Losing teeth changes what a person can eat, how they speak, and how they feel in a room. The VA does compensate for it, but under narrower terms than most veterans expect, and the cause of the loss matters more than the number of teeth.
What Diagnostic Code 9913 actually rates
Diagnostic Code 9913 in 38 CFR 4.150 covers loss of teeth due to loss of substance of the body of the maxilla or mandible without loss of continuity. Ratings run from 0 percent where the lost masticatory surface can be restored by a suitable prosthesis, up to 40 percent where all teeth are lost and no prosthesis can restore the surface.
The percentage depends on two things: how much of the arch is affected, and whether a prosthesis can restore function. A veteran with a well-fitting denture will usually sit at 0 percent even with extensive loss, which surprises people until they read the code.
The cause requirement
The note under the code limits it to loss resulting from trauma or from disease such as osteomyelitis, and excludes loss due to periodontal disease. This is why the same extraction can be compensable for one veteran and not another. Our periodontal disease guide explains the treatment-only rule that applies to the excluded causes.
In-service trauma is the cleanest path. A documented facial injury, a vehicle accident, an assault, or a training injury that fractured the jaw or knocked out teeth creates a direct line. Those cases often also involve fracture residuals rated under codes 9902 through 9904 - see our jaw fracture guide.
Medication-related decay and dry mouth
The path that gets overlooked is secondary. Under 38 CFR 3.310, a disability caused or aggravated by a service-connected condition is service connected. Reduced salivary flow is a well-documented side effect of many medications prescribed for service-connected conditions, including selective serotonin reuptake inhibitors and other antidepressants, anxiolytics, several antihypertensives, muscle relaxants, and opioid pain medications.
Saliva protects teeth. When it drops, decay accelerates, existing restorations fail, and teeth are eventually lost. A medical opinion that ties the prescription record to the documented xerostomia and then to the dental deterioration is doing real work, and it is exactly the kind of reasoning our nexus letter explainer describes.
Where the same picture involves mental health treatment, our mental health series covers the primary conditions those prescriptions usually treat.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service or an already service-connected disability.
Aggravation counts too
Secondary service connection is not limited to conditions a service-connected disability caused outright. Aggravation of a pre-existing dental condition is also covered, which matters for veterans who had some decay before the medications started. The opinion should describe the baseline and the worsening separately.
Building the file
Pull the complete pharmacy record with start dates, the full dental chart including every extraction and its stated reason, imaging that shows bone levels and the pattern of decay, and any note where a dentist or physician recorded dry mouth. Statements describing the practical effect - what you cannot chew, the weight change, the switch to softer foods - support the functional picture. The general structure is in our evidence checklist.
Dietary restriction also matters if a jaw joint condition is in play, because the higher tiers of Diagnostic Code 9900 combine limited opening with diet.
Where veterans go from here
If the loss traces to trauma in service, the direct claim is usually straightforward. If it traces to medications, the claim needs a medical opinion that walks the chain. A records review identifies which of those the documentation supports before anything is written.