Surgical Mission to Phillipines

During my residency training I had the privilege of participating in a surgical mission trip to Philippines to provide care for many underserved patients. This trip proved to be a life-changing experience and this past January I was invited to return for another mission trip. Our team was comprised of myself and another maxillofacial surgeon, 2 plastic surgeons, 3 general surgeons, 4 anesthesiologists and two surgical assistants. We were able to provide a total of 84 surgeries to the community in just 4 days. Since the incidence of cleft lip and palate is much higher in Asia, that part of the world is a common destination for surgical mission trips.
Cleft lip and palate is a birth defect caused by abnormal facial development during pregnancy. Contributing factors to Cleft lip and palate deformities include chemical exposures, radiation, maternal hypoxia (lack of oxygen), certain drugs, nutritional deficiencies, physical obstruction as well as genetic influences.

In developed countries, like the United States, specialized teams are formed in most cities to provide the necessary life-long care for cleft lip and palate patients. Patients require multiple surgeries during the course of their life time including; repair of the lip around the age of 3 months, repair of the palate around the age of 18 months (followed by bone grafting at the cleft site), orthodontic treatment, jaw corrective (orthognathic) surgery, dental implants, extensive dental procedures, placement of ear tubes (myringotomy) due to recurrent ear infections, speech therapy, pharyngeal flap surgery (to improve speech) other various cosmetic procedures.

In developing countries, such as the Philippines, many patients do not have access to such specialized teams and these patients don’t get the appropriate care they need during their developing years. Even worse is that Cleft lip and palate patients are typically ostracized by society as the community does not understand the deformity and how it is easily fixed to allow for a normal life.

We performed our surgeries at the Howard Hubbard Memorial Hospital, which was built by the Dole corporation to provide healthcare to their employees as well as the surrounding community. Dole Philippines, Inc. is the largest provider of fresh and canned pineapple in the world and employs over 6,000 people in the region. Our mission would not be possible without the incredible support of the Dole company and the hospital staff.

The most remarkable and rewarding thing about these mission trips is the appreciation and thankfulness you get from the patients and their families which reminds me of why I wanted to pursue this career in the first place. Providing care in an underserved, rural and poverty stricken area of the world makes you realize how important your services can be to someone and how fortunate we are here in this country. In addition, the sense of accomplishment and community service at the end of the trip is hard to put into words. I hope that I can continue to participate in these types of trips and help improve the lives of those less fortunate.

The Benefits of Jaw Surgery

Denver Metro OMS can help improve your life by repairing a multitude of jaw issues.

Jaw surgery, or orthognathic surgery, is needed when the lower and upper jaw do not align properly. This can lead to a laundry list of complications, including: difficulty chewing, biting, or swallowing, sleep apnea, breathing problems, protruding jaw, open bite, or issues that braces or retainers cannot fix.

These problems have an array of root causes, whether existing since birth, developed after birth – due to hereditary or environmental influences, or even physical trauma. Any of these issues can dampen your quality of life. But Drs. Cosby, Patterson and DiPasquale are here to help!

Before any concrete decisions can be made, a consultation will need to be set up so that x-rays can be taken to decide what the next steps will be. Using the most up-to-date technology, Drs. Cosby, Patterson and DiPasquale will explain how jaw surgery can correct your skeletal problem and improve your jaw function. They will show you how your jaw alignment and your bite will be improved and how you will look after surgery. Helping patients understand the surgery they will receive and how it will improve their lives is important to the staff at Denver Metro OMS.

Contact Denver Metro OMS to schedule a consultation today!

Why Dental Implants are more than Just Vanity

The notion of dental implants is most likely one that makes you think of someone who is looking for a more beautiful, healthy smile. People who are considering dental implants have probably found that they are in need of something more than veneers, dentures, bridges, or braces.

Dental implants (which have been around since the Mayan civilization, a mere 1,350 years ago) are usually made out of titanium and are inserted into the jawbone, where natural roots should be. These implants will bond with the jawbone (this usually takes about two to four months) and become the setting for an artificial tooth, or set of teeth. During this time when the implants fuse with the bone, known as Osseointegration, the patient will be able to wear dentures.

After the normal 8-12 week healing period, the doctor will be able to place the artificial teeth onto the implants. In some instances, tooth restoration can be placed the same day as the implant surgery, known as “immediate loading.”

The doctors at Denver Metro OMS, will perform the initial grafting, tooth extraction, and implant surgery, but your regular dentist will complete the process by fitting your new teeth and setting them permanently. As for anesthesia, patients can either select local anesthesia with or without intravenous sedation.

If you are considering dental implants, try to take some proactive steps even before being approved for surgery. Smoking greatly increases your chances of rejection for surgery or failure of the implants (after many years of use). Great oral hygiene is crucial to the success rate of your implants. If you stick with a daily habit of brushing at least twice a day, flossing at least once a day, using a disinfectant mouthwash (such as Listerine), visiting your dentist regularly, and avoiding smoking and an excess of sugary foods, your implants can last a lifetime. Now who doesn’t want that?

Contact the staff of Denver Metro OMS to set up a consultation and see if implants are the right fit for you.

Cherry Creek Office

180 Adams Street Suite 100
Denver CO 80206
303.321.0333 – Phone
303.393.0617 – Fax


Why Should “Wisdom Teeth” Be Removed?

Third molars (AKA wisdom teeth) are very likely to remain impacted within the jawbone.  An impacted tooth simply means that the tooth grows inside the jaw due to lack of space.  On occasion there is enough space for the tooth to partially erupt, but eruption does not imply a state of good health.   When wisdom teeth do erupt, they often cause acute infection (pericoronitis) due to difficulty in maintaining oral hygiene and due to inadequate soft tissue support leading to periodontal deterioration.   A visible wisdom tooth and adjacent teeth have a higher incidence of periodontal (gum) disease.

  “The presence of impacted third molars adversely affects the periodontium of adjacent second molars as reflected in   disruption of the periodontal ligament, root resorption, and pocket depth associated with loss of attachment.” (1)

Periodontal disease has been shown to be progressive even in the presence of asymptomatic third molars.  The        incidence of dental decay (dental cavity) is also much higher in third molars that are retained into adulthood.

Many clinicians believe third molars may cause dental crowding and recommend their removal to prevent crowding.     Dental crowding is multi-factorial and a cause and effect relationship between third molars and dental crowding is    difficult to establish and is only one factor in the decision making process for their removal.

Due to the high incidence of problems that develop from maintaining wisdom teeth, oral surgeons recommend that  third molars be removed early before the development of problems.  Typically, younger patients (< 25 years of age)  have an easier recovery with fewer complications from surgery.  Younger patients tend to heal faster and have better  prognosis if complications occur.  Also, younger patients usually are able to allocate adequate time off for recovery.    Most adults that maintain their wisdom teeth end up at some point in their adulthood having to undergo wisdom teeth  extraction due to development of pathology such as cysts, periodontal disease, or decay.   For the best possible  outcome extraction of wisdom teeth is recommended around ages 15-18 (or younger), depending on tooth  development.  As a matter of fact, removing lower third molars with less than 1/3 root development has the lowest  incidence of morbidity.

Unfortunately surgery is not without associated possible risks.   The most common sequelae from removal of third molars include:  loss of periodontal support distal to the second molar, paresthesia  (numbness) of the lip, chin and tongue, and infection.  Loss of  periodontal support distal to the second molar depends on the age  of the patient, plaque control and on the pre-exiting bone defect  prior to surgery.  Older patients (>25) are more likely to have periodontal support loss distal to the second molar.  No single surgical technique has been shown to yield increased bone level distal to the second molar after removal of third molars.   Bone grafting may increase attachment level post-operatively in cases where pre-operative bone loss is present distal to the second molar, although additional studies are necessary.

“The position and disposition of unerupted teeth has been found to be dynamic and unpredictable. Therefore, the ultimate decision regarding the management of such teeth is best made by an expert clinician after clinical examination and review of factors such as the age of the patient, position of the tooth, anticipated difficulty of removal, type of overlying prosthesis, and risks associated with removal”. (1)

Reference:  1. AAOMS White Paper on Third Molar Data

For patient information regarding Wisdom teeth removal, visit