Introduction: My name is Dr. Douglas Johnson. I have been in dentistry for over 30 years and at Providence Dental Spa for over 5 years.
How did you get into dentistry? I actually started as an Air Force pilot after college and my career goal was to become a pilot, but it wasn’t a favorable time because of the airline embargo and no airlines were hiring. I was young and single, so I decided to travel. Afterwards, I figured that I needed to start my career. I met many doctors and dentists along the way when I was teaching sailing for Club Med in Hawaii and Mexico during my travels. After visiting 5-6 dental practices to shadow, I decided to apply to dental school. I didn’t have enough science credits, so I went to the University of Florida’s fifth year program, designed for people who needed credits to pursue a new career. I enrolled at 29 and after 3 quarters, I was able to apply to dental school. I graduated from the University of Florida’s School of Dentistry in 1982.
How did you decide to come to Providence Dental Spa? I started in general dentistry, running my own practice. As I neared retirement, I became interested in treating patients with sleep oral appliances. After liquidating my practice, I found the prospect of getting to focus on just sleep apnea treatment at Providence Dental Spa very appealing. I enjoy the work and the job does not require the physical bending that general, cosmetic, or surgical dentistry requires.
Are oral appliances a new treatment for sleep apnea? Oral appliances have been used for mild to moderate sleep apnea for about 20 years.
How do oral appliances compare to CPAP machines? Most doctors prescribe a CPAP for patients with sleep apnea right away. Although a CPAP might be slightly more effective if used properly, patients tend to have greater compliance with oral appliances. CPAP masks can trigger some patients’ claustrophobia. Also, some patients complain about dryness or feeling uncomfortable hooked into the mask. If a patient is only going to use a CPAP a few hours per night, but can keep an oral appliance in all night, the oral appliance is a wise choice. Oral appliances tend to be better for patients with claustrophobia, latex allergies, or a need for smaller/less binding options. I don’t push patients either way on CPAP vs. oral appliances. If patients are not able to keep up with their CPAP, they will be back to see me.
What are your patients like? Most of my patients have been diagnosed with sleep apnea previously and already have CPAP machines and are looking for an alternative. I have some patients who have been recently diagnosed and decided to try oral appliances first before going with a CPAP.
How is sleep apnea diagnosed? Sleep apnea is usually diagnosed using an evaluation form and a sleep study.
Is there a cost difference between CPAP and oral appliances? I don’t think there is a large cost difference between CPAP and oral appliances. Insurance coverage may vary though. We work with patients’ insurance for oral appliances.
How many patients do you see per week? I see an average of 4-5 patients per week. These patients either have symptoms of sleep apnea or already have a diagnosis.
What are the signs of sleep apnea? Sleep apnea is an underdiagnosed condition, but there are clear signs to look for. If you wake up feeling unrefreshed or experience daytime sleepiness, mental fog, or gasping for air, you may have sleep apnea. I personally have sleep apnea and have been using an oral appliance successfully for 10 years. When I started using the oral appliance, I felt like I was sleeping 12 hours when I was only sleeping 7.
What are the risk factors for sleep apnea? Being over 50, having high blood pressure, having an increased BMI
Is snoring a sign of sleep apnea? Snoring is correlated, but not diagnostic. A sleep test is the only way to know for sure that you have sleep apnea.
What happens when you have sleep apnea? Sleep apnea is defined as a cessation of breathing that lasts for 10 seconds or more that results in a drop in your blood oxygen level of at least 3%. Sleep tests can detect how long you stop breathing and the desaturation. A sleep test adds up how many times your breathing is disturbed in an hour—5 times or more equals sleep apnea.
How does your body respond to sleep apnea? When your subconscious brain senses the blood oxygen levels going down, the alarms sound. Your adrenal gland releases epinephrine. The adrenaline causes your body to take you to a lighter sleep, so you realize that you need to breathe. This process is why sleep apnea patients never feel rested. We can never stay in deep sleep; basically, we are like a porpoise coming up and down for air. The arousal mechanism has harmful effects on the body. Sleep apnea can be a major cause of many other issues, such as heart attack, stroke, gastric reflux, restless legs, type 2 diabetes, Alzheimer’s, congestive heart failure, clenching/grinding teeth, atrial fibrillation, pulmonary hypertension. Sleep apnea does not cause much harm in the short-term, but long-term sleep apnea starts wearing your body out.
How do you spend your time off work? I spend time with my family—I’ve been married for 41 years. I have 3 grown children and 4 grandchildren. Besides traveling to see my grandchildren often, playing golf is my passion outside of the office
How is Providence different from other practices? Providence is a top tier dental practice—the facility, the staff, the culture, and the technology. The culture is super professional, centered, patient, friendly, and welcoming to diverse patients. The advanced technology and procedures at Providence cannot be duplicated in many other practices.
What is the most satisfying part of working with sleep apnea patients?—Because sleep apnea is such a dangerous long-term disease and our treatment is successful, I went from saving teeth to saving lives. That’s the most satisfying thing. It is a gentle process–no shots, no pain, and a stress-free experience.