Dr. Royce W. Woolfolk Jr., DDS
Following The Golden Rule
by Charles McGuigan
Dr. Royce Woolfolk, Jr.’s dental practice is located up the hall from his wife Cindy’s company, James River Trade Exchange. They’re in a building on Monument Avenue within hailing distance of Willow Lawn. The waiting room is not at all institutional. It’s furnished with antiques and feels more like a living room. Royce enters the room and invites me in to his office. He takes a seat on the operatory chair and I sit in the chair he’d ordinarily be seated in. He wears a bolo and a dark shirt. His hair is swept straight back and his eyebrows bushy.
I’ve sat where he now sits on more than one occasion. Royce is the man who restored my faith in dentists and gradually rubbed out a fear of his profession that had been with me since boyhood. When we lived in South Carolina we would always make the trek to South Philly to see the old family dentist named Dr. Bell. He was a stout man with arms thick a.nd hairy and he wore blue scrubs and smelled of Aqua Velva. He looked more like a butcher than a dentist and he never used any kind of local anesthetic when drilling for cavities. The high-pitched hum of that drill paralyzed me with fear and after grinding into the pulp and exposing the nerve he would hand me a small paper cup of water, tell me to rinse my mouth and spit into a green glass sink no larger than a soup bowl. The smell of that ground tooth was like rancid butter and to this day I’ve never been able to stomach movie theatre popcorn. That was back in the 1960s but the fear followed me and it was always an ordeal to visit the dentist until I started seeing Royce seven years ago.
“My favorite part in my practice is helping people overcome their dread fear of dentistry,” says Royce. “My personal opinion is that back in the fifties and sixties dentists were of the opinion that patients should be able to endure pain, so therefore they didn’t use as much anesthetic or were afraid to or just weren’t compassionate enough to use it. So consequently a lot of people grew up having to endure the decisions of lazy dentists.”
Royce works on a different principle. He wants his patients to feel comfortable and experience as little pain as possible. “Do unto others has you would have them do unto you,” he says. “I follow the golden rule. I would appreciate that on myself.”
Even after he’s applied a topical anesthetic—benzocaine— Royce pinches your cheek and shakes it very rapidly, which eliminates even the faintest pricking sensation of the needle penetrating skin. “One it distracts you; and two it fires the fibers in your nervous system and so consequently you don’t feel any pain at all,” he says and I’ll vouch for that.
Royce started his practice 34 years ago in a suite of offices a couple miles east on Monument Avenue. Born in Richmond at Stuart Circle Hospital (at the corner of Lombardy and Monument) he grew up in Lakeside with one brother and two sisters and his parents, Jane and Royce, Sr. After graduating from Hermitage High, Royce attended Randolph-Macon College in Ashland where he double-majored in English and Chemistry. Raw out of college, he worked as a chemist for three years, first for Philip Morris and then for the State of Virginia. And then in 1972 he entered the Medical College of Virginia and completed his dental training four years later.
He considers the technological advantages in the practice of dentistry in the intervening years since he first started his practice. “For one thing we didn’t have cone-beam computed tomography,” Royce says. “Cone-beam computed tomography gives you a three dimensional product. All we had was plain old X-rays.”
Technology has made certain procedures much quicker. “Another thing that wasn’t there when I started was cad cam dentistry, computer assisted design, compute assisted machinery,” says Royce. “You can now cut a tooth or prep a tooth and when you’re finished preparing the tooth you can put this camera on the tooth preparation, take a picture of the tooth preparation and in ten to twelve minutes you’ll have a finished ceramic crown. You’ve eliminated taking an impression, sending it to the lab waiting for it to be made, making a temporary crown, and then having it put in on your second visit You can do it all in one visit.”
Seven years back Royce performed a root canal on me and the whole procedure reminded me of the building of a bridge, how the pylons are sunk into bedrock and the supporting structure is built on that foundation. Royce tells me that there are similarities between dental procedures and structural engineering, but it not simply about utility. There is also an aesthetic value so the completed work is no common overpass but a veritable Brooklyn Bridge.
“You want it to be sound and structurally intact, but that’s of no use if it won’t stay put and it doesn’t look good,” he says. “It has to be aesthetic and at the same time functional. There are two requirements that you’re trying to meet.”
As a dentist, Royce is a teacher. “I tell everybody the same story, to just practice prevention and good oral hygiene to prevent a problem for starting,” he says. “Cavities are like children: They start out small and get bigger. So do yourself a favor and practice good hygiene and you’ll prevent the decay process from even starting. If you practice some form of adequate hygiene it will be a small cavity as opposed to a big one. And of course you have to get regular checkups, floss at least once a day and brush twice a day.”
When these prescriptions are not followed the inevitable occurs. “The most common problems are dental decay and periodontal disease and both are treatable,” Royce says. He looks overhead from his reclined position in the operatory chair. A porcupine fish, a murex, an angel fish, a sea biscuit, shark jaws, parrots, conchs, a sponge, sea urchin, seagull, starfish and barnacles dangle from monofilaments tied to the supports of the acoustic tile overhead. When I ask Royce why, he says, “That’s what the patient’s looking at so I can transport their mind off to some tropical island, just give them something to think about or engage their mind while I’m working on them.” There’s also always music, either the NPR affiliate or rock and roll. Something else, too: While Royce works he is prone to hum melodies, at times even sing. “I’m just a happy guy, I whistle while I work,” says Royce.
Sometimes when a patient has not practiced good dental hygiene things like periodontal disease can set in. “A lot of people don’t’ know that they have periodontal disease so they’re unpleasantly surprised when I tell them,” says Royce. “Some are even shocked and even in disbelief. But then after I show them my findings and educate them then they’re on board and ready to salvage their teeth. I’ve never had anybody refuse treatments and maybe that’s because I’m a good motivator.”
It all ultimately gets down to the patient’s willingness to listen and take preventative measures. “I try to put it in language that the patient will accept because I’m not the tooth policeman,” Royce says. “I tell you what you need to know and then you decide what you’re going to do with your own dental health. I’ll give you all the information and education and motivation that you need but dental treatments is treatment, it’s not a cure. You can’t cure dental disease you can only treat it so therefore if you have all the tools necessary to keep all the bad bugs at bay then you could probably keep all your teeth for your whole life. Once you’ve been given the information then it’s your choice.”
There used to be a sort of Adam and Eve story about my grandparents. My grandmother McGuigan had decided to have all her teeth removed when she was in her fifties and have them replaced with dentures. She told my grandfather how great it was and he followed suit but absolutely loathed his false teeth and rued the day his dentists plucked them one by one from his gums. That really happened and that was in the late fifties.
As I tell this story, Royce is shaking his head. “A lot of people still have all their teeth removed,” he says. “They do it because it’s the cheapest way out. If you need dental treatment and a lot of it and you just don’t have it in the wallet to have all those problems fixed the cheapest way out is to have dentures made which is sad. But it’s reality. There are plenty of dentists that do that on a daily basis.”
Not so with Royce. To him it seems almost unethical. “I’m not the right dentist to see because my whole philosophy is to save what you can within reason,” he says. “I won’t do it. I’ll say, ‘You need to go someplace else because I’m not going to do that to you.’”
Then he says this, which puts it all into perspective. “Someone says, ‘Well I can’t see well enough to drive.’ I don’t think you’re going to a doctor and ask him to put your eyes out. You’re going to ask to have glasses made. If you have bad teeth if they can be fixed or treated I’m not going to pull them out, I’m going to fix them. If there are things that can be done I’m going to save what I can if at all possible.”
One thing that separates Royce Woolfolk from some dentists is his chair side manner. He is frank with the patient but treats them all with kid gloves.
“I just going back to the golden rule,” he says. “I mean I’m demanding and I know being the expert that it can be painless so why not make it painless. When I get my teeth checked I go to a classmate. I’m a dentist but I’m also a human being who could fall prey to dental disease and I need to have my teeth cleaned. It’s funny that in my head while I’m being worked on I think of the case of the hunter becomes the hunted. Now I’m not sitting back in my chair working on somebody. I’m the one sitting in the chair being worked on. It gives you a good perspective. You need to be the patient once in a while to know what your patients are feeling. It just makes for a better doctor patient relationship.”