A Smile Restored, and a Life Reclaimed – The New York Times

Cancer weakened Eileen Gaetas teeth. When she needed to replace a partial denture, she turned to a consumer assistance program for help.

After Eileen Gaeta learned she had lymphoma in 1991, she was treated with radiation therapy. The treatments were effective, but the side effects took a toll.

I was a mess, she said. The process burned her skin, caused her hair to fall out, made her infertile and weakened her teeth and bones.

My teeth were always gorgeous, said Ms. Gaeta, now 61.

It took years of intensive dental treatments, including root canals and caps, to restore her smile.

Throughout the ordeal, Ms. Gaeta raised a son, took care of her mother and worked as an investigator at the New York City Department of Correction.

Six years ago, shortly after she retired, her life took another unwelcome turn. She had a heart attack while she was visiting Atlantic City, N.J., and had three stents inserted to open narrowed arteries. Months later, her mother died after falling in a rehabilitation center and slipping into a coma.

Everything started going wrong, Ms. Gaeta said.

The dental work she had done years earlier had not held up, and she was outfitted with dentures in 2014. Last year, she started having oral pain and was told she needed a new partial lower denture, but her insurance would not cover it.

I couldnt eat anything, Ms. Gaeta said in an interview in the apartment that she shares with her son, Jason, 40, in the New Springfield section of Staten Island. I had to eat applesauce and yogurt. She said her weight dropped to 96 pounds.

She fought with her insurance company for at least six months and appealed the decision several times to no avail. I didnt go to four weddings in my family because of that, she said. I was sick and depressed.

While she was fighting with her insurance company, Ms. Gaeta received help from Community Health Advocates, a consumer assistance program operated by Community Service Society, one of the seven organizations supported by The New York Times Neediest Cases Fund.

What we do is help people who have health insurance or people who are uninsured, said Elisabeth Benjamin, the societys vice president of health initiatives.

Community Health Advocates counselors explain the complexities of health insurance and assist people who have medical debt and those who need supplemental coverage or help appealing coverage denials.

Ms. Gaeta reached out to Community Health Advocates after seeing its phone number on the back of an appeal letter. A counselor negotiated with her dentist to lower the price of a partial denture to $850 from $1,450.

In March 2019, Community Service Society used money from The Neediest Cases Fund to cover the cost of Ms. Gaetas denture replacement.

I can eat steak now, said Ms. Gaeta, who receives $1,920 in disability benefits and $1,460 from her pension each month. The programs counselors also helped lift her out of depression by checking in on her, she said.

Ms. Benjamin said that many of the people who call Community Health Advocates are seeking help with dental care. Its not a guarantee that New Yorkers will have dental coverage, she said.

If people do have dental plans, they often have waiting periods or exemptions, Ms. Benjamin said. Theres an issue with the adequacy of the dental coverage that is out there in the world, she added.

Many private health insurance plans do not include dental coverage, forcing consumers to do without or buy it separately. Though Medicaid covers dental care for low-income children, the program offers comprehensive coverage to adults in only 18 states and the District of Columbia.

Medicare does not cover routine dental care, including cleanings, fillings and dentures.

Access to affordable dental care could improve the quality of life of adults over 45, according to a recent study published in The Journal of Health and Aging. One in eight adults in that age group a cohort that includes Ms. Gaeta cannot afford dental care, researchers found.

Poor oral health also increases the prevalence of periodontal diseases, said Shillpa Naavaal, the lead author of the paper and an assistant professor at the Virginia Commonwealth University School of Dentistry.

Having good oral health makes you more confident, more likely to be in the work force and to be in those positions where you have to talk and socialize, Dr. Naavaal said. People who have dental problems have a higher rate of embarrassment.

For Ms. Gaeta, the dental care she received with help from Community Health Advocates has helped restore her to full health and improved her spirits.

What they did for me was like a kid getting up and seeing things under a Christmas tree, she said. It may not mean a lot to other people, but when youre in that position and everything is going wrong, it means a lot.

Donations to the Neediest Cases may be made online, or with a check or over the phone.

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A Smile Restored, and a Life Reclaimed - The New York Times