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

Welcome, Dr. Carroll!

You all saw our recent post about how much we will miss Dr. Silcher, and the smiles he has brought to our community, as he heads off into retirement.

Now, we’d like to formally welcome Dr. Keldon Carroll (and his lovely family) to the Bitterroot Valley!

Dr. Carroll is a well-educated and well-traveled air force veteran, who has always dreamed of moving to Montana. He will be taking over Dr. Silcher’s practice, and though he has big shoes to fill, we are confident he will do a stellar job.

We can’t wait to see the smiles you bring to our community, Dr. Carroll!

Thank You Dr. Silcher!

From Dr. Holtzen:

When I first relocated my family and my practice to Montana a decade ago, one of first and warmest welcomes I received was from Dr. Peter Silcher. In the subsequent years, Peter has become both a friend and a valued partner in the care of our many patients. Professional relationships like this, based on mutual respect and trust, are invaluable to both doctors and the care they provide for their patients.

Peter Silcher received his education from several of the finest institutions and training programs in the country. This beginning was reflective of both his brilliant mind and his dedication to excellence. Dr. Silcher recently announced his retirement from his practice of orthodontics in our community. The contribution Dr. Silcher’s career has made to our community has been so significant, and touched the lives of so many individuals, that it is challenging to even comment on this event in a fashion that will do justice to the impact. However, we cannot let this event pass without attempting to share our thoughts.

There are few aspects of the human body that have a greater influence on a life than the human smile. Dr. Silcher has spent decades giving his patients their smiles. Thousands of people of all ages have benefited from his expertise, gaining much more than function and comfort. His patients have been given the gift of improved self-image, self-respect and confidence. Individuals with a smile they are proud to display have better relationships, more successful careers, and better lives. A career dedicated to enhancing the lives of his patients has earned Peter the respect, admiration, and gratitude of his colleagues and our entire community.  

The entire Alpine Oral and Facial Surgery team are grateful for our years of partnering with Dr. Peter Silcher and his team in caring for our community. We regret his professional departure, but we are simultaneously excited for the next phase of his life and congratulate him on a job well done.

And if you are wondering who might try to fill the considerable shoes of Dr. Silcher and restore the loss to our community that will result from his retirement, look for our future post welcoming Dr. Keldon Carroll to the Bitterroot Valley!

A Statement About COVID-19

We take the safety of our patients and our staff very seriously. We want to remain as available as possible to our patients, while we strive to maintain the highest standards of safety and care. It is with this in mind that we have decided that we will remain open and available until further notice, with the following protocols in place: 

-As always, we will utilize universal safety precautions with all patients.

-We will avoid any physical contact that is not necessary to deliver care.

-We will facilitate space between patient groups by moving all patients immediately into individual rooms upon arrival. 

-We will disinfect all surfaces such as door knobs, computers and tablets, etc. every two hours throughout the day, as well as between every patient. 

-All patients will be screened upon arrival for symptoms, and elective surgeries will be postponed for anyone with worrisome symptoms. If you are experiencing any symptoms of illness, please call to reschedule your appointment.

-Patients will be allowed in the office with a maximum of ONE additional person when necessary. If others are present, we will require that they wait in the car in order to avoid unnecessary exposure to others. This will include children. 

Also, we will soon be instituting telemedicine virtual visits for consultations and post-ops, so  please stay tuned for news on that! 

Stay safe out there! We will keep you updated on any and all protocol changes via our website and social media as new challenges arise. 

Valentine’s Day Dental Implant P.S.A.

Whether you’re celebrating Galantine’s Day or Valentine’s Day: (I’ve heard a rumor that bachelors just celebrate St. Patrick’s Day twice?) You’ve got a holiday coming up! Why is it that with every holiday comes candy? You’re just peacefully sitting at your desk, writing the company’s next blog, and before you know it, you’re showered with chocolate and affection?

 Just kidding. I think that was just a dream I had. But… I mean, there are probably some stale conversation hearts in the staff lounge. You’ll walk by them a few times before you shove them in your gourd, and then remember that you don’t even like conversation hearts. In fact, NOBODY likes conversation hearts. Do they?

I digress, but the point is: There will be candy, and you will eat it, probably. So, what kind of affect does all that sugar have on your teeth? How about your dental implants? Let’s talk about it.

Most of us know that sugar causes cavities, but how does that work? Well, essentially the sugar interacts with bacteria in your mouth, creating dental plaque, and if that plaque isn’t easily removed from saliva or brushing, your mouth becomes acidic and wears down enamel, eventually causing tooth decay. It doesn’t happen exactly like that with your dental implant, but you still need to be wary.

Dental implants are made of pretty tough stuff. But while an implant crown may not be vulnerable in the exact same ways as a real tooth, it can still stain, crack, or break altogether, and the same bacteria in your mouth that cause tooth decay could eventually contribute to gum disease around your implant.

 Also, the type of candy matters. Those conversation hearts may not be your dental implant’s worst nightmare, but watch out for hard candies like jolly ranchers, or those strawberry bonbons that literally everyone’s grandma has for some reason. (Seriously, what’s up with that? Is there a secret society?) Hard candies and chewy ones could crack your implant crown. Other potential tooth/ implant crackers are the nuts or toffees hidden in those “delicious” [sic] chocolate variety packs.

Okay, listen. I’m not saying that sugar is the devil or anything, except maybe I am! The best practice is to allow yourself some tasty treats in moderation, and practice good oral hygiene. This goes for your dental implants, too. The whole point of dental implants is that they are the tooth replacement option that functions the most like a real tooth. So, care for them as you would your real teeth and you should be fine!

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.