AUGUSTA — Called to testify in a case that may decide his professional future, Lewiston oral surgeon Jan Kippax offered a careful and unbudging defense against state charges that he acted unprofessionally in cases involving five patients who spoke before him in the first two days of what may be a lengthy hearing.

After 10 hours Saturday, the long-delayed proceeding before the Maine Board of Dental Practice shut down until November before Dr. Kippax could address most of the allegations made against him, but he did spar with an assistant attorney general who sought to pin him down on specifics.

Kippax generally said he didn’t recall the details of the cases but insisted his records and normal office routines ensured that patients were well-treated.

Each of the five patients whose complaints were included in the trimmed-down list of charges got a chance Friday or Saturday to paint Kippax as a cold, cruel dentist who ignored their blood and pain and resisted pleas for relief.

Christine Duplissis of Greene told the five-member panel that she had tears rolling down the side of her face from the pain as she begged Kippax to stop trying to pull a bad tooth. But the dentist told her he was nearly done and kept on despite her plea, she said.

Another patient, Meagan Westervelt of Bridgton, said Kippax pulled five of her teeth – one allegedly by mistake – and chipped two of her remaining teeth in the process. She said she woke up from the procedure “choking and coughing. There was a lot of blood in my mouth and going down my throat.”

Joshua Robbins said he agreed to have Kippax remove eight teeth as long as he was knocked out for the duration of the dentist’s work. He woke up to find Kippax hovering over him trying to get the last one or two of them out. He said he immediately panicked and told the dentist to quit.

“I was distraught. I was crying. I was very aggravated,” he said.

Richard Jackson, a retired pathologist, said when he saw Robbins in the recovery room, the man was packing and asking him to “get me out of here before I slug someone.”

Kippax said Robbins was “agitated, aggressive and combative” but he doesn’t remember his former patient telling him to stop.

He said that patients sometimes indicate clearly they want him to stop. When that happens, Kippax said, he does. But more often, Kippax said, they are “just vaguely moaning,” groggy from sedation and “just sort of rambling.”

Kippax also said that accusations that he didn’t do anything about excessive bleeding are off the mark. “A drop of blood and a lot of saliva can look like a full-blown hemorrhage,” he said.

He also said complaints that he took out the wrong tooth, or too many teeth, are “a fairly common thing” because it’s hard for patients to see exactly what was done. He said he asks them to come in and they count teeth together so he can “clear the air and find out what the truth is.”

In addition, Kippax said that many of his patients – nearly half of whom are on government health care programs that many dentists won’t take – have a history of drug use that limits his options for controlling their pain.

He said he has “worked with addicts for a long time” and has learned to be wary. “You have to be more conservative, more questioning” about what pills to prescribe and what sedation to use during a procedure, Kippax said.

“We want to make patients as comfortable as we can. But it’s variable with these people,” he said, and in some cases “it may approach” being impossible to prevent them from feeling some discomfort. Kippax said it’s important to keep a wide “safety margin” with them in terms of drug use.

Duplissis said that’s part of the problem.

A former drug user, she said that she initially held back from filing a complaint about the way Kippax treated her, but ultimately decided she had to stand up to him.

“People like me go to dentists like him,” she said, and are dismissed because officials too often push them aside as junkies who make poor decisions. Duplissis said they “try to discredit us” to make our complaints less important than ones from people who aren’t struggling so much.

The hearing will continue Nov. 17 and 18, with more testimony from Kippax on the agenda as well as experts for both sides of the dispute. It appears unlikely the case will be resolved then, however, and more dates have not yet been scheduled.

The dental board has the power to strip Kippax’s ability to practice dentistry. It can also fine or censure him. It can also clear him.

Kippax’s attorneys are carefully laying the groundwork for a possible court case later if the board’s decision goes against their client.