Body system: Dental and Oral ConditionsRegulation: 38 CFR § 4.150DBQ: DBQ MUSC Temporomandibular Disorders
DC 9905 covers temporomandibular (jaw joint) disorder. The VA rates it first on the measured opening of the mouth, in millimeters between the upper and lower front teeth, and on side-to-side movement, and then raises the level when the limited opening also forces a diet of soft, pureed or liquid foods, from 10% up to 50% (38 CFR 4.150). Pain alone is not a level; the measured opening and the dietary restriction are. Two rules from the regulation's notes: a rating for limited opening is not combined with one for limited side-to-side movement, and a modified diet raises the level only when a physician has recorded or verified it.
Rating levels
- 50% — You can only open your mouth between 0 to 10 millimeters at most (about the width of your pinky fingernail or less), and you cannot eat any regular solid foods. All your food must be mechanically altered, meaning it has to be chopped, ground, blended, or liquified before you can eat it because your jaw opening is so severely limited.
- 40% — You can only open your mouth between 0 to 10 millimeters (about the width of your pinky fingernail), but you can still eat normal foods without needing them to be chopped up, pureed, or mechanically softened. This severe jaw limitation (interincisal range refers to how far apart your upper and lower front teeth can be separated) significantly restricts mouth opening for talking, yawning, or dental care, though your ability to chew and swallow regular food remains intact.
- 40% — You can only open your mouth between 11 to 20 millimeters (about half an inch to three-quarters of an inch) when measured from your top teeth to bottom teeth at maximum opening without assistance. Your jaw problems are severe enough that you must eat only soft, chopped, ground, or pureed foods because you cannot chew normally due to the limited mouth opening.
- 30% — Your jaw can only open between 11 to 20 millimeters when measured from your top teeth to bottom teeth (interincisal range is the distance between your upper and lower front teeth when your mouth is open as wide as possible). You can still eat normal foods without needing them to be chopped, blended, or specially prepared, even though your jaw opening is significantly limited.
- 40% — You can only open your mouth between 21 to 29 millimeters (about 3/4 to 1 1/8 inches) when opening as wide as possible without assistance. Your jaw condition is severe enough that you're restricted to eating only full liquid foods like smoothies and soups, plus pureed foods (foods blended to a smooth consistency), because you cannot chew normally due to the limited jaw opening.
- 30% — You can only open your mouth between 21 to 29 millimeters at most (measured between your front teeth - this is about the width of a nickel to a quarter). Because of this limited jaw opening, you're restricted to eating only soft foods like mashed potatoes, soup, and yogurt, or semi-solid foods that don't require much chewing.
- 20% — You can open your mouth between 21 to 29 millimeters when measured from your top teeth to bottom teeth (interincisal range is the distance between your upper and lower front teeth when your mouth is open as wide as possible without help). Your jaw opening is somewhat limited, but you can still eat all types of regular food without needing it to be chopped up, ground, or softened first.
- 30% — You can only open your mouth 30 to 34 millimeters (about 1.2 to 1.3 inches) when measured from your top teeth to bottom teeth at maximum opening without assistance. Your jaw condition is severe enough that you can only eat liquid foods like smoothies or soups, and pureed foods like baby food or mashed potatoes - you cannot chew regular solid foods.
- 20% — You can only open your mouth 30 to 34 millimeters at most (about 1.2 to 1.3 inches, or roughly the width of your thumb). Because of this limited jaw opening, you're restricted to eating only soft foods like mashed potatoes, yogurt, and soup, plus semi-solid foods like pasta or soft bread that don't require much chewing.
- 10% — You can open your mouth between 30 to 34 millimeters when measured from your upper teeth to your lower teeth (interincisal range is the distance between your top and bottom front teeth). Your jaw opening is somewhat limited, but you can still eat all types of regular food without needing it to be chopped, ground, or softened first.
- 10% — Your jaw can only move sideways between 0 to 4 millimeters when you try to slide it left or right. Lateral excursion (sideways jaw movement) is measured by how far you can shift your lower jaw to either side, and this severely limited range means your jaw is significantly restricted compared to normal movement.