran asserts that he is entitled to service connection for a dental condition that began during service. Generally, to establish service connection there must be competent evidence showing: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service injury incurred or aggravated during service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for a dental disorder for compensation purposes can only be established 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 the body of the maxilla or mandible. See Simmington v. West, 11 Vet. App. 41 (1998). For loss of teeth to merit compensation, bone loss through trauma or disease such as osteomyelitis must be shown; 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, at Note. Review of the Veteran's service treatment records (STRs) reveal that the Veteran complained of tooth pain in December 2005. Also, in December 2005, the Veteran signed a high-risk caries treatment plan due to his high incidence of cavities. The Veteran appeared for a hearing before the Board in June 2019. During the hearing, the Veteran testified that he had complained of a cavity while in service. He stated that the presence of a cavity was denied until a year later after his condition progressed. He reported that he was then treated for his cavity. The Veteran also stated that he was diagnosed with TMJ and sleep apnea in 1988 and suggested that both conditions could be related to his dental condition. The Veteran appeared for a VA examination in January 2021 to determine the nature and etiology of his dental condition. The Veteran was diagnosed with irreversible pulpitis; pulpitis is defined as "inflammation of the dental pulp, usually due to bacterial infection in dental caries, tooth fracture, or other conditions causing exposure of the pulp to bacterial invasion." Dorland's Illustrated Medical Dictionary 1553 (32nd ed. 2012). However, the examination report indicates that the Veteran does not have loss of the substance of the body of the maxilla or mandible related to trauma or disease, such as osteomyelitis. Further, the Veteran did not report experiencing any trauma resulting in a dental injury during service. The examiner reported that the Veteran's dental condition was related to his military service. The Board acknowledges that the Veteran's tooth loss and decay is related to his active service. However, the VA examination reports do not document any loss or damage to the Veteran's teeth due to a loss of substance of the body of the maxilla or mandible. Similarly, there is no evidence that he experienced bone loss due to trauma or disease such as osteomyelitis. Moreover, there is no indication that the Veteran experienced any in-service dental trauma. As noted above, service connection for compensation for dental issues is limited to defined categories which the Veteran is not shown to meet. The Board has referred the issue of entitlement to treatment for the Veteran's dental disability to the AOJ for further processing. The preponderance of the evidence is against the claim for compensation purposes and it is denied. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. K. Hall, 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.