Name Change!!

Dr. Holtzen is reaching out with exciting news!

For many years we’ve been known as Surgical Arts Centre.  It has been a privilege to be of service to our colleagues and patients in the community, and you can count on us to continue to provide the highest level of service to those who need the care we offer.

As many of you are already aware, Dr. Clark Taylor will be concluding his practice in our area at the end of December. The time has thus come to take a step forward into the future of our practice. We will operate from the same facility, with Dr. Holtzen at the helm (and the same administrative staff and assistants by his side), providing many of the same procedures, with the same insurance participation, on the same schedule.

As part of our practice’s transformation, we will now operate with a new name!




  1. relating to high mountains.

Alpine biomes are found in mountain regions worldwide, including the Andes, the Alps, and in the Rocky Mountains we call home. It is with an alpine spirit and courage of conviction, that we strive to reach the highest heights of patient satisfaction, comfort, and care.

What was once “Surgical Arts Centre” will now be “Alpine Oral and Facial Surgery.”

We will be gradually integrating our new name into everything (from our website and social media to our signs and forms) in the coming months.  You can always reach out to us with any questions you may have.  We will keep you posted on our progress every step of the way and provide you with everything needed to easily stay in touch and ensure the best experience for our patients. 

Thanks for being part of the Alpine Oral and Facial Surgery family.  We look forward to our continuing work together, and you can rest assured that this announcement is one of progress, rooted in our dedication to meeting your needs and exceeding your expectations.

Best regards,

Dr. John Holtzen and the

Alpine Oral and Facial Surgery Team

Can a Lack of Good Oral Health Habits Kill You?

This is not a drill. Oral health is serious. You remember our last blog on Winter Oral Health? Oh, you don’t?  Well go read it right now. Or, maybe, just read it after you read this blog, I don’t care. Read both. Follow us on Instagram! Tell everyone about us, including your grandmother! Okay, I digress. The point of this blog is not to talk about how awesome we are. So, what is the point?

Neglecting your oral health can have serious consequences, and not just for your mouth. The mouth is a gateway to your respiratory system and your digestive system, and poor oral hygiene can be linked to multifarious health complications and diseases, including problems with pregnancy, endocarditis, cardiovascular disease, pneumonia and more.

“But how?! It’s just a mouth! “   

            Well, young Padawan, allow me to explain. The mouth is the gateway of all our internal systems. Aside from the old “you are what you eat” adage, this means a lot. You have an idea of what plaque and tartar are right? I hope you go to the dentist at least that often, but just in case you don’t, I’ll cover it really fast.

 Plaque is what happens when food particles attract bacteria to form a slimy film on your teeth. Gross, but as long as you’re brushing and flossing regularly, you can get rid of it. Tartar, however, is what happens when plaque is left long enough to calcify and harden. You will need your dentist’s handy little tools to scrape that stuff off.

The devil is in the tartar. It can lodge in your gums, making them inflamed and causing pockets to develop, eating away at not only your gums, but your tooth structure. Bacteria can enter through those pockets into your bloodstream, and this is where even more serious issues occur. That bacteria causes inflammation, and we all know that inflammation is no bueno: It’s what links to the laundry list of other serious conditions. Oral health has been linked to things like Alzheimer’s, stroke, and erectile dysfunction.  Some doctors have even started recommending periodontal treatments as preventative medicine for diabetes.  

One more thing: Sugar is not good for your teeth or your overall health. I know you already know this. Sugar causes the bacteria on your teeth to release acids that attack enamel. So, go ahead and put down that seventh Christmas cookie! I know it’s a party and you deserve to #treatyoself, but let’s be honest, the line for that was approximately one vat of icing ago

Seriously! Use your toothbrush, mouthwash and floss. Go to the dentist and take care of your mouth. It could actually save you money in the long run, and you will be significantly more likely to avoid a variety of health issues.


Men’s Journal

Mayo Clinic

Winter Oral Health

Winter has arrived unceremoniously at our doorstep. Unfortunately, Jack Frost is free from the constraints of polite society, and therefore cares not what affect the frigid air has on our oral health. Don’t worry, Alpine Oral and Facial surgery has your back, and… your mouth?

Keep reading for common winter maladies to be aware of, and the preventative measures you can take. 

Dry Mouth

The air is dry, and therefore so is your mouth, probably. For crying out loud, stay hydrated! Just because there is snow on the ground and you’re cold doesn’t mean you don’t need water to survive. Remember the rule: Eight 8oz glasses. That’s four pints. We saw those pictures from the family reunion. You have no trouble putting down four pints, okay? We’re onto you.

Tooth Sensitivity

The air is not only dry, it is cold, as I’m sure you’re aware. That makes us want hot drinks. (Hot chocolate, anyone?). Cold air + hot drinks = our least favorite time of day (tooth-hurty). Try brushing your teeth with a toothpaste made especially for sensitive teeth.

Canker sores

Speaking of dry mouth and hot things, both can exacerbate canker sores. If you don’t know what a canker sore is, you are one lucky reader. A quick Google search will leave you feeling unsettled. If you already have a canker sore, try rinsing your mouth out with warm salt water, and saying no to the Tabasco or extra jalapeños. Also, if these sores are occurring frequently, maybe consult your healthcare provider about preventative medication.

Chapped Lips

The air has entered phase three. It is dry, it is cold, and it is windy. How rude. I’m no biologist but I’m pretty sure the skin on our lips is to regular skin what tissue paper is to cardstock. Therefore, the triple threat that is winter air does even more work on our lips than the rest of us. Be sure to keep your lips hydrated too! We recommend using a lip balm with SPF consistently throughout the day.

Sun Damage

Yes, really. Sun burn, dry skin, or worse. It may feel like you haven’t seen the sun for 17 years, but that doesn’t mean the sun hasn’t seen you. It’s there, waiting just beyond the clouds for you to realize you’ve already been burned, laughing at your vitamin D deficiency… Okay, maybe that’s a little melodramatic but you should still definitely wear a moisturizer with SPF.

Barring forgoing the tundra altogether and purchasing winter lodging in the Bahamas, there isn’t much more winter advice we can give you here.  All year-round you should brush, floss, keep an eye out for infection, and go to your dentist. No, seriously. Just make the tooth cleaning appointment. You may think you just did it, but it was probably actually last December. Look at your calendar. Told you so.

P. S. Our friends at Care Credit gave us the idea for this blog. Check them out if you need assistance financing an oral surgery procedure.

Could you have Sleep Apnea? Signs and symptoms.

Sleep Apnea is a disorder that occurs when breathing stops and starts repeatedly during sleep. If this occurs because the brain is unable to send the proper signals to breathe, it’s called “Central Sleep Apnea.” If it occurs because the airway is blocked during sleep, physically reducing airflow, then it’s referred to as “Obstructive Sleep Apnea”.

Both forms of Sleep Apnea have overlapping symptoms, so it may be hard at first to determine which you have.

Symptoms include:

Loud snoring
Daytime fatigue
Lack of focus
Depression/ Anxiety
Gasping for air during sleep
Waking up with dry mouth
Morning headache

There are different risk factors for each form of Sleep Apnea, though for both forms the risk is higher for males, and for those older than middle-age.

Risk factors for Obstructive Sleep Apnea include:

Excess weight
Large neck circumference
A narrowed airway
Nasal congestion
Use of alcohol, sedatives,
or tranquilizers

Those for Central Sleep Apnea include:

  • Heart Disorders
  • Use of Narcotic/ Opioid pain medication
  • Stroke

If any of these risk factors apply to you, and you are experiencing symptoms, be sure to schedule an appointment with your doctor, and see if you may qualify for a sleep study. The primary therapy for the treatment of obstructive sleep apnea is the use of CPAP; which consists of a device worn on the face while sleeping that pressurizes the air entering the nose and mouth. Many patients are, for various reasons, unable to tolerate the use of a CPAP machine. For these individuals, Dr. Holtzen offers a surgical solution that is virtually curative for up to 98% of patients. To find out if you may be a candidate for this life changing procedure, schedule your consultation today!

You don’t have to suffer. There are solutions out there for Sleep Apnea that could improve your quality of sleep, and thereby your quality of life.




Patient Story: A Veteran Finds His Smile Again With All-on-4 Dental Implants

Each year, the Surgical Arts Centre offers a transformative treatment to a veteran in need in an effort to show our thanks to the men and women who put their lives at risk in order to protect our country.

This year, maxillofacial surgeon Dr. John Holtzen and Surgical Arts teamed up with Dr. Stacey Gividen and Big Sky Denture Group to give 71-year-old veteran Lauren Kelly a second chance at a winning smile.

Battles on and off the field

Kelly grew up in Washington State before joining the Marine Corps. He completed basic training and flight training to become an officer and a pilot just as the Vietnam War begin. He served 13 months in Vietnam and several more years as a jet fighter pilot before leaving the military for other careers, which included working in the hospitality industry and software industry.

When he was 63 years old, Kelly was diagnosed with leukemia. He battled the disease and won, but his teeth, which were already being affected by age, were also adversely affected by the aggressive chemotherapy he received.

“It was hard to eat, and you get obsessive about smiling, going out, and having people see you,” said Kelly of his poor teeth. “I’d gone in to the dentist to see about dentures, and they talked about the All-on-4 option, and of course that looked good. But it was too expensive for me at the time.”

He wasn’t sure what to do until he heard that the Surgical Arts Centre was looking for a veteran to assist.

The best solution and a second chance

Once everyone was on board to help, Kelly’s transformation began. The bulk of the process took place on a single day, in which Kelly’s teeth were removed and four implants were inserted into the top and bottom of his mouth. A temporary set of teeth were installed for six months, and then the permanent teeth were connected to the posts. These teeth should last for the rest of Kelly’s life.

“The All-on-4 procedure is a life-changing way to give folks like Lauren back the function and quality of life that time and disease have conspired to take away,” said Holtzen, who executed the procedure with the help of the Surgical Arts team. “Smiling and eating are fundamental to what it means to be human, and the opportunity to restore these pleasures is nothing short of amazing for both the patient and our team.”

Kelly was sure that the teeth would improve his life, and that he would be better off than some of his friends who had dentures and complained about their discomfort. But he had no idea just how much better his day-to-day would be with All-on-4.

“It’s made a tremendous difference in my life, Kelly said. “Being able to eat again is amazing. But it really hit me when we had friends over for New Years because I could smile again. I had also stopped doing volunteer work because I didn’t want to be seen. Now [my wife and I] have plans to volunteer, and to travel and see people. It’s like a whole new life. I don’t feel like I have to hide.”

The All-on-4 solution look, feel, and function like real teeth. Unlike dentures, they do not have to be maintained in any way other than the care needed for natural teeth. And unlike dentures, they do not break or need to be refitted. Dental implants also prevent the deterioration of the jaw bone over time that occurs with dentures.

Kelly not only appreciated his new teeth, he also appreciated the treatment that he received at the Surgical Arts Centre. During his cancer treatment seven years ago, he had several scary, months-long experiences in hospitals, and he was hesitant to return to a medical facility for any reason. But he was surprised and comforted by his treatment.

“I ended up being in the hospital probably for nine months overall, with one four-month stretch,” he said of his experience with cancer, “so I have a real aversion to being around medical facilities. It was very reassuring to walk into Surgical Arts because everyone was so friendly and welcoming. It calmed me right down.”

Dr. Holtzen and the team at Surgical Arts enjoyed working with Kelly just as much.

“Having the opportunity to help someone who has put his or her life on the line for our way of life is a great privilege,” said Holtzen. “I only hope all those we don’t get a chance to touch personally, will see this as a sign of our gratitude for them as well. Working with and getting to know Lauren was humbling and inspiring, because like most veterans, he is so humble. He takes little credit for the great sacrifices he has made and seems surprised by the gratitude we feel.”

With new trips and volunteer opportunities on the horizon, Kelly is simply planning to enjoy his retirement and his new teeth, all with a smile.

“I’d never heard of the all-on-4 before I went through it, and I can’t recommend it enough. It’s like having a whole new set of teeth, you don’t even have to think about it. All the horror stories from my friends about dentures, I have none of that,” he said. “It is almost an odd feeling, because I look in the mirror and I have new teeth again!”

Schedule A Consultation Alpine Oral and Facial Surgery

Dr. Holtzen and the team at Alpine Oral and Facial Surgery have helped hundreds of patients find their smile again through All-on-4 dental implants. To learn more about the procedure, to ask Dr. Holtzen a question, or to schedule a consultation, please contact us today or call (406) 549-6600.

Understanding Prolotherapy Injections For Pain Treatment

Prolotherapy is a non-surgical treatment for tendon and ligament issues that can help relieve pain in the area and help with recovery. The treatment is an injection that helps to rebuild collagen in the affected area, which in turn stabilizes the joint, returns functioning, lessens pain, and bolsters healing.

At the Surgical Arts Centre, we offer prolotherapy to a wide range of people who are living with a painful and/or debilitating joint injuries.

Prolotherapy can help heal and relieve pain for:

  • Lower back injuries.
  • Neck injuries.
  • Knee injuries.
  • Ankle injuries.
  • Shoulder injuries.
  • Hand and wrist injuries.

Who Is A Good Candidate For Prolotherapy?

Prolotherapy can be useful for adults, teens, and older children. It is often an effective treatment for both people who suffer from chronic joint issues as well as those who are recovering from an acute injury. Likewise, prolotherapy may be helpful both if you are looking for an alternative to a surgical option or if you are looking for pain relief before a surgery down the road.

“In our office, we often see people cutting back on their activity because of a joint issue,” says Dr. Lisa Pacheco, the director of the Surgical Arts Centre’s medical spa. “They stop hiking or walking or hunting or fishing. They might stop dance classes, all because they have a bum neck or back or knee. When we stop exercising, our general health suffers. Daily exercise can decrease our risk of dying from all causes by 30 percent. Prolotherapy is anti-aging. It can help get your joint in working order again, and get you back in the woods or onto the dance floor.”

Your Prolotherapy Appointment

Depending on the treatment you need, most prolotherapy appointments take less than an hour and only involve a few minutes of injection time. Recovery time after a prolotherapy injection is minimal.

Prolotherapy results are not instant: it can take 3-6 weeks for the rebuilding of collagen to have a noticeable effect. In some cases, patients will need a series of injections over a span of time in order to achieve the results they are looking for. In other cases, prolotherapy may not have ideal results and the patient may then consider other treatment alternatives. Studies have shown that 85 to 95 percent of patients report improvement after receiving prolotherapy treatments.

Learn If Prolotherapy Is Right For You During A Private Consultation

Whether you are recovering from an acute injury, or whether you are seeking treatment for a chronic injury, prolotherapy may be a good choice for your pain relief and recovery. To learn more about our medical center, prolotherapy, or your options for treatment, we encourage you to contact us today for a consultation with Dr. Lisa Pacheco by calling 406.549.6600.

Train Crash Investigation: New Jersey Transit Engineer Had Undiagnosed Sleep Apnea

After a deadly train accident in Hoboken, New Jersey, on September 29, 2016, the engineer conducting the train has been diagnosed with obstructive sleep apnea. In a statement released by his attorney and the National Transportation Safety Board (NTSB), Thomas Gallagher suffers from the common sleep disorder, though he did not know that he had it at the time of the train crash.

Untreated sleep apnea can cause daytime drowsiness, memory issues, and difficulty concentrating.

The crash occurred when the train slammed into a station platform during morning rush hour, killing one woman who was standing on the platform and injuring more than 100 other people who were commuting to work. Bystanders said the train never slowed down as it entered the station, and investigators said that the station and train did not have an automatic braking system. At this point in the investigation, it is not clear whether Gallagher fell asleep at the controls or not.

Sleep Apnea-Related Public Transportation Accidents

This is not the first time that a public transportation driver has been found to suffer from sleep apnea after a fatal crash. The most recent fatal train incident took place in the Bronx in 2013, when an engineer with undiagnosed severe sleep apnea fell asleep on the job, causing the train to derail. Four people were killed and dozens more were injured in that accident.

In recent years, other accidents involving trains, buses, planes, and commercial trucks have also involved drivers who either knowingly or unknowingly suffered from obstructive sleep apnea.

Sleep Apnea Regulations For Engineers, Conductors & Drivers

Sleep apnea screening and testing for transportation drivers has been a hot topic in the last decade because of high-profile crashes as well as growing awareness and research involving sleep apnea and the sleep apnea-related accidents.

Currently, more and more organizations and private entities are screening their employees for sleep apnea, and federal regulations are in the works for commercial drivers.

New Jersey Transit reported that it has a sleep apnea screening program for its conductors, but did not say whether the driver in question was screened or what the results were.

Sleep Apnea Surgery At The Surgical Arts Centre

At the Surgical Arts Centre, we understand how untreated sleep apnea can affect your everyday life, and that it can even be dangerous for those who operate vehicles or have a job that involves the safety of others. We also known that CPAP therapy is not effective for everyone, either because of side effects or because of compliance issues. We offer an innovative bimaxillary advancement surgery that has an efficacy rate of over 95 percent.

To learn more about treating your sleep apnea with surgery, please call us today at (406) 549-6600 or fill out our short contact form.

New Study: CPAP Therapy Does Not Lower Heart Risks Tied To Sleep Apnea

no more cpap - sleep apnea surgery at the Surgical Arts Centre

A number of studies have confirmed that continuous positive air pressure (CPAP) devices can significantly reduce or eliminate the number of apneas experienced by a patient suffering from obstructive sleep apnea (OSA). But until now, fewer studies have examined whether CPAP therapy also has an effect on the serious health conditions that are tied with suffering from OSA, such as heart attack, heart disease, and stroke.

Now, a new sleep apnea study conducted by the Adelaide Institute for Sleep Health of Flinders University of South Australia and the George Institute for Global Health has found that normal use of CPAP therapy does not change the chance of patients suffering from heart attacks, strokes, heart failure, or atrial fibrillation.

What does this mean for patients with sleep apnea who are using CPAP devices? While more research needs to be conducted regarding CPAP use and heart health, those who engage in CPAP therapy should be aware that just because their apneas are being treated, they may still be at higher risk for heart conditions and adverse heart events.

The Connection Between CPAP Therapy & Cardiovascular Risks

For the sleep apnea study, entitled, “CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea,” scientists studied sleep apnea patients across the world for four years, tracking their sleep apnea symptoms, their CPAP usage, and their instances of heart-related health conditions.

An initial pool of over 15,000 participants were considered, though only about 2,700 completed the study. Patients were eliminated for a number of reasons. The patients who were included in the study:

  • Had moderate to severe sleep apnea.
  • Were between 45 and 75 years old.
  • Had a history of cardiovascular concerns.
  • Used their CPAP machines at least three hours on average each night.
  • Did not suffer from excessive daytime sleepiness and were not at risk for a fatigue-related accident.
  • Did not have congestive heart failure.

The study broke the patients into two distinct groups. The first group did not use a CPAP device and instead were just instructed on how to best manage their sleep apnea without a device–through lifestyle changes and sleep positions. The second group did use and CPAP device and were asked to carefully track their use.

The results of the study found that the incidence of heart-related health issues was almost identical in both groups: over four years, 17% of patients who used CPAP devices suffered a serious heart health issue over four years, while 15.4% of patients who did not use CPAP devices suffered a serious heart health issue over four years.

The sleep apnea study was published in the New England Journal of Medicine (NEJM) in August 2016.

Sleep Apnea Surgery At The Surgical Arts Centre

Many of the patients that we see who choose our sleep apnea surgical solution have tried but failed to find success with CPAP therapy. Some report side effects related to the therapy that cancel out the benefits of the device. Some say they simply cannot be compliant with the therapy because of the commitment to wearing a bulky mask and traveling with a bulky machine. Still others worry that CPAP therapy does not fully treat their OSA or aide in eliminating comorbidities.

Bimaxillary advancement surgery is successful in eliminating the symptoms of sleep apnea in 95 percent of our patients–and it is a treatment that is permanent and free of inconvenience. If you are having difficulty with CPAP therapy, or if you are simply looking for a better solution, we invite you to call us today to ask a question, learn more about the surgery, or schedule a consultation: (855) 560-7378.

Four Common Types of Facial Trauma

Injuring your face is often both physically and emotionally traumatic–not to mention that facial trauma can have a significant effect on your health, your quality of life, your finances, and your appearance. After a serious facial injury, it is absolutely vital that you seek professional medical care as soon as possible and that you closely follow your physician’s treatments and recommendations for optimum recovery.

How Does Facial Trauma Happen?

Facial trauma is almost always the result of either an accident or a physical assault. More specifically, the most common causes of facial trauma include:

  • Traffic accidents.
  • Physical assaults (including punching, kicking, stabbing, and gunshots).
  • Sport and recreational injuries.
  • Workplace accidents.
  • Childhood accidents.
  • Falls.
  • Dog bites and animal attacks.

The Four Main Types Of Facial Trauma

Facial trauma is an extremely serious injury because it may affect a number of important sensory organs and bodily processes. For example, facial trauma could affect the eyes (and ability to see), the ear (and the ability to hear), and the mouth (and the ability to speak, eat, and breathe). Getting medical assistance for facial trauma immediately can help mitigate damage and prevent or minimize the long-term effects of the injuries.

The four most common types of facial trauma include:

  • Soft tissue injuries. Soft tissue injuries are the most common and often least serious type of facial injury. Soft tissue injuries may include contusions (bruises), burns, and lacerations (cuts). Soft tissue injuries can be painful, cause significant blood loss, and lead to infection. In addition, soft tissue injuries can leave injury victims with scars and deformities that require further treatment, sometimes for years to come.
  • Broken facial bones. Some of the most common facial bone fractures include a broken orbital bone, a broken nose, and a broken jaw. All three of these medical issues require medical attention and some could require reconstructive surgery and other procedures. If broken bones in the face do not heal correctly, they could cause long-term issues with your sight or your breathing. Broken facial bones may also change your appearance if not treated correctly.
  • Dislocated jaw. A dislocated jaw takes place when one or both of the joins connecting your jaw to your skull become unhinged. This injury requires immediate treatment, especially if a patient is in pain, bleeding, or having difficulty breathing. The jaw will need to be repositioned and stabilized during the healing process or else the patient may have ongoing issues with breathing, biting, chewing, speaking and sleep apnea.
  • Tooth trauma. Lower face and jaw trauma is often accompanied by broken teeth, loose teeth, or missing teeth. Tooth trauma is not only painful, it can also affect your ability to speak, eat, and smile. You should know that teeth that have been knocked out may be able to be replaced if you can recover them and quickly seek the help of a physician or dentist.

Facial Trauma Treatment & Healing At The Surgical Arts Centre

It’s a misconception that the Surgical Arts Centre only offers cosmetic procedures–we have also helped a number of patients recovering from facial trauma, from broken and dislocated jaws to broken teeth to soft tissue injuries. In addition, two of our surgeons, Dr. Clark O. Taylor and Dr. John Holtzen, are both active staff members at five different hospitals where they regularly treat the victims of facial trauma.

To learn more about our services or to schedule an appointment, please call (406) 549-6600 or fill out our Contact Form.