AUGUSTA -- A Hallowell woman claims a Lewiston dental surgeon botched a biopsy procedure six years ago, leaving her with permanent nerve damage and less of a smile.

Nancy Jacob, 61, is suing Dr. Jan B. Kippax and Androscoggin Oral and Maxillofacial Surgeons in a civil trial that began Tuesday in Kennebec County Superior Court.

She claims Kippax violated standards of care in the surgery at his Lewiston office on Dec. 17, 2002. But a three-person medical malpractice screening panel concluded in November 2007 that Kippax met the standard of care in handling Jacob's case.

Kippax, 51, practices in Lewiston and Topsham.

John Flynn, an attorney representing Jacob, told jurors Tuesday that Kippax provided Jacob substandard care. He asked jurors to award Jacob money "to make her whole" for pain, suffering and permanent impairment, as well as followup medical bills.

Flynn said Jacob, a Hallowell artist, was referred to Kippax on Dec. 5, 2002, after her front tooth was pulled by another dentist who died a short time later.

Jacob complained of pain in the extraction area and after X-rays showed no problems, Flynn said, Kippax prescribed antibiotics and arranged to see her 10 days later.

On her return visit, Jacob complained of worsening pain and the beginning of numbness, and Kippax recommended a biopsy. Flynn said this procedure was flawed, violating standards of care.

"He went far beyond the area of potential infection and injured the nerve that runs from the cheek-to-nose area," Flynn said.

Flynn showed a series of photos of Jacob smiling broadly starting in childhood that ended with photos of a smile-less, swollen, bruised face. Jacob wiped her eyes as she watched the photos appear one by one.

"It's now impossible for her to smile without experiencing pain," Flynn said.

Kippax's attorney, Alan Stone, said Kippax made prudent decisions, appropriately documented his treatment of Jacob and made "a deep incisional biopsy" only after Jacob signed consent forms and returned to the office a day later for the procedure.

Stone pointed to his own mouth to show the area of the surgery and the placement of facial nerves. He, too, showed postsurgery photos of Jacob.

"It looks bad," Stone told jurors. "Bruising is not pretty; swelling is not pretty. Nobody wants their patient to look like that, but it happens and it doesn't mean the doctor did anything wrong."

Stone said Jacob made inconsistent statements in her deposition about the effect of the surgery on her life. He showed photos of Jacob serving as grand marshal of the Hallowell Mardi Gras parade weeks after the surgery, saying she was still going out in public.

The trial, with Justice Joseph Jabar, is expected to run through next Tuesday.

Betty Adams -- 621-5631

badams@centralmaine.com