A Keene-based pediatric dentist who was previously sanctioned for practicing while impaired faces new allegations of professional misconduct, including claims that he overused restraints and nitrous oxide, performed unnecessary dental work and did not fully obtain informed consent for some procedures.

The N.H. Board of Dental Examiners leveled the new allegations against Dr. Blake C. Wullbrandt in a notice dated Tuesday.

Wullbrandt is scheduled to appear before the board Nov. 8 for a hearing on the allegations and, if proven, whether they warrant disciplinary action. State law authorizes the board to suspend or revoke a dentist’s license, or impose other sanctions, if it finds evidence of misconduct.

Wullbrandt’s practice is Children’s Dental Care on Railroad Street. Reached by phone Friday, he declined to comment on the dental board’s latest allegations. He did not answer when asked if he has been actively practicing.

The Board of Dental Examiners, which regulates dentistry in New Hampshire, issued Wullbrandt a license to practice in 2001, according to an online state directory. His license was active as of Friday afternoon.

In the spring of 2018, Wullbrandt agreed to a one-year suspension of his license to settle allegations that he had practiced or attempted to practice while impaired in 2015 and 2017, in one case drilling too far while treating a child. Because he had agreed not to practice pending the outcome of the case, the settlement agreement allowed him to resume practicing dentistry that August.

Meanwhile, the N.H. Attorney General’s Office had launched a criminal probe into the potential “abuse/neglect” of patients at Children’s Dental Care, according to a letter the office’s Medicaid Fraud Control Unit sent to parents in the fall of 2017.

Kate Spiner, a spokeswoman for the office, said in an email that the Medicaid Fraud Control Unit later closed its investigation without charges and referred the case to the dental board.

In March 2018, the Medicaid Fraud Control Unit referred a complaint about Wullbrandt to the dental board, according to the board’s recent notice of hearing. The board received another complaint two days later, this one from a former employee of Wullbrandt’s.

After reviewing complaints about Wullbrandt’s treatment of four patients, the dental board launched an investigation, according to the notice, and found a “reasonable basis” for convening an adjudicatory and disciplinary hearing this November.

Between 2005 and 2017, the board alleges, Wullbrandt “provided too much, and in some cases, unnecessary dental work on young patients during one appointment.” The notice claims there were 12 such cases.

The board also claims Wullbrandt kept insufficient medical records that failed to document certain procedures in enough detail.

One of the board’s allegations involves the use of physical restraints. Limiting a young patient’s movement to safely provide care — known as “protective stabilization” — is sometimes appropriate, according to the American Academy of Pediatric Dentistry, which has issued guidelines on the practice.

But the dental board alleges Wullbrandt’s use of restraints was “excessive and/or lengthy” in seven cases between 2013 and 2018, causing the patients physical or emotional harm.

The board also alleges Wullbrandt used nitrous oxide — a standard way to control a patient’s pain or anxiety — “routinely and without a specific behavioral reason to warrant it,” specifically in two cases between 2012 and 2014.

In three other cases between 2012 and 2017, according to the board, Wullbrandt performed extensive or invasive dental work while using only nitrous oxide and local anesthesia on patients.

Choosing the appropriate type of sedation for such procedures depends on different factors, said Dr. Kevin Donly, the president of the American Academy of Pediatric Dentistry and a professor at the UT Health San Antonio School of Dentistry in Texas.

“It really depends on the situation, the age of the child and things like that,” Donly said, speaking about practices in general and not the specifics of Wullbrandt’s case. “I’ve done extensive restorative care with just nitrous oxide and local anesthesia, but it’s on a child that’s, you know, old enough to be able to handle it.”

Another of the dental board’s claims alleges Wullbrandt “obtained insufficient informed consent to justify the repeated use of the papoose board [a type of restraint mechanism], nitrous oxide, and/or extensive dental procedures, and/or failed to document that alternative treatments were offered.”

The notice refers to patients by initials and does not specify their ages.

Wullbrandt’s hearing is scheduled for Nov. 8 at 10 a.m. in the dental board’s office at 121 South Fruit St. in Concord.

This article has been updated with a statement from the Attorney General's Office clarifying that Wullbrandt is no longer subject to a criminal investigation.

Paul Cuno-Booth can be reached at 352-1234, extension 1409, or pbooth@keenesentinel.com. Follow him on Twitter at @PCunoBoothKS