C.F.R. » Title 38 » CHAPTER I—DEPARTMENT OF VETERANS AFFAIRS › PART 3—ADJUDICATION › Subpart A—Pension, Compensation, and Dependency and Indemnity Compensation

38 C.F.R. § 3.381

Service connection of dental conditions for treatment purposes

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(a) The Veterans Benefits Administration (VBA) will adjudicate a claim for service connection of a dental condition for treatment purposes after the Veterans Health Administration determines a veteran meets the basic eligibility requirements of § 17.161 of this chapter and requests VBA make a determination on questions that include, but are not limited to, any of the following:

(1) Former Prisoner of War status;

(2) Whether the veteran has a compensable or noncompensable service-connected dental condition or disability;

(3) Whether the dental condition or disability is a result of combat wounds;

(4) Whether the dental condition or disability is a result of service trauma; or

(5) Whether the veteran is totally disabled due to a service-connected disability.

(b) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may nevertheless be service connected solely for the purpose of establishing eligibility for outpatient dental treatment as provided for in § 17.161 of this chapter. These conditions and other dental conditions or disabilities that are noncompensably rated under § 4.150 of this chapter may be service connected for purposes of Class II or Class II (a) dental treatment under § 17.161 of this chapter.

(c) The rating activity will consider each defective or missing tooth and each disease of the teeth and periodontal tissues separately to determine whether the condition was incurred or aggravated in line of duty during active service

(d) In determining service connection, the condition of teeth and periodontal tissues at the time of entry into active duty will be considered. Treatment during service, including filling or extraction of a tooth, or placement of a prosthesis, will not be considered evidence of aggravation of a condition that was noted at entry, unless additional pathology developed after 180 days or more of active service.

(e) The following principles apply to dental conditions noted at entry and treated during service:

(1) Teeth noted as normal at entry will be service-connected if they were filled or extracted after 180 days or more of active service.

(2) Teeth noted as filled at entry will be service-connected if they were extracted, or if the existing filling was replaced, after 180 days or more of active service.

(3) Teeth noted as carious but restorable at entry will not be service-connected on the basis that they were filled during service. However, new caries that developed 180 days or more after such a tooth was filled will be service-connected.

(4) Teeth noted as carious but restorable at entry, whether or not filled, will be service-connected if extraction was required after 180 days or more of active service.

(5) Teeth noted at entry as non-restorable will not be service-connected, regardless of treatment during service.

(6) Teeth noted as missing at entry will not be service connected, regardless of treatment during service.

(f) The following will not be considered service-connected for treatment purposes:

(1) Calculus;

(2) Acute periodontal disease;

(3) Third molars, unless disease or pathology of the tooth developed after 180 days or more of active service, or was due to combat or in-service trauma; and

(4) Impacted or malposed teeth, and other developmental defects, unless disease or pathology of these teeth developed after 180 days or more of active service.

(g) Teeth extracted because of chronic periodontal disease will be service-connected only if they were extracted after 180 days or more of active service.

(Authority: 38 U.S.C. 1712) [64 FR 30393, June 8, 1999, as amended at 77 FR 4470, Jan. 30, 2012]
Notes of Decisions
Cited in 24 cases, 1991–2020 · leading case: Regis J. Byrd v. R. James Nicholson, 19 Vet. App. 388 (Vet. App. 2005).
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Regis J. Byrd v. R. James Nicholson, 19 Vet. App. 388 (Vet. App. 2005). · cites it 6× “She argues that VA regulation 38 C.F.R. § 3.381 (a), which precludes compensation for service-connected periodontal disease (also known as gum disease), conflicts with 38 U.”
Manio v. Derwinski, 1 Vet. App. 140 (Vet. App. 1991). “382 (c) (1990); see also 38 C.F.R. § 3.381 (b) (1990) (pyorrhea present before service can form basis for service-connected disability).”
Thomas M. Nielson v. Eric K. Shinseki, 23 Vet. App. 56 (Vet. App. 2009). “The Court remanded the matter and ordered the Board to “consult with the [VA] General Counsel as to the proper interpretation of 38 C.F.R. §§ 3.381 (e) [(1993)] and 17.123(c) [now § 17.”
Simington v. West, 11 Vet. App. 41 (Vet. App. 1998). “38 C.F.R. § 3.381 (a) (1997). Treatable carious teeth, replaceable missing teeth, and periodontal disease are not disabling conditions, and may be considered service connected solely for the purpose of determining entitlement to dental examinations or outpatient dental treatment.”
04-37 821 (Board of Vet. App. 2011). · cites it 7× “38 C.F.R. § 3.381 (a) (2010). In determining service connection, the rating activity will consider each defective or missing tooth and each disease of the teeth and periodontal tissues separately to determine whether the condition was incurred or aggravated in the line of duty…”
Regis J. Byrd v. R. James Nicholson (Vet. App. 2006). · cites it 6× “She argues that VA regulation 38 C.F.R. § 3.381 (a), which precludes compensation for service-connected periodontal disease (also known as gum disease), conflicts with 38 U.”
06-12 124 (Board of Vet. App. 2016). · cites it 3× “30, 2012); 38 C.F.R. § 3.381 (a) (2014). Review of the record reveals, however, that the agency of original jurisdiction (AOJ) (i.”
12-01 358 (Board of Vet. App. 2016). · cites it 3× “30, 2012) (adopting the proposed rule as a final rule without changes); 38 C.F.R. § 3.381 (a). FINDING OF FACT The Veteran sustained an in-service injury to teeth numbers 8, 9 and 25; there is no evidence that the Veteran has tooth loss due to loss of body of the maxilla or…”
190306-5486 (Board of Vet. App. 2019). · cites it 3× “The Board also notes that in the context of dental claims, the United States Court of Appeals for Veterans Claims (CAVC) has specifically held that a claim for compensation for a dental disability is also a claim for VA outpatient dental treatment under 38 C.F.R. § 3.381 (2018).…”
181004-864 (Board of Vet. App. 2019). · cites it 3× “§§ 1712 , 5107; 38 C.F.R. §§ 3.381 , 4.150, 17.161. 7. The criteria for service connection for fatigue have not been met.”
200320-72627 (Board of Vet. App. 2020). · cites it 3× “§§ 1110 (2012); 38 C.F.R. §§ 3.381 , 4.150. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1960 to February 1964.”
06-11 084 (Board of Vet. App. 2010). · cites it 5× “§§ 1110 , 1712 (West 2002); 38 C.F.R. §§ 3.381 , 4.150 (2010). 2. With resolution of reasonable doubt in the appellant's favor, the criteria for service connection for dental disability to tooth number 6 and any associated teeth as medically indicated, for VA dental treatment…”
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