Smiling hasn’t always come easy for Yakov Shapiro.

But sitting in a dental chair on a November afternoon, the 84-year-old Holocaust survivor is beaming.

“I always had a problem with teeth,” he said in his native Russian, through a translator. “I was always in pain. I was fixing one tooth, another one is painful. I couldn’t enjoy life. I wasn’t eating properly and was having stomach aches.”

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Most living Holocaust survivors were children during the war. They often lacked adequate nutrition and oral hygiene. Today, these lasting effects are compounded by the typical oral health challenges facing seniors.

Shapiro required upward of three dental implants and dentures — procedures that would cost more than $15,000 and he couldn’t afford. But thanks to the Alpha Omega-Henry Schein Cares Holocaust Survivors Oral Health Program, Shapiro is pain free and all smiles.

The program, launched in 2015 by international health care products and services distributor Henry Schein Inc., as well as the Alpha Omega International Dental Fraternity, was borne out of former U. S. vice-president Joe Biden’s call for public-private partnerships to serve the needs of vulnerable Holocaust survivors.

It connects dentists throughout North America to financially challenged survivors, providing pro bono oral care, from emergency care to restorative, endodontic, periodontal, and prosthetic treatment.

Of roughly 17,000 Holocaust survivors living in Canada, about one quarter live in poverty, including more than 2,000 in Toronto. In the U.S., about one-third of 100,000 survivors are estimated to live below the poverty line.

“I don’t know that most people are aware. It’s sort of a hidden challenge in society. We thought this was a perfect opportunity for us to swing into action,” said Allison Neale, director of public policy for Henry Schein and co-founder of the program.

The three-year pilot has served survivors in 21 North American cities, including Toronto, Montreal, Calgary and Winnipeg. It’s provided free dental care, valued at more than $1.3 million, to about 700 economically vulnerable Holocaust survivors.

The initiative includes laboratory partners such as Orthodent Ltd. in Canada that donates crowns, dentures and other appliances, as well as other corporations and U.S. dental schools that lend their time and expertise.

“This is a population where, as children, they had no dental care for many years at the beginning of their lives and they had incredible nutritional deprivation and struggles following the Holocaust,” said Neale.

Shapiro, who is from Ukraine, was 8-years-old when the war broke out. He recalled escaping his hometown on a windowless supply train that was pelted with bombs by the Nazis and living on a diet of bread and potatoes, because meat was too expensive.

“People were starving,” he said.

After the war, Shapiro worked as an electrical engineer in the transportation sector and could afford oral health care, but a limited pension since arriving in Canada in 1998 with his late wife Katerina made it a challenge.

“When I came to Canada, I knew that teeth were very expensive, so I decided to ask for some help,” he said.

Shapiro was matched with Dr. Ira Schecter, a Toronto dentist who’s been practicing for nearly 40 years.

“He needed teeth and I couldn’t say no,” Schecter said. “I wasn’t going to treat Yakov any differently than I treat the rest of my practice. I gave him the best I could.”

He has treated three patients through the program and says it has been one of the most rewarding experiences of his career.

“When you can treat somebody who shows the appreciation that a man like Mr. Shapiro shows, it’s just overwhelming,” he said. “It’s unnecessary, it’s not warranted, but it can’t help but make you feel like you made a significant contribution to someone’s life.”

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Schecter said he sees helping Holocaust survivors as not only a professional duty, but also a personal one — he is the son-in-law of a survivor.

There are about 60 dentists in the Toronto area who volunteer their time to the program, says Toronto liaison, Dr. Gerald Pearson. To be eligible, patients must be referred by a social service agency, such as Jewish Family and Child Service in Toronto. They meet with Pearson, who assesses their needs and matches them with a participating dentist.

Pearson said about 35 Holocaust survivors have benefited from the program in Toronto alone.

“They’ve certainly suffered enough in their life and if it wasn’t for them, I guess a lot of us wouldn’t be around. For most of us, it’s very rewarding because these people, most of them, show appreciation that you can’t buy with money. You’re doing a mitzvah (Jewish commandment).”

Raisa Zonenberg, who needed a new denture, two crowns and a root canal, says Drs. Sharon Perlmutter and Samantha Fialkov have blessed her with the simple ability to chew.

“It’s not owed to me,” Zonenberg said of the free dental work. “It’s something that people give and I’m thankful.”

Zonenberg was 6-years-old when the war broke out in her home of Kyiv, Ukraine. She experienced plenty of hardship during her early life. She and her mother escaped by cattle car to a Russian village after the war started, where they shared a log cabin with another women and her two children, all of whom slept on top of an oven to stay warm. They later joined her mother’s sisters in Uzbekistan, where the whole family caught malaria.

Zonenberg and her late husband Ruven settled in Canada in the 1970s. She brought her dental woes.

“I have a whole bouquet of things that I’m fixing now or that are unfixable. “I’ve had bad teeth since I was a child, after the war. I remember now how one tooth was inflamed and it was taken without anesthetic.”

One day, she said she felt her tooth break and was sent to see Dr. Pearson.

Zonenberg is one of three patients Dr. Perlmutter has treated through the program.

“When you don’t have dental problems, you don’t think about dentists. When you’re not 75 or over, you don’t think about it the same way either. People take a lot of things for granted, that’s just human nature,” Perlmutter said. “What we don’t realize is it’s a matter of eating, which is such a basic thing that we take for granted, it’s a matter of looking in the mirror at yourself and being able to smile.

“When Raisa smiles, I can’t describe the feeling. Nobody else can give her that. We’re given a gift and we have to give it to people who need it.”

While 2017 marks the end of three-year pilot portion of the project, Neale said its founders are hoping it will grow even bigger as it moves to its next stage.

Shapiro wishes he had the proper words to express his gratitude toward Schecter and the dentists behind the program.

“You can’t even imagine how he changed my life,” he said. “I wish a long life and health and all the best to the people who created this program for survivors.”