A higher percentage of people struggle to eat well on a regular basis in Napa than in most other California counties. But for low-income residents like Laretta Powell, the struggle to put food on the table took a turn for the worse when the state of California stole her teeth.

Powell, a 65-year-old transplant from Texas, has been making a hand-to-mouth living working as a masseuse in the Napa Valley for over 20 years. What she lacks in education she makes up for in strong thumbs and resilience in dire circumstances; frequently homeless, she often lives in a truck donated to her by a client. In that same truck, she travels with her massage table to make house calls in Napa. Much of her steady work involves providing pain-reliving massage to low-income seniors living in a number of Napa's mobile-home communities.

In early 2009, Powell enrolled in Medi-Cal and was approved for major dental work. A serious infection required extraction of all her teeth and replacement with dentures. Powell underwent the surgery, but when it came time to pick up her dentures in June, she was told they'd been lost. They have remained "lost" ever since.

"At one appointment," Powell says, "the lady held up a white paper bag and shook it and said, "These are your teeth, but you're not gonna get them because Medi-Cal isn't going to pay for them."

Silvia Denny, one of Powell's more affluent clients and a steady customer for decades, finally decided to advocate on behalf of her masseuse. The 80-year-old Denny, originally from Britain, is astounded that such a thing can happen in the United States, one of the few wealthy countries in the world. "It's one thing to be homeless," Denny says. "But homeless and toothless is unbearable and inhumane."

Denny claims that in the time that had lapsed between Powell losing all her teeth and going back to pick up the replacements, the state had cut the dental program. "I asked her about her teeth almost every week," Denny says. "And she would always have a new lead to follow, always a story about somebody here or there who was going to help her. Meanwhile she was existing on peanut butter and soup." Denny observed that Powell did not have the ability to find her way through the bureaucracy, so she stepped in to help her.

"After encountering the red tape firsthand," Denny says, "I realize the social services system can defeat even those of us with a master's degree." Denny claims to have called agency after agency trying to get Powell's teeth back. "They were very nice. But they all recommended I get in touch with someone else," Denny says. "It wasn't their department."

Finally in April of 2010, Powell started talking about paying for the dentures herself, even though her life savings were not enough to cover the $4,000 replacement teeth. But her life is at stake. "I'm a diabetic and for the past year I've not been able to eat what I needed to eat," Powell says, "only things I could squish up real good and swallow. This made my blood sugar go up and up, so I had to go the hospital three times. It's been a year already. At the hospital, they told me I had to get my teeth no matter what. The blood sugar spikes are going to injure my heart if I can't keep my blood sugar under control."

Powell went back to the dentist and was offered the option to become involved in complicated loan options she didn't really understand. Finally Denny decided to loan her the cash because paying up front reduced the cost to $3,600.

As of this writing, Powell is still on peanut butter and soup. While she is paying off her teeth, she is also saving for a lighter massage table, one that weighs only 25 pounds. "It will be easier to lug up stairs," says the Napa senior. There is no golden retirement in sight, but things are looking brighter. "Somewhere around the first of June," Powell says optimistically, "I might have teeth again."

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