Dental and Oral Conditions Rating Guide

The Rules That Decide Every Dental and Oral Claim

The single most important thing to understand about dental claims is the split between treatment and compensation. Most dental conditions never get a disability rating at all; instead they qualify a veteran for VA dental care. A much smaller list of structural jaw and mouth problems is rated for compensation under 38 CFR § 4.150. These rules sort your condition into the right path.

1. Most dental conditions are not compensable

Ordinary tooth loss, cavities, and gum (periodontal) disease generally do not carry a disability rating. Instead, they can qualify a veteran for VA dental treatment under one of the dental eligibility classes. This is a real and valuable benefit, but it is a health-care benefit, not monthly compensation. Filing for a rating on these conditions usually ends in a denial because there is no rating to award.

2. Compensation is limited to specific structural problems

Under 38 CFR § 4.150, loss of teeth is compensable only when it is caused by loss of substance of the jawbone (the maxilla or the mandible) from trauma or disease, and where the bone loss cannot be corrected with a prosthesis. Teeth lost to gum disease or ordinary decay do not qualify. The distinction the VA draws is the cause: bone loss from injury or disease, not periodontal disease.

3. Loss or nonunion of part of the jaw is compensable

The jaw itself is rated. Nonunion or malunion of the mandible (a jaw that did not heal, or healed in the wrong position), and loss of part of the mandible, maxilla, hard palate, ramus, or condyloid process, each carry a rating under 4.150. The rating turns on how much bone is lost and whether the loss affects motion and function.

4. Jaw joint (TMJ) impairment is rated on limited motion

Temporomandibular (jaw joint, or TMJ) impairment is rated on how much your jaw can move, measured by how far the mouth opens and how far it moves side to side. Less motion means a higher rating. Because the rating depends on those measurements, a TMJ claim needs an exam that actually records inter-incisal (open-mouth) range and lateral (side-to-side) range in millimeters.

5. Osteomyelitis and osteoradionecrosis of the jaw are compensable

Infection or radiation damage of the jawbone is rated. Osteomyelitis (bone infection) and osteoradionecrosis (bone death from radiation, often after radiation therapy for a head or neck cancer) of the mandible or maxilla each carry a rating under 4.150. These are structural bone conditions, the kind the dental schedule is built to compensate.

Find the Guide for Your Condition

This system does not have a dedicated per-condition guide yet. For dental care eligibility, use the dental benefits guide; for a specific jaw or TMJ rating, open the condition lookup:

For a specific jaw or oral condition, open its condition lookup page for the rating levels and Board data.

Common Secondary Conditions

Some oral conditions are best claimed as secondary to another service-connected condition rather than directly. Because the cause is what makes jaw damage compensable, the connection to the underlying condition matters:

• Jaw or TMJ problems from a head injury. Jaw joint impairment that follows a service-connected head injury or facial trauma can be claimed as secondary to that injury.
• Osteoradionecrosis after cancer treatment. Bone death of the jaw from radiation given for a service-connected head or neck cancer can be claimed as secondary to that cancer.
• Dental trauma documented in service. Teeth or jaw damaged by an in-service injury, when the trauma is in the record, may support a claim tied to that event.
• Loss of smell or taste after facial trauma. Facial or head trauma can damage the nerves for smell and taste, which are rated separately. See smell and taste and secondary conditions.

Open the lookup page for a specific code to see the live Board grant rates for that condition's most common pairings.

Evidence That Wins

• Dental and oral-surgery records, showing the diagnosis and the structural problem, not just a treatment history.
• Imaging of the jaw (X-ray, panoramic, or CT) showing bone loss, nonunion, or a fracture, the objective backbone of a 4.150 claim.
• A measurement of jaw motion for a TMJ claim, recording open-mouth (inter-incisal) and side-to-side (lateral) range in millimeters.
• Service dental records showing the original trauma or the in-service event that caused the damage.
• The matching DBQ for the dental or oral condition, which prompts the examiner to capture the measurements and findings the rating depends on. See the DBQ guide.

Common Mistakes

Frequently Asked Questions