{"id":"F2025L00151","name":"Statement of Principles concerning tooth loss (Reasonable Hypothesis) (No. 29 of 2025)","slug":"statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442736,"registerId":"F2025L00151-fast-fetch-1775957685931","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning tooth loss (Reasonable Hypothesis) (No. 29 of 2025)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nTOOTH LOSS  (Reasonable Hypothesis)\n\n(No. 29 of 2025)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated    18 February 2025.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\n\n \n\n \n\n   \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n \n\n\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning tooth loss (Reasonable Hypothesis) (No. 29 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 25 March 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning loss of teeth No. 124 of 2015 (Federal Register of Legislation No. F2015L01678) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about tooth loss and death from tooth loss.\n\n\nMeaning of tooth loss\n\n1.           For the purposes of this Statement of Principles, tooth loss:\n  1.           means partial or complete permanent loss of a tooth (consisting of the enamel and dentine) of the natural secondary dentition, with or without retained dental root; and\n  2.           includes tooth loss due to surgical extraction; and\n  3.           excludes superficial tooth wear confined to the enamel.\n\n\nNote 1: Secondary dentition refers to the 32 permanent teeth and not the primary dentition.\n\nNote 2: Tooth loss may involve the tooth substance, the gomphosis or the alveolar bone.\n\n1.           While tooth loss attracts ICD‑10‑AM code K08.1 or K08.3,  in applying this Statement of Principles the meaning of tooth loss is that given in subsection (2).\n2.           For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\n\nDeath from tooth loss\n\n1.           For the purposes of this Statement of Principles, tooth loss, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's tooth loss.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that tooth loss and death from tooth loss can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n1.                Factors that must exist\n\n\nAt least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting tooth loss or death from tooth loss with the circumstances of a person's relevant service:\n\n1.           having dental caries in the affected tooth at the time of clinical onset;\n2.           having periodontitis in the periodontium supporting the affected tooth at the time of clinical onset;\n3.           having periodontal abscess of the affected tooth at the time of clinical onset;\n4.           having dental pulp and apical disease of the affected tooth at the time of clinical onset;\n5.           having a fracture of the affected tooth where the fractures involves the dentine before clinical onset;\n6.           having luxation of the affected tooth (partial or complete displacement of the tooth from its alveolar socket) at the time of clinical onset;\n7.           having traumatic avulsion of the affected tooth (total displacement of the tooth out of its alveolar socket) at the time of clinical onset;\n8.           having a fracture of the alveolar bone supporting the affected tooth before clinical onset;\n9.           undergoing a course of radiotherapy for head or neck cancer, where the affected tooth was in the field of radiation, within the 4 years before clinical onset;\n\n\nNote: The radiotherapy for head or neck cancer can result in osteonecrosis of the bone which leads to tooth displacement and loss.\n\n1.       having pericoronitis of the affected tooth at the time of the dental decision to extract the partially erupted tooth; \n\n\nNote: Pericoronitis causes inflammation of the gingiva surrounding a partially erupted tooth, especially the third molar or wisdom tooth, and is related to the accumulation of food particles and micro-organisms under the gum flap.\n\n1.       taking ribavirin at the time of clinical onset;\n2.       inability to obtain appropriate clinical management for tooth loss before clinical worsening.\n\n\n1.            Relationship to service\n  1.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n  2.           The factor set out in subsection 9(12) applies only to material contribution to, or aggravation of, tooth loss where the person's tooth loss was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA;\n\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary  \n\nNote:               See Section 6\n\n1               Definitions\n\nIn this instrument:\n\n                                MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                               relevant service means:\n\n(a)          operational service under the VEA;\n\n(b)          peacekeeping service under the VEA;\n\n(c)          hazardous service under the VEA;\n\n(d)          British nuclear test defence service under the VEA;\n\n(e)          warlike service under the MRCA; or\n\n(f)           non-warlike service under the MRCA.\n\nNote: MRCA and VEA are defined in the Schedule 1 - Dictionary.\n\n                               terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a)           pneumonia;\n\n(b)           respiratory failure;\n\n(c)           cardiac arrest;\n\n(d)           circulatory failure; or\n\n(e)           cessation of brain function.\n\n                               tooth loss—see subsection 7(2).\n\n                               VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the prior Statement (No. 124 of 2015) (s4) and replaces it with updated criteria. The new Statement explicitly includes death from tooth loss and defines terminal events (s7(4); Schedule 1), adds specific factors such as radiotherapy within 4 years (s9(9)), ribavirin use (s9(11)) and inability to obtain appropriate clinical management with a limited application (s9(12); s10(2)). The source text does not contain the prior instrument, so the extent of substantive change versus drafting/update cannot be fully determined from this instrument alone."},"complexity_factors":["Repeal and replacement of a prior Statement (s4) — requires comparing instruments to assess substantive change.","Medical and dental terminology and diagnostic distinctions (definition of tooth loss, inclusion/exclusion of superficial wear) (s7(2)).","Detailed enumerated causal factors that require clinical evidence (s9(1)–(12)): caries, periodontitis, abscess, pulp/apical disease, fractures, luxation, avulsion, alveolar bone fracture.","Specific treatment/medication and temporal rule: radiotherapy for head/neck with 4‑year window (s9(9)); ribavirin use at clinical onset (s9(11)).","Non-clinical evidentiary factor: inability to obtain appropriate clinical management as a factor and its limited application where loss pre-existed service (s9(12); s10(2)).","Requirement that any listed factor be related to the person’s relevant service (s10(1)) and cross-reference to other Statements of Principles when factors overlap (s11).","Use of an evidentiary standard based on a \"reasonable hypothesis\" and the Authority’s view of medical‑scientific evidence (s8; instrument made under s196B(2) VEA (s3)).","References to ICD‑10‑AM codes and an external classification (s7(3)–(4)) — reliance on external clinical coding for interpretation.","Inclusion of death from tooth loss via contribution to a terminal event and definition of terminal event in the Dictionary (s7(4); Schedule 1).","Applicability limited to claims under specified statutes (s5) — administrative and claims-processing implications for decision‑makers."],"plain_english_summary":"This instrument replaces an earlier Statement and sets the medical criteria the Repatriation Medical Authority will use to decide whether tooth loss, or death contributed to by tooth loss, can be connected to a person’s relevant service for claims under the VEA and MRCA. It lists specific clinical circumstances (dental disease, trauma, radiotherapy in the head/neck within 4 years, ribavirin use, or inability to obtain appropriate care) that must exist to raise a \"reasonable hypothesis\" linking the condition to service."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement of an existing Statement of Principles (No. 124 of 2015). It maintains the same scope—determining medical factors for service-connected tooth loss claims under the veterans' compensation scheme. The structure and purpose align with the original intent of the 2015 instrument and the broader statutory framework under section 196B(2) of the VEA."},"complexity_factors":["12 specific medical factors with precise clinical definitions (e.g., 'luxation', 'pericoronitis', 'dentine')","Cross-references to two separate Acts (VEA and MRCA) and their service categories","Conditional logic in section 10(2) limiting factor 12 to aggravation cases only","Nested definitions requiring reference to Schedule 1 and subsection 7(2)","Medical coding reference (ICD-10-AM Tenth Edition) with specific ISBN and effective date","Section 11 creates dynamic incorporation of other Statements of Principles by reference","Specific temporal limitations (4-year window for radiotherapy, 'at time of clinical onset' requirements)"],"plain_english_summary":"This instrument replaces the 2015 rule and sets a new list of 12 medical/circumstantial factors that, if present, create a \"reasonable hypothesis\" that adult tooth loss was linked to Australian Defence Force service. It applies to veterans and current/former service members claiming under the VEA or MRCA across all service types. The lower \"reasonable hypothesis\" threshold makes it easier for affected personnel to have dental loss claims assessed for treatment, compensation and pensions."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025","history":"/api/acts/statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-tooth-loss-reasonable-hypothesis-no-29-of-2025/documents"}}