Sjogren's Syndrome (Oral Manifestations)

DC 9913Dental/Oral38 CFR 4.150, DC 9913

Oral symptoms of Sjogren's syndrome, an autoimmune condition that attacks moisture-producing glands. Causes severe chronic dry mouth (xerostomia), accelerated tooth decay, difficulty swallowing, and frequent oral infections. Rated based on the frequency and severity of oral symptoms.

How the VA rates this condition

The VA rates this condition based on how often symptoms occur and how severe each episode is. The examiner will ask about the frequency, duration, and intensity of your episodes, as well as how they affect your ability to work.

Diagnostic code

DC 9913

Rating range

0% – 30%

Rating levels

Rating criteria are defined in 38 CFR 4.150, DC 9913. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have extreme oral manifestations with near-complete absence of saliva, requiring constant management. You have lost multiple teeth, have chronic oral infections, and require a modified diet due to swallowing difficulty.

What the VA looks for

Near-complete absence of saliva confirmed by testing
Multiple teeth lost due to accelerated decay
Chronic oral infections requiring ongoing treatment
Modified diet required due to swallowing difficulty
Significant impact on nutrition and quality of life

Common Pitfalls

⚠Not obtaining salivary flow rate testing to objectively document the severity of dry mouth — subjective reports alone may not support the claimed rating level.
⚠Not documenting the accelerated dental deterioration caused by dry mouth — keep records of every cavity, tooth extraction, and dental procedure to show the pattern.
⚠Not filing for separate ratings for other Sjogren's manifestations such as dry eyes, joint pain, and fatigue — the oral component is only one part of the condition.
⚠Not connecting Sjogren's to military service or to service-connected conditions — autoimmune conditions can be triggered by environmental exposures or may be secondary to other autoimmune conditions.

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…

Sjogren's Syndrome (Oral Manifestations)

How the VA rates this condition

Diagnostic code

DC 9913

Rating range

0% – 30%

Rating levels

Rating Levels

What the VA looks for

Near-complete absence of saliva confirmed by testing
Multiple teeth lost due to accelerated decay
Chronic oral infections requiring ongoing treatment
Modified diet required due to swallowing difficulty
Significant impact on nutrition and quality of life

Common Pitfalls

⚠Not obtaining salivary flow rate testing to objectively document the severity of dry mouth — subjective reports alone may not support the claimed rating level.

⚠Not documenting the accelerated dental deterioration caused by dry mouth — keep records of every cavity, tooth extraction, and dental procedure to show the pattern.

⚠Not filing for separate ratings for other Sjogren's manifestations such as dry eyes, joint pain, and fatigue — the oral component is only one part of the condition.

⚠Not connecting Sjogren's to military service or to service-connected conditions — autoimmune conditions can be triggered by environmental exposures or may be secondary to other autoimmune conditions.