Diagnostic Code 9905 · 38 CFR §4.150
Temporomandibular disorder (TMD, commonly called TMJ) affects the jaw joint and the muscles that control jaw movement. Symptoms typically include jaw pain, difficulty chewing, clicking or popping when you open your mouth, jaw locking, headaches, and ear pain. Veterans often develop TMD from dental trauma during service, jaw injuries sustained in combat or training, stress-related teeth grinding (bruxism) in high-pressure military environments, or as a secondary effect of dental procedures performed while on active duty. The VA rates TMD based on two factors: how far you can open your mouth (measured in millimeters between your upper and lower front teeth) and whether your condition requires you to eat mechanically altered foods such as liquids, purees, or soft foods. Both dimensions matter — a veteran with moderate opening limitation who can only eat pureed food may rate higher than someone with the same opening range who eats normally.
| Rating | Criteria |
|---|---|
| 50% | Your maximum unassisted jaw opening is between 0 and 10mm, and you are restricted to mechanically altered foods (pureed, liquid, or soft diet as verified by a physician). This is the highest TMD rating and reflects near-total loss of jaw function. |
| 40% | This level applies in three scenarios: (1) jaw opening of 0-10mm without dietary restrictions to mechanically altered foods; (2) jaw opening of 11-20mm with dietary restrictions to all mechanically altered foods; or (3) jaw opening of 21-29mm with dietary restrictions to full liquid and pureed foods only. |
| 30% | This level applies in three scenarios: (1) jaw opening of 11-20mm without dietary restrictions to mechanically altered foods; (2) jaw opening of 21-29mm with dietary restrictions to soft and semi-solid foods; or (3) jaw opening of 30-34mm with dietary restrictions to full liquid and pureed foods. |
| 20% | This level applies in two scenarios: (1) jaw opening of 21-29mm without dietary restrictions to mechanically altered foods; or (2) jaw opening of 30-34mm with dietary restrictions to soft and semi-solid foods. |
| 10% | Jaw opening of 30-34mm without dietary restrictions to mechanically altered foods, or lateral excursion (side-to-side jaw movement) limited to 0-4mm. Normal opening is considered 35-50mm, so this captures mild limitation. |
| 0% | TMD is diagnosed and service-connected but jaw opening is 35mm or greater with no dietary restrictions. A 0% rating still establishes service connection, which matters for future worsening and secondary conditions. |
You need a diagnosis of TMD from a dentist, oral surgeon, or maxillofacial specialist. The single most important measurement is your inter-incisal range — the distance in millimeters between your upper and lower front teeth at maximum unassisted opening. This must be documented precisely. Imaging such as X-rays, MRI, or CT of the TMJ showing joint abnormalities strengthens the claim. Under the current rating criteria, dietary restrictions also affect the rating, so if your doctor has placed you on a modified-texture diet (soft foods, purees, or liquids), get that documented in your medical records by a physician. If TMD resulted from a jaw injury during service, include service treatment records. If it developed from stress-related bruxism, records showing nightguard prescriptions, muscle relaxant use, or referrals for TMJ treatment support the service connection.
Yes. Bruxism (teeth grinding) is a common stress response and is frequently associated with PTSD. If grinding has caused or worsened TMD, you can claim it secondary to your service-connected PTSD. A nexus opinion from a dentist or oral surgeon connecting the bruxism to your PTSD and the resulting TMD strengthens this claim significantly.
The examiner places a ruler between your upper and lower front teeth (incisors) at maximum unassisted opening. The VA considers normal range to be 35-50mm. Rating thresholds sit at 34mm, 29mm, 20mm, and 10mm, so every millimeter matters. Open only to where pain or the joint itself limits you — do not force it wider.
The VA defines four levels: full liquid, puree, soft, and semi-solid foods. These are foods that have been blended, chopped, ground, or mashed to make them easier to chew and swallow. To qualify for a higher rating based on dietary restrictions, the modified-texture diet must be recorded or verified by a physician in your medical records.