Nonprofit helps cancer survivors smile again

Painful surgery. Endless clinic appointments. Chemotherapy sessions that last for hours. Hair loss. Radiation treatment that brings burns and fatigue.

Raven Burroughs knew all of those would be part of her battle after being diagnosed with breast cancer in 2009.

What she didn't know was the damage that treatment would do to her mouth.

After undergoing chemotherapy in June 2009, a mastectomy that December and radiation in March 2010, her gums started getting spongy, as she puts it. By August, her teeth were breaking off and falling out.

"It was strange," says the 33-year-old, recalling how she would wake up choking on a piece of tooth, or find herself spitting them out as she ate.

Dental problems are among the least-known side effects of cancer treatment. Aggravating the bad situation is the lack of dental insurance to cover the problems.

Burroughs spent hours online and on the phone looking for help . Her regular dentist and others she called wouldn't treat her because she had had radiation up to the neck, a result of her cancer having spread to lymph nodes .

Despite having letters from her oncologist and radiologist clearing her for dental treatment, those who denied her treatment said it was because of the risk of osteoradionecrosis of the jaw bone, a condition that can complicate oral surgery.

Even if she had found someone to treat her, Burroughs says, she doesn't know how she would have paid for it.

She was laid off in October 2010 from the construction management company where she worked. Her medical insurance, which she described as weak to begin with, didn't include coverage for dental treatment, even if a doctor vouched for its being directly related to a covered condition such as cancer -- which, again, her doctors did.

"I didn't know what I was going to do," says Burroughs, a single mother of a 10-year-old son.

That's where Las Vegas dentist Olya Banchik steps in.

Banchik started Smiles for Survivors to help breast cancer patients get the oral care they need and to raise awareness about the link between cancer treatment and oral health.

A former co-worker told Burroughs about Smiles for Survivors.

By the time Burroughs got in to see Banchik, all but a few of her teeth were broken off at the gum line. Her mouth was filled with infected sores.

Besides the pain, there was the humiliation of not being able to smile, or even speak, comfortably .

Some 15 visits and nearly a year later, as she notes that she is cancer-free, Burroughs flashes a bright grin.

"They gave me my life back," says Burroughs, who was treated by both Banchik and Dr. Mark Degen, an oral maxillofacial surgeon.

Filling a need

Banchik was inspired to found Smiles for Survivors by her mother, Tanya Gordin, who was diagnosed with breast cancer in 2005. Following Gordin's recovery, Banchik began looking for ways to get involved in the breast cancer community.

She was surprised to learn of the high percentage of cancer patients who experience oral complications -- about 40 percent, according to literature she received from Comprehensive Cancer Centers of Nevada.

"I know dentistry," she says. "So, I realized this was something I could do to help them."

After a couple years of research and planning, Smiles for Survivors obtained its 501(c)(3) nonprofit designation this year. Burroughs was its first patient.

The group's mission is twofold.

First, focusing on people diagnosed with breast cancer, it provides free oral care to those who could not get it otherwise. Second, it raises awareness about the effect that cancer treatment can have on patients' oral health.

The potential pool of people in need is created, in part, by spotty dental insurance coverage. According to the Centers for Disease Control and Prevention's National Health Interview Survey, 43.8 million Americans had no health insurance in 2008 (that number rose to 48.6 million in 2010). Even among those who had health insurance, 45 million under the age of 65 had no dental insurance.

Counting those older than age 65, analysts estimate that nearly 100 million people had no dental insurance at the time of the survey.

That number is likely higher today, with the recession causing more people to cancel or opt out of supplementary coverage.

Linda Buckley, breast health nurse navigator in the Breast Center of Sunrise Hospital, refers patients to resources that can help them with the various issues they encounter during treatment and recovery. Buckley says she had never heard of anyone offering dental services before Smiles for Survivors -- although she was aware of the need for it, based on her own experience.

"When I went through chemotherapy at the age of 33, I was shocked to have cavities because I was the kind of kid who never did," she says.

Banchik says cancer treatment can damage oral health in several ways. Most commonly, chemotherapy can cause xerostomia, or dry mouth. Without saliva to wash away plaque and bacteria, teeth are vulnerable to decay.

Another side effect of chemotherapy can be sores in the mouth, which can sometimes get infected.

Dry mouth and sores, with the general malaise of being sick, can cause people to avoid eating, hydrating and brushing properly .

"When a patient is diagnosed with cancer, something that should be done 100 percent of the time is an oral exam to take care of anything that might be problematic in the future," Banchik says. "Unfortunately, that's not a priority."

It's understandable that a visit to the dentist would be the last thing on the mind of someone recently diagnosed with cancer, she adds, although oncologists do refer patients for pre-treatment dental exams.

Keep smiling

Smiles for Survivors is helping to raise awareness of the issue with its first event in October, national Breast Cancer Awareness Month.

Banchik would like to get more volunteers on board so patients can be treated comprehensively. Once the Las Vegas Valley organization is established, she would like to foster similar efforts in other areas.

"My goal is to work at the community level, addressing all the needs of one individual at a time," she says. "In the case of Raven, for example, there is a woman on the Smiles for Survivors board who is a clinical psychologist specializing in nutrition, and she'll be working with Raven on a nutritional program to help in her recovery."

Although the program is designed for people with financial need, applicants will be evaluated case-by-case. You can get information and applications at http://www.smilesforsurvivors.org.

If the experience of Burroughs is any indication, the effect of the program can be huge. The dental problems that resulted from her cancer treatment affected everything in her life, she says:

"You quit talking and smiling and eating and everything after a while. You become reclusive. I've gotten over this now. I will go to a restaurant and spend $20 on a steak. Now I have a mouthful of teeth again, it's hard to get used to. They fit perfect, and they're beautiful."