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Veterans Benefits Administration

Washington, D.C. 20420

October 12, 2010

Director (00/21)

All VA Regional Offices and Centers

Fast Letter 10-42

SUBJ: Guidance on Rating Dental Conditions


This letter provides clarification on establishing eligibility for outpatient dental services and treatment.


The Veterans Health Administration (VHA) has been receiving from Veterans copies of rating decisions in which service connection "for treatment purposes" is established for certain dental conditions. Examples include periodontal disease on a direct service-connection basis, periodontal disease as secondary to diabetes mellitus, bruxism secondary to post-traumatic stress disorder, and dental caries secondary to medication-induced xerostomia (dry mouth).

VHA is responsible for notifying Veterans of the determination of eligibility for dental treatment. Eligibility for dental treatment is limited by statute. VHA generally has no authority to treat a noncompensable dental condition or disability, even if service connected, unless the dental condition or disability is due to combat wounds or other service trauma; the Veteran is a former prisoner of war; the Veteran is in receipt of compensation at the 100-percent rate due to service-connected disability; the Veteran is participating in a rehabilitation program under 38 U.S.C. Ch. 31 and requires dental services for certain reasons stated in 38 CFR 17.47(g); OR the Veteran is applying for one-time dental care within 180 days of discharge or release from active service. Conditions such as periodontal disease, carious teeth, and missing teeth can be service connected for dental treatment purposes under 38 C.F.R. § 3.381(a) only as provided in 38 C.F.R. § 17.161. Sections 1712 and 2062, title 38, United States Code, and 38 C.F.R. §§ 17.161-163 and 17.165-166 provide the eligibility requirements for Veterans' outpatient dental treatment.

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