6 minute read
Lt. Cmdr. Joshua W. Johnson Shares What Dentistry Aboard a Naval Ship Is Like
General dentistry can often feel like the wild west, where every day is different in terms of what might show up in your office. But what if you took that already exciting atmosphere and intensified it even further, such as with a controlled supply of resources, no specialists within a 100-mile radius and… on a boat? These are the circumstances under which Lt. Cmdr. Joshua W. Johnson, DMD, MS, practices as the sole dentist serving 1,000–2,000 military personnel aboard a naval amphibious assault ship, which is a type of ship designed to take Marines and their aircraft into battle. While there is no shortage of challenges in this kind of practice environment, there is also no shortage of professional fulfillment.
AGD Impact: What made you decide to become a dentist? What inspired you to join the Navy?
Johnson: I graduated from high school in May 2001. As a graduation gift, I went on a trip to Washington, D.C., and New York City. I was fortunate to be able to see the iconic New York skyline, including the World Trade Center, from the top of the Empire State Building. Three months later, I watched on the news as those two towers came down. I realized that what would be called the Global War on Terror would be fought by the youth of my generation. I felt the pull to contribute to this struggle, and, at the same time, I knew that I wanted a college education, though I didn’t yet know for what purpose. After visiting with several military recruiters, I enlisted in the Marine Corps Reserve and spent the next six years completing my bachelor’s degree in between military assignments and deployments. During my time as a Marine, I had several interactions with Navy dentists, and I was always impressed with their calm professionalism in the intense Marine Corps military setting. At that point in my life, I knew that I wanted a career path that would offer professional longevity and fulfillment while allowing me to continue serving alongside our country’s warfighters. I decided that a career as a Navy dental officer would accomplish both of these desires.
What did you imagine your career as a dentist would be while you were in dental school, and how has your service in the military changed and broadened that image?
While I was in dental school, I tried not to have many set expectations for my impending career in Navy dentistry. I knew that the Navy assigned dental officers to serve with the Marines and on some ships, but that was as far as my knowledge extended. Since graduating dental school in 2017, I have learned that a career as a Navy dentist can be much more rewarding than I expected. Military dentistry offers a ready-made system for postgraduate specialty education and continuing education (CE) opportunities. Every young general dentist coming out of school has access to a vast network of mentors and specialists to whom they can turn for guidance. A career in military dentistry gives my family the opportunity to experience new places and cultures all over the world. And yes, as expected, it has also given me the opportunity to have very professionally rewarding experiences serving with Marines and on Navy ships.
What is it like to practice dentistry on a ship? What does your day-to-day schedule look like?
I practiced dentistry on board the USS Bataan during a seven-month deployment at sea in 2020, and I am currently assigned as the dental officer on board the USS Tripoli. The Tripoli is an amphibious assault ship whose primary mission is to deliver the Air Combat Element of the Marine Air-Ground Task Force in support of our nation’s national security objectives. The Tripoli also has a robust medical capability that can respond to mass casualty events as well as humanitarian disasters around the world.
As the sole dentist on board, I am responsible for the oral health of all 1,100 crew members, along with the other tasks related to operating a dental clinic, such as supply, sterilization, administration and equipment maintenance, to name a few. As part of the integrated medical team, the dental department is also responsible for casualty triage and operating the walking blood bank — so-named because crewmembers who match the needed blood type “walk” themselves to the blood draw location on the ship — during mass casualty events.
When the Marines come on board during deployments, the ship’s population more than doubles. Thankfully, I’ve been blessed with an oral hygienist and an outstanding team that really make my job enjoyable. What’s exciting about practicing dentistry on a ship is that, while I’m at sea, there are no specialty providers to whom I can refer my patients. I truly get to operate in a vacuum in which I am the go-to expert for all things dental. It has really helped me to diagnose and treatment-plan more comprehensively. Also, prepping teeth while the ship is rocking with the waves can be quite an adventure!
How do you keep your skills sharp between deployments?
As I mentioned earlier, the military has a large educational network. Several CE courses are offered throughout the year all over the country. The Army, Air Force and Navy all have one- and two-year advanced education in general dentistry (AEGD) and general practice residency (GPR) programs that all general dentists are encouraged to apply for. I was fortunate enough to complete a one-year AEGD with the Navy and, later, a two-year AEGD with the Air Force.
What disadvantages are there to practicing dentistry on a ship, and how do you overcome them?
Because ships are so vital to national security, every item of supply and piece of equipment in the clinic must be approved at a higher level. For example, many things used in dentistry are flammable or contain hazardous material. These items must be tightly controlled and regulated to minimize risk to the ship. Most of the disadvantages to ship dentistry are resource-related. I have to be innovative in each clinical scenario to give each patient the best treatment I can with the resources I have available. However, I love that I have the freedom to offer the best treatment I can personally give, as opposed to only providing treatment that the patient can afford or that their insurance will reimburse.
