The Mouth and Teeth

Topics:

The Lower Jaw
The Upper Jaw
The Jaw Joint
The Palates
The Teeth
Other Mouth and Teeth Conditions
DBQs for Mouth and Teeth Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

 


The Lower Jaw

Military disability is given for mouth and teeth conditions

The mandible, or lower jawbone, is the only movable bone on the head.

Code 9900: Osteomyelitis or osteoradionecrosis of the mandible or maxilla is rated under code 5000, osteomyelitis.

Code 9901: If the entire mandible is missing or is completely non-functional, then it is rated 100%.

Code 9902: If about half of the mandible is missing and the jaw is unable to move or is limited in its movement, then it is rated 50%. If the jaw motion is not affected, then it is rated 30%.

All other ratings for the mandible are based on the degree to which the ability to chew food is affected. If the mandible is still able to chew food with no real limitations, then the condition would be considered “a slight limitation”. On the other hand, if the mandible cannot move enough to chew food at all, then it would be considered “a severe limitation”.

Code 9903: If the mandible has been broken and did not heal back together, then it is rated 30% for a severe limitation and 10% for a moderate limitation.

Code 9904: If the mandible has been broken and did heal, but not correctly so that there is a definite disfigurement to the bone, then it is rated 20% for severe, 10% for moderate, and 0% for slight. Military disability is given for mouth and teeth conditions

The back of the mandible is made up of the ramus, the coronoid process and the condyle.

Code 9909: If the coronoid process is missing, then it is rated 10% for one side and 20% for both sides.

Code 9906: If more than half of the ramus is missing and the ability to chew or move the jaw is limited, then it is rated 30% for one side and 50% for both sides. If the ability to chew or move the jaw is not limited, then it is rated 20% for one side and 30% for both sides.

Code 9907: If less than half of the ramus is missing but the jaw function is not limited, then it is rated 10% for one side and 20% for both sides.

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The Upper Jaw

Military disability is given for mouth and teeth conditions

The maxilla, or upper jawbone, is connected directly to the skull.

Code 9914: If more than half of the maxilla is missing and cannot be replaced by a prosthetic piece it is rated 100%. If it can be replaced by a prosthesis, then it is rated 50%.

Code 9915: If 25 to 50 percent of the maxilla is missing and cannot be replaced by a prosthesis, then it is rated 40%. If it can be replaced by a prosthesis, then it is rated 30%. If less than 25 percent of the maxilla is missing and cannot be replaced, then it is rated 20%, and if it can be replaced, it is rated 0%.

Code 9916: If the maxilla has been broken and hasn’t healed back together or has healed incorrectly, then it is rated based on how severely the bone has been disfigured and thus limits its ability to function. If it is severely disfigured, it is rated 30%. If it is moderately disfigured, it is rated 10%. If it is slightly disfigured, it is rated 0%.

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The Jaw Joint

Military disability is given for mouth and teeth conditions

The temporomandibular joint, jaw joint, includes the condyloid process of the mandible. This process includes the condyle and the condyle neck.

Code 9908: If the condyloid process is missing on one or both sides, then it is rated 30%.

Code 9905: All other jaw joint conditions (including TMJ) are rated based on limited motion of the joint. The jaw can move in two directions: open and closed, and side-to-side. Only one direction of motion can be rated. If the jaw can’t move side-to-side or open and close, then only the one that will give the higher rating is used.

If the jaw can’t move side-to-side more than 4 millimeters (mm), then it is rated 10%.

If the jaw can’t open more than 10 mm (about 0.4 of an inch), then it is rated 40%. If it can open between 11 and 20 mm (about 0.4 to 0.8 of an inch), it is rated 30%. Between 21 and 30 mm (about 0.8 to 1.2 inches) is rated 20%, and between 31 and 40 mm (about 1.2 to 1.6 inches) is rated 10%.

Note: The Painful Motion principle applies in cases of TMJ or any other condition that causes pain when moving the jaw. So, whether or not the jaw can move, the minimum rating if pain is present is 10%.

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The Palates

Military disability is given for mouth and teeth conditions

The hard palate is the hard tissue that makes up the roof of the mouth. Directly behind it is a softer tissue called the soft palate.

Only the hard palate is rated in the VASRD. Most conditions of the soft palate do not cause symptoms and are not rated by the VASRD. They could be rated under these codes, however, if the conditions and symptoms are similar.

Code 9911: If half or more of the hard palate is missing and cannot be replaced by a prosthesis, then it is rated 30%. If it can be replaced by a prosthesis, then it is rated 10%.

Code 9912: If less than half of the hard palate is missing and cannot be replaced by a prosthesis, then it is rated 20%. If it can be replaced, it is rated 0%.

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The Teeth

The loss of teeth by themselves are not ratable since they are not truly disabling and are easily replaced by false teeth. Teeth also cannot be rated if they are lost from naturally occurring diseases related to ageing. They must be lost as a result of injury, accident, or diseases such as osteomyelitis.

If the loss of teeth is caused by part of either the maxilla or mandible missing, then it can either be rated under the following code or under the codes for the missing maxilla or mandible, whichever code provides the higher rating. If not enough of the mandible or maxilla is missing to qualify for a rating under their codes, then the condition is simply rated here. The condition cannot be rated twice, once for the maxilla or mandible and once for the teeth. Only one or the other. Military disability is given for mouth and teeth conditions

Code 9913: Regardless of how many teeth are missing, if they can be replaced by a prosthesis or false teeth, then it is rated 0%. If, however, they cannot be replaced, they are rated as follows:

All teeth missing is rated 40%. The loss of all the upper teeth or all the lower teeth is rated 30%. If all the upper and lower posterior teeth or all the upper and lower anterior teeth are missing, it is rated 20%. If only all the upper anterior teeth or all the lower anterior teeth are missing, it is rated 10%. If all the upper and lower teeth on one side are missing, then it is also rated 10%.

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Other Mouth and Teeth Conditions

Diseases that affect the mouth and teeth can be found on the Diseases of the Musculoskeletal System page and cancer in the mouth and teeth can be found on the Cancer and Tumors of the Musculoskeletal System page. All other mouth and teeth injuries or conditions will be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

In the case of osteomyelitis or osteoradionecrosis affecting the mandible or maxilla bones, the condition is rated as osteomyelitis (code 5000), and the final code will actually be 9901-5000. The first four-digit code tells us that the osteomyelitis affects the jaw and the second four-digit code is the code the condition is actually rated under.

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DBQs for Mouth and Teeth Conditions

Here are the Disability Benefits Questionnaires (DBQs) used for mouth and teeth conditions: TMJ DBQ and Mouth and Teeth Conditions (other) DBQ.

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Principles that Apply

Painful Motion: If pain is present with motion, then the minimum rating must be given.

Pyramiding: A single condition can only be rated once! However, if a nerve condition or other condition exists that is additional to the dental condition (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified physician in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

 

Please see the Musculoskeletal Principles and the VASRD Principles pages for further guidance.

For muscle conditions, see The Facial Muscles. For other mouth conditions, see The Digestive System page. For disfigurements or scars, see the Scars page.

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