Osteonecrosis of the Jaw

DC 9914Dental/Oral38 CFR 4.150, DC 9914

Death of jawbone tissue from reduced blood supply, which can result from bisphosphonate medications, radiation therapy, or trauma during service. Causes pain, swelling, exposed bone, and infection.

Rating Levels

You have lost substantial jaw substance requiring reconstruction, or you have osteomyelitis requiring aggressive treatment.

What the VA looks for

Substantial jaw bone loss confirmed on imaging
Jaw reconstruction surgery performed or planned
Osteomyelitis confirmed by biopsy or imaging
Aggressive treatment (IV antibiotics, multiple surgeries)
Significant functional impairment in eating and speaking

Common Pitfalls

⚠Not connecting to bisphosphonate medications prescribed for service-connected conditions — if you were put on bisphosphonates for a service-connected condition, the jaw necrosis is a secondary condition.
⚠Not documenting exposed bone with photographs in your medical records — visual evidence is critical for rating.
⚠Not getting CT scan showing extent of bone involvement — standard X-rays may not show the full extent of necrosis.
⚠Secondary to radiation therapy for service-connected cancer should be automatically connected — make sure this link is clearly documented.

Related DBQ Forms

DBQ Dental and Oral Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…