UMDNJ Magazine - fall 2004 VOLUME 1 NUMBER 1

Being invited to serve as editor of a professional journal is a coveted honor. These faculty members at New Jersey Dental School "moonlight" as journal editors in what little spare time they have.

From left to right: Grant Gallagher, PhD; Mel L. Kantor, DDS, MPH; Cheryl Biber, MS, DMD, MPH; Emanuel Goldman, PhD; Joseph Holtzman, PhD; Michael Krakow, DMD, MS, MFS; Gary Hartwell, DDS, MS; Michael Glick, DMD; Milton Houpt, DDS, PhD.

This group formed the basis of the journal's editorial board. The first issue of Genes and Immunity was published in September 1999, with Gallagher and another researcher, Michael F. Seldin of the University of California at Davis, at the top of the masthead.

"The publishers felt that to create a high-quality journal, it needed to be international," says Gallagher. "So the editors were from two different continents, and the editorial board was also from across the world." Gallagher subsequently came to the U.S. in September 2001, but he says the journal still maintains its international flavor, receiving more than half its manuscript submissions from research groups outside the U.S.

Lots of work, no pay

Being invited to serve as editor of a journal is a coveted honor. For a school the size of NJDS, having nine faculty members who are editors is something of a coup. "It says quite a bit about the quality of our faculty that so many here are journal editors," states Gary Hartwell, DDS, MS, professor and chair of endodontics. He is an associate editor of the Journal of Endodontics, euphemistically nicknamed JOE.

The "literary lions" at NJDS are involved in a variety of publications, from basic science journals to newsletters for professional associations. In terms of subject matter the journals run the gamut, ranging from basic science to clinical practice. Highly technical journals may have a circulation of a few hundred, while publications of professional associations have many more.

Big professional associations generally publish and distribute their own journals. Other journals are produced by independent publishers. For the most part, "editor" and "associate editor" are honorific titles given to those who contribute their time, expertise and energy to a publication. Thanks to high technology, computers and e-mail, editors from different parts of the country (even the world) are able to work together as a team. The editorial boards generally meet once a year (often in conjunction with an association annual meeting) to do strategic planning and discuss the direction of the journal.

Hartwell explains that at JOE, and other journals as well, the main role of the associate editors is to review manuscripts that have been submitted for publication. When a manuscript comes in, the editor assigns it to an associate editor. He or she in turn sends it to two reviewers, choosing from a list of 50 or so. The reviewers receive a"blind" copy, meaning that the author's name and affiliation are deleted. They have three weeks to review the manuscript. When they complete the review, they are graded on how thorough they were. "If the reviewer is chronically late, or does a cursory job of reviewing, they're off the list," says Hartwell.

After the review process, the associate editor reads the manuscript and makes a recommendation: accept, revise or reject. "Usually we're in agreement with the reviewers," says Hartwell. "But sometimes opinions differ. That always makes things interesting."

Hartwell says there are two qualities the editors look for: good science and good writing. "If the science is there, but the piece is poorly written, or in the case of a foreign paper, poorly translated, we usually reject it. We just don't have the time or the resources to rewrite it."

As associate editor for international affairs for the Journal of Oral Implantology (or JOI), Cheryl Biber, MS, DMD, MPH, assistant director of educational technologies at NJDS, also sees submissions from overseas. JOI, the official publication of the American Academy of Implant Dentistry, is published six times a year.

"The international community of implant dentists contributes scientific, peer reviewed articles as well as case reports, and write-ups of meetings and social events," she says. "Generally, most of the contributors submit manuscripts in English, but many of them need more precise editing and there lies a large part of my responsibility. Some of the translations do not capture the scientific nuances that are important to the readership."

Biber, also an NJDS alum (class of 78), completed a week-long workshop in science writing at the Columbia University School of Journalism to improve her editorial skills. She also oversees the NJDS Web site and writes for it as well, and she is developing an instructional DVD for community dentists on providing care for special needs patients. "While I'm no longer in clinical practice, my passion lies in teaching dentistry and getting information out in more creative and innovative ways," she says.

Unique Perspectives

The faculty members agreed that being a journal editor is not only personally gratifying, it's also a way to promote or advance your specialty. Mel Kantor, DDS, MPH, professor and vice chair of diagnostic sciences at NJDS, is an associate editor of Radiology, the journal of the Radiological Society of North America (RSNA), the largest radiology association in the U.S. Radiology is not a dental journal, but serves the radiological community at large. Kantor, an oral and maxillofacial radiologist, has the distinction of being the only dentist on its masthead.

Oral and maxillofacial radiology is one of nine specialties recognized by the American Dental Association. "It's radiology below the brain and above the neck," Kantor explains. "We have strong links to our medical counterparts, and use the same tools - from plain film to CT and MRI - to evaluate patients and make diagnoses." Kantor welcomes the opportunity to represent oral and maxillofacial radiology in the larger radiological community. "While it's nice to be the only dentist on the masthead, what's more important is to have a dentist there at all," he says. "It is somewhat of a breakthrough for our specialty, that its importance and relevance is recognized by a field of medicine."

He has been a member of RSNA since the mid-1980s, and his involvement with the journal goes back to 1990. "First you're tapped as a reviewer for your content expertise," he says. "Once you've proven yourself by doing the work and meeting the deadlines, the editor might select you for an associate editor position."

While he appreciates good writing, Kantor says that as a student, he did not particularly like English. "I wasn't crazy about biology either, but things change," he adds with a laugh. "My father was a printer, and there were always a lot of journals and books around. I guess it rubbed off on me."

Joseph Holtzman is another faculty member who is quite different from others on the masthead. He's associate editor of the journal Special Care in Dentistry, but he's a medical sociologist, not a dentist. The journal covers dental care for the elderly and those who are handicapped or disabled. These individuals pose unique challenges to dentists: They are often more difficult to treat, and as a group, their oral hygiene is generally poorer than those who are not disabled. They may have problems accessing and paying for care and finding dentists capable and willing to treat them.

How is a behavioral scientist able to contribute to a dental journal? "People come to the dentist will all kinds of fears and anxieties," Holtzman says. "There are many social, economic and psychological issues in dentistry, and even more among special needs patients. My primary role at the journal is to evaluate the articles dealing with socio-behavioral issues."

He cites as an example a recent submission to the journal. A researcher wrote a paper about oral defense syndrome, claiming it was a group of behavioral symptoms that taken together explain why certain children will not open their mouths for a dentist. He recalls, "It sounded very scientific, and the reviewer sent the editor conflicting recommendations concerning whether or not the article should be published. They brought it to me and asked me to resolve the issue.

After reading the article and evaluating the available data, I concluded that there was insufficient information at this time to support the existence of the syndrome. So the submission was ultimately rejected."

Beyond dentistry

Making this and future generations of dentists more medicine-oriented is a personal mission of Michael Glick, DMD, professor and chair of the department of diagnostic sciences at NJMS. It's also one of the reasons he has become involved with the Journal of the American Dental Association (JADA). Glick was named to the JADA editorial board eight years ago, and he's currently one of five associate editors. He is section editor of dentistry and medicine. "JADA is an interesting mix of research, entertainment, clinical information and education," he says. "Some readers want more science, while others want more informational items. It's not easy pleasing everyone, but I think we're a good amalgamate - kind of a cross between a scientific journal and a source of non-scientific information geared specifically to our constituency."

And a fat one too: There is a fair amount of advertising in JADA. Most journals accept advertising and are happy to have it. Ad sales are generally left to the journal publisher with little or no input from the editors.

Glick's specialty is oral medicine - providing dental care for medically complex patients: those with diabetes, hypertension, heart disease, infectious diseases (including hepatitis and HIV) and other conditions. "The patient population is getting older," he points out."They come in with chronic diseases, but still retain their teeth. As dentists, we have to modify the way we treat these patients. Protocols need to be developed."

He believes dentists should take things one step further, and play an active role in screening for medical problems. Some 65 percent of all adults in the U.S. went to see a dentist within the past year - while far fewer people visited a physician's office. "Dentists have the potential to screen for a number of diseases, including hypertension and diabetes," he says. "The tests are simple to perform and don't take much time. For example, only 34 percent of people with hypertension have it under control. By screening for it, dentists are in a position to help the other 66 percent, many of whom don't even know they have it."

JADA has some 150,000 readers, making it the largest dental journal in the world.

Glick took on the associate editorship of JADA in part to promote his different vision of dentistry to this large group. He believes the journal provides an excellent forum for promoting a more medicine-oriented approach to dentistry.

"JADA's readership is very diverse, including clinicians, researchers, students, and others," he explains. "Such a wide audience makes it a great place to spread the word: we're not just treating teeth."

The other end of the spectrum

In contrast to JADA is the newsletter of the American Academy of Oral Medicine: AAOM News. Much more modest and "homegrown," it is published twice a year and distributed to academy members, who number roughly 1,000. Michael Krakow, clinical associate professor of diagnostic sciences, is editor of the publication. He says he's always enjoyed writing and grammar, and describes his editorship as a labor of love.

Krakow JOIned the NJDS faculty in January 2003, following a long and distinguished career in the Army. After 25 years of service in the U.S. and all over the world, most recently as chief of the oral medicine service at Walter Reade Army Medical Center in Washington, DC, he retired as a colonel. Following a four year stint teaching at Howard University College of Dentistry, he came to NJDS, where he is clinical associate professor in the Department of Diagnostic Sciences.

He became editor of AAOM News after many years of membership in AAOM. "Back then, the newsletter was not all it should have been," he says.

"There were errors, and it looked amateurish - not at all like a publication of a professional association." He took it over in October 2002 and set about trying to improve it.

Krakow is a hands-on editor, to say the least. He does much of the writing and editing himself, with other members submitting articles for publication. He e-mails the final files to the printer, a local shop in Closter, NJ. He estimates that he spends between 60 and 100 hours on each issue. He recently named Paul Vankevich, a colleague at Tufts University, as the newsletter's official photographer and associate editor.

A primary goal of the newsletter is to obtain specialty recognition for oral medicine. (There are currently nine specialties formally recognized by the American Dental Association). "We feel very strongly that oral medicine should be recognized as a specialty, and we're working hard to get this designation," says Krakow. "The newsletter is a way to demonstrate our growth and let our members know of our progress."

'How'm I doing?'

In dentistry, it isn't difficult to evaluate the quality of someone's work. A tooth is filled, a complicated procedure completed, and the patient goes about his or her business. In publishing, however, it's a bit more complicated.

Manuscript submission is one benchmark. The acceptance/rejection ratio is an important indicator of a journal's importance in a given field. "When a journal is really outstanding, researchers want to be published in it," says Holtzman. He says that Special Care in Dentistry receives 300 to 400 submissions a year, and publishes some 20 to 30 percent of them.

Genes and Immunity publishes approximately one-third of all manuscripts received, says Gallagher. "You have to be selective, and use some common sense too," he says. "We need to publish studies with a large enough study population to permit legitimate statistical analysis."

A more definitive evaluation is the impact factor: measurement of how frequently papers in the journal are quoted by other scientists. It is a ratio of the number of papers published in a specific journal to the number of papers cited.

A Web search for journal citation reports brings up Journal Citation Reports on the Web (JCR® on the Web), which "presents statistical data that provides a systematic, objective way to evaluate the world's leading journals and their impact and influence in the global research community." The science database covers some 7,500 leading international scientific journals from all over the world.

Grant Gallagher explains the simple formula: "If you publish 10 papers and have 100 citations, your impact factor is 10. The journals are ranked every year. The impact factor and rankings change from year to year. You can compare yourself to other journals in your field."

In 2003, Genes and Immunity received an impact factor of 3.8, which Gallagher describes as "high." He says, "We have consistently received the highest impact factor of all the immunogenetics journals (there are half a dozen or so), and are currently ranked 25th among all immunology journals, and 17th among immunology basic research journals overall." Not bad grades at all for a journal, particularly such a specialized one that counts its subscribers in the hundreds.

Report cards aside, all the editors agree that the hours they put in are well worth the rewards they gain. "You work hard on something like this, and try to improve it," says Krakow. "It's not exactly what you were trained for. But it's very gratifying when you see it's getting better and better."