Citation Nr: 21059679 Decision Date: 09/23/21 Archive Date: 09/23/21 DOCKET NO. 17-37 962 DATE: September 23, 2021 ORDER Service connection for a dental condition, to include as secondary to diabetes mellitus, is denied. FINDING OF FACT The Veteran does not have a dental disorder for which compensation is payable. CONCLUSION OF LAW The criteria for entitlement to service connection for a dental condition, to include as secondary to diabetes mellitus, have not been met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.381, 4.150 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1964 to April 1968. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In the previous June 2020 decision, the Board remanded the claims for service connection for the following disabilities: diabetes mellitus, ischemic heart disease, peripheral neuropathy of bilateral upper and lower extremities, erectile dysfunction, an eye condition, and a dental condition. In July and September 2020, the RO granted service connection for all of these disabilities except for the dental condition. Therefore, the claims granted are no longer on appeal. There has been substantial compliance with the June 2020 remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). The issue of entitlement to service connection for a dental disability for treatment purposes only has been raised by the record but has not been adjudicated by the Agency of Original Jurisdiction (AOJ). Therefore, the Board does not have jurisdiction over it, and it is referred to the AOJ for appropriate action. 38 C.F.R. § 20.904(b). Service connection for a dental condition, to include as secondary to diabetes mellitus, is denied. The Veteran claims service connection for a dental disability. Service connection requires competent evidence of (1) a current disability; (2) the incurrence or aggravation of a disease or injury during service; and (3) a causal relationship between the current disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Service connection for treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, or periodontal disease will be considered solely for the purpose of establishing eligibility for outpatient dental treatment. 38 C.F.R. § 3.381. Service connection for compensation purposes is not available for a dental condition other than for injuries sustained as a result of dental trauma. Dental disabilities that may be awarded compensable disability ratings are set forth under 38 C.F.R. § 4.150. These disabilities include chronic osteomyelitis or osteoradionecrosis of the maxilla or mandible, loss of the mandible, nonunion or malunion of the mandible, loss of the maxilla, nonunion or malunion of the maxilla, limited temporomandibular motion, loss of the ramus, loss of the condyloid or coronoid processes, loss of the hard palate, loss of teeth due to the loss of substance of the body of the maxilla or mandible and where the lost masticatory surface cannot be restored by suitable prosthesis, when the bone loss is a result of trauma or disease but not the result of periodontal disease. 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. To establish entitlement to service connection for loss of a tooth, the veteran must have sustained a combat wound or other in-service trauma. 38 U.S.C. § 1712; 38 C.F.R. § 3.381(b). The significance of finding that a dental condition is due to in-service trauma is that a veteran will be eligible for VA outpatient dental treatment, without being subject to the usual restrictions of a timely application and one-time treatment. 38 C.F.R. § 17.161(c). The term "service trauma" does not include the intended effects of therapy or restorative dental care and treatment provided during a veteran's active service. See 38 C.F.R. § 3.306(b)(1); VAOGCPREC 5-97. The Board notes that the portion of VA's Schedule for Rating Disabilities addressing dental and oral conditions was revised effective September 10, 2017. The Veteran has not been notified as to the changes in the regulations and the RO has not adjudicated his claims under the new regulations; however, as the new regulations involve benign or malignant neoplasms that are not applicable to the Veteran's current claim and the other changes involved only clarification of the rating terms, the Board finds that there is no prejudice in adjudicating the Veteran's dental claim. Turning to the evidence, the Veteran's service treatment records do not note any injuries to the mouth or teeth. In July 1964, the Veteran underwent extraction of teeth number 19. The separation examination in April 1968 noted normal mouth and throat examination. The treatment records associated with the claims file do not demonstrate any dental disability. The records sporadically show reports of dental pain, and clinical observations of poor dentition with dental caries. The Veteran underwent a VA in-person examination for oral and dental conditions in September 2020. The examiner noted that all available records were reviewed. The Veteran reported that his dental condition had onset in 1967 which has progressed and worsened. He stated his diabetes level is high and is progressing into his eye. He reported multiple teeth are broken down to root pieces, and that there were large cavities on multiple teeth. The examiner noted that the Veteran does not have nor has ever been diagnosed with an oral or dental condition. The examiner also noted the Veteran did not have any of the following dental or oral conditions: mandible; maxilla; teeth; mouth, lips, tongue, and disfiguring scars to the mouth or lips; osteomyelitis, osteoradionecrosis, or osteonecrosis of the jaw; tumors or neoplasms; or other dental or oral conditions, pertinent physical findings, or scars due to dental or oral conditions. The examiner opined that a determination as to whether the claimed condition is related to service, or whether it is caused or aggravated by his diabetes cannot be made as there is no current dental condition or diagnosis. Considering the pertinent evidence in light of the above, the Board finds that the Veteran does not have a compensable dental disorder. There is no competent medical or dental evidence of loss of teeth due to loss of substance of the body of the maxilla or mandible, bone loss through trauma, or any other condition for which service connection for compensation purposes could be allowed. The records do not indicate that during service the Veteran incurred an injury to the mandible or maxilla and the Veteran does not contend otherwise. While there is evidence of removal of tooth 19 in service, there is no evidence that it was the result of trauma with loss of bone in the mandible or maxilla. Thus, Diagnostic Codes 9900 through 9916 do not apply in this case. Further, as previously noted, Diagnostic Codes 9917 and 9918 are also not applicable because they involve neoplasms, which are not present in this case. Moreover, the regulations listed above clearly prohibit service connection for purposes of compensation where the disability involves treatable carious teeth or replaceable missing teeth. 38 C.F.R. § 3.381. The Board notes that "Congress specifically limits entitlement to service-connected disease or injury where such cases have resulted in a disability . . . in the absence of a proof of present disability there can be no claim." Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Given the above, the Veteran has not been diagnosed with a dental disability during the appellate period for which service connection for VA compensation purposes may be granted. Likewise, the Veteran's service records show routine dental care with a tooth extraction, and do not contain evidence of in-service trauma or disease resulting in loss of teeth due to the loss to bone loss of the maxilla or mandible. Having failed to satisfy the requisite elements of a dental service connection claim, the Veteran's appeal must be denied, and the benefit-of-the-doubt doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). J. GALLAGHER Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Jake Choi, 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.