By Alison Kuznitz
State House News Service
Cancer patients and survivors grappling with radiation treatment aftereffects and out-of-pocket dental bills totaling thousands of dollars sought financial relief from Beacon Hill lawmakers Tuesday.
Denise DeSimone, a throat and neck cancer survivor, said the lack of saliva in her mouth, caused by 40 radiation treatments, set off a slew of dental problems that required extractions and crowns. She ended up paying $8,000 to replace her two front teeth, and she estimates her seven to eight crowns cost $4,000 each.
DeSimone sought to rally support for a Rep. Paul McMurtry proposal (H 1094) that would require health insurers to “provide coverage for a dental procedure that is related to or resulting from a medical condition for which coverage is provided.”
Dental complications, including deteriorating teeth, caused by radiation treatment only worsen over time, she and fellow survivors told the Joint Committee on Financial Services.
“This bill is not just about dental care — it is about restoring dignity, confidence and our ability to live healthy and fulfilling lives,” DeSimone said at a hearing, as she noted the bill is also cost-effective. “By providing comprehensive dental care, we prevent further complications, reduce the need for additional medical interventions, and ultimately save dollars in the long run.”
Insurance companies typically do not consider cancer patients’ related dental care to be medically necessary, meaning those individuals are forced to saddle the cost burden, a McMurtry aide told the News Service.
The bill was reported out favorably last session by the committee, but the Joint Committee on Health Care Financing later sent it to study.
Massachusetts Oncology Patients, Survivors, and Supporters (MOPSS), an advocacy group focused on the legislation, said the bill is supported by the Dana-Farber Cancer Institute, Mass General Brigham, Massachusetts Society of Clinical Oncologists, Mass Eye and Ear, Massachusetts Society of Otolaryngology/Head and Neck Surgery, and Boston Medical Center, among other organizations.
Dr. Mark Varvares, a head and neck surgeon at Mass Eye and Ear, said he’s had patients mortgage their homes to afford a denture-like device that costs tens of thousands of dollars. The device is needed when surgeons remove part of their patients’ mouths to treat their cancer, he said.
Patients must have a full dental evaluation before undergoing radiation treatment, Varvares said. But he’s seen “many” patients who cannot afford dental care, such as a full mouth extraction, and therefore cannot proceed with radiation as their cancer spreads, he said.
“This lack of coverage for patients to get basic dental care before their head-neck cancer treatment is threatening their survival,” Varvares said. “Something has got to be done about it — we see it over and over again.”
Thomas Healy, founder of MOPSS, said the bill would create a new framework for health insurers, which have historically handled dental and cancer treatments separately.
“When a patient identifies they have dry mouth or lack of saliva, that’s the time for the people in oncology to get involved on that dental issue. That’s when the door is going to start to open for the oncology patients,” Healy said. “Hopefully, that conversation starts to take place from oncology with the dental and the insurance company to start that process.”
Amy Gross, who survived rare nasal cavity cancer, said she tries to practice hygiene measures to protect her teeth, such as extra rinsing and brushing. Gross said she’s always had good teeth, but radiation is likely to affect her oral health.
“I fear the day when my preventive measures fail, and I start down the road of root canals, crowns, tooth extraction, dentures, implants. I may lose my teeth, and I have no idea if it’s going to be covered,” Gross said.
She added, “Patients find themselves well into decades of survivorship having to argue with both insurance and dental insurance companies for basic oral procedures, dentures, prosthetics and implants that impact our health and daily quality of life.”