Robert P. Scholz: When did you first become interested in dental journalism?

David L. Turpin: During my first few years in practice, 2 classmates and I became dissatisfied with our inability to bring about some changes we wanted to see in the Pacific Coast Society of Orthodontists (PCSO). I joined them in writing a letter to the PCSO board of directors, and they answered it by giving us all jobs.

RPS: I remember that you moved up from the Northern Regional Editor of the PCSO Bulletin to the editor of the entire Bulletin in 1978. Did you have any experience to prepare you for this job?

DLT: I was pretty wet behind the ears, but, while working with the Bulletin editor, Bill Parker of Sacramento, Calif, I became enamored with the challenges of dental journalism and sought to implement everything he taught me. As editor of the PCSO Bulletin , I increased the number of dedicated associate editors representing the north, central, and southern components and then hired journalism professionals to present workshops on basic writing skills every year during the constituent meeting. At these workshops, we learned how to write news stories, how to edit poorly written material, and how to interview famous people who happened to be orthodontists on the West Coast. With the election of a new PCSO president every year, I would invite myself over to conduct an in-home or in-office interview. The articles this practice generated enlivened the pages of the Bulletin with an array of stories supported by “real-life” photos. The goals of our elected constituent presidents became common knowledge to our readers.

RPS: What other changes did you make?

DLT: I started publishing the initial records of an unusual case report in the front of the Bulletin , with a challenge for the reader to predict how it was actually treated to achieve the desired treatment objectives. We published the posttreatment records near the end of the journal, with an overall summary of the results achieved or, in some cases, not achieved. These always stimulated letters to the editor and even more attention to the next issue. We (the entire Bulletin staff) always sought to summarize every scientific presentation made by the speakers at the 8 or 9 local PCSO meetings every year. This was a tremendous undertaking and is still a mainstay of the PCSO Bulletin today under the leadership of Editor Jerry Nelson. In 1985, I changed the size of the Bulletin to conform to most other contemporary magazines to allow for greater creativity in layout and design. When my board grew nervous with the increased costs, I pushed for increased advertising sales and looked for ways to increase the number of orthodontists who would want to receive the Bulletin . Until this time, only PCSO members received the publication, which was included in their dues. How could I increase this income without raising dues (a move obviously opposed by the board members)? I boldly implemented a plan of promoting Bulletin subscriptions to members of the other constituents of the American Association of Orthodontists (AAO), one at a time, until I had raised sufficient revenues. Within a year, I had more than doubled the number of orthodontists, taking the quarterly publication to about 3000, and this solved the budget problem. This change, with a national audience, also made it easier to sell more advertisements in California.

My favorite change was the addition of a cartoon to match every editorial. The larger page layout made this possible, but where was I to find the cartoons? I discovered that most cities have vocational schools and associated clubs that specialize in designing and drawing all types of cartoons. After meeting a few and examining their art, I settled on a political cartoonist who enjoyed the challenge. After reading my editorial, he would draw his interpretation of the point I wanted to make. A discussion of the fine points might follow, and he’d finish the job for a fee of about $100. My favorite was the drawing of a complex scaffolding fastened to the mandibular incisors as several tiny periodontists prepared to place a free gingival graft.

RPS: You left the PCSO Bulletin in 1988 to become editor of the Angle Orthodontist . Did you foresee making many changes to that journal or plan to maintain the status quo?

DLT: I was eager to change it to a full-size journal from the smaller version it had been since 1930. To do this, I took several American Dental Association workshops and met a retired journalist who had taught in the School of Journalism at Northwestern University for many years. He was working as a business consultant but had agreed to help the American Dental Association with the workshop. After I befriended him in Chicago, he agreed to design a more contemporary format for the Angle Orthodontist at no cost. I jumped at the opportunity and lived with that design for another 10 years. In 1990, the International College of Dentists honored this change in format with its Golden Scroll Award, Division I, proclaiming, “The Angle Orthodontist is a significant publication in its 59th year that has been redesigned in large format, with handsome typography and fine illustrations. A narrow outside column on each page accommodates figure and table legends. The article abstract and list of key words used in the article are handled well. Paper and printing are exceptionally good.” Sheldon Peck was instrumental in assisting with the move of all publishing operations to Allen Press, a relationship that is still in place today. Over time, a small editorial board was replaced with a large number of reviewers with special areas of expertise. These people served for rotating 3-year terms depending on their interest and activity as reviewers.

RPS: You became editor of the American Journal of Orthodontics and Dentofacial Orthopedics ( AJO-DO ) in 2000, when Tom Graber retired. You had some big shoes to fill. Did you anticipate making many changes?

DLT: To honor the centennial and 100 years of orthodontics, the AJO-DO ‘s publisher from the beginning, C. V. Mosby, joined us in producing a special cover for the April 2001 issue. It consisted of a gatefold design, creating a 4-panel cover with an artistic array of museum pieces provided by the AAO. The inside of the cover included a summary of AAO history. This cover was subsequently recognized with a First Place award by Trends Association magazine. This photograph was also made into a poster that was distributed widely in 2001 and served as part of the new AJO-DO cover for the next 12 months. With smiles as our most visible outcome, the next year I decided to ask AAO members and AJO-DO subscribers to submit attractive smiles for use on the cover. This practice has continued today, although I cannot use nearly all the photos I receive. Following closely was expansion of the use of color on all pages without charging authors for the additional cost.

RPS: The AJO-DO is a very different journal today than it was when you took over. What are the most significant changes? What is the impact of the changes on our specialty?

DLT: Under the guidance of Vince Kokich, we have standardized the publication of case reports. With strictly enforced guidelines, case report submissions have increased in both quality and number. Vince works with each author to get his or her best work for the Journal . With help from Michael Rennert, we moved the Journal ‘s continuing-education program to the AAO and made it available online, allowing for immediate grading and awarding of the appropriate continuing education credits. Thanks to our publisher, Elsevier, we moved to an electronic manuscript submission and review process. This has greatly speeded up the submission and review process and made it available to many orthodontists around the world. Last year, we received nearly 1000 new submissons, compared with about 200 per year a decade ago. Our international prominence has expanded, and our manuscript acceptance rate has fallen to less than 30%. In 2006, we added the AJO-DO Product Resource Guide as a supplemental issue every April, providing a member benefit as well as additional revenues. With 13 issues published each year, we produce more pages of refereed scientific material than any other orthodontic journal. The AAO has successfully limited the increase in cost per member to only $3 (from $30 to $33 for domestic and international members) over the 10-year period. To help deal with the increase in submissions, we expanded the use of associate editors, noted for their specific areas of expertise. Associate editors appoint reviewers, evaluate reviewers’ comments, make recommendations, and evaluate revised submissions. This expansion is still ongoing. Most recently, we initiated the abridged 2-page format for research studies, aimed at reducing the current publication delay while also giving the Journal a more clinical appearance.

RPS: How and when did the wheels start turning on getting our Journal into digital format? Who was involved with the process, and how long did it take to get to today’s result?

DLT: I worked with the AAO board of trustees and Elsevier to expand online access back to Volume 1, published in 1915. AJO-DO subscribers now have free, unlimited access to all articles in all issues at www.ajodo.org ; nonsubscribers can access articles on a pay-per-view basis. This effort took nearly 8 years to accomplish at some cost to the AAO and Elsevier.

RPS: We know that the AJO-DO is a peer-reviewed publication. Are most dental journals reviewed, and why is this important?

DLT: Independent review is an important step in the publication process of many scientific journals, including some dental journals. One of the reviewer’s challenges is to identify sources of bias in research. Bias can easily creep into a study in several ways. For example, if a study is not properly blinded, the person measuring outcomes can inadvertently introduce bias. Financial conflicts of interest might also play a role. When planning a scientific study, it is of utmost importance that a biostatistician be involved at the very beginning. It is amazing to me how many authors conduct an impressive study and submit a manuscript without every having completed a power determination to calculate the number of subjects required for statistically significant conclusions. This must be determined before the study, not after gathering the data from the subjects.

Most journal editors say that they believe in relying on independent reviewers. How thorough they are in carrying that out is the concern. Retaining the services of the best reviewers requires setting limits on how many times we call on them. I try to limit requests to 1 review every other month, or no more than 5 or 6 a year. Although material incentives are not common, reviewers obviously deserve to be recognized for their work. About 400 reviewers complete at least 2 or 3 reviews for the AJO-DO in a 12-month period; we consider them the most active members of our Editorial Review Board and publish their names in the Journal . However, at least 600 additional reviewers complete 1 review in that same period, and we could not operate without all these volunteers. We update the Editorial Review Board list in January and July, so that it reflects changes in reviewers’ activity levels.

RPS: I know that the AJO-DO is ranked the top orthodontic journal by impact factor. What is the impact factor, and how important is this ranking to authors?

DLT: The impact factor measures and ranks the citation of published articles. A high impact factor means that journal articles are cited frequently in the literature. It is frequently used as a proxy for the relative importance of a journal in its field; journals having higher impact factors are deemed more important than those with lower ones. The impact factor was devised by Eugene Garfield, the founder of the Institute for Scientific Information, now part of Thomson Reuters. Impact factors are calculated yearly for journals that are indexed in Thomson Reuters’ Journal Citation Reports. The AJO-DO ‘s impact factor has increased consistently every year, from 0.706 in 1999 to 1.442 in 2008, surpassing all other orthodontic journals.

RPS: Do you ever see the day when we will be totally electronic with no paper version?

DLT: This is still an unknown. Every year, more of our subscribers prefer to search for articles online and refer to their print journals less often. Within 5 years, I am quite sure that more members will read the Journal on an electronic reader, such as the Kindle, than will pick up a printed and bound copy to leaf through while sitting in a comfortable chair by the fireplace. But will the hard copy be gone forever? I simply don’t know.

RPS: Please tell us about the staff people who help put the journal together each month.

DLT: I hired Chris Burke 25 years ago to work part-time on the PCSO Bulletin . Today, she is the managing editor of the AJO-DO . Her job has changed dramatically over the years. We used to prepare PCSO Bulletin articles for typesetting, and we worked with a local print shop to paste up the articles and get each issue printed. Now we do everything electronically. Articles are submitted online in the Elsevier Editorial System. We communicate with authors and reviewers exclusively via e-mail. We no longer need file cabinets to hold the submissions we are processing; we no longer need a copy machine and a postage meter to send articles for review or revision; we scarcely need the office that the Department of Orthodontics at the University of Washington has been kind enough to provide over the years. We handle 5 times as many articles as we did 10 years ago and 25 times more than we did on the Bulletin ! Chris handles 90% of the correspondence with our authors, reviewers, and letter writers; if you have submitted an article or a letter to the editor in the last 10 years, you have communicated with Chris. When diplomacy is needed, I turn to her. I will miss working with her—someone I have learned to trust completely in every difficult decision—more than I will miss the next monthly deadline for an editorial.

Chris works closely with Carol Haufler, our issue manager at Elsevier. Carol manages the production process. She works with a copyeditor and a production team to prepare articles for print and online publication, and then she works with authors to make their changes and obtain their approval of the proof, and finally she fits all the pieces together each month so that the issue mails on time; if you have published in the Journal in the last few years, you have worked with Carol.

Our publisher at Elsevier is Jane Ryley. She oversees the big picture for us, including tracking our advertising revenue and impact factor. A number of other people at Elsevier also contribute to the Journal , updating our website and providing technical support.

RPS: You are soon stepping down from a very busy commitment. Are you looking for new opportunities to continue serving?

DLT: With conclusion of the 7th International Orthodontic Congress in Sydney, Australia, I expect to begin a 5-year term as a member of the Executive Committee of the World Federation of Orthodontists, joining Tom Ahman and Amanda Maplethorp in representing North America. I look forward to working with Roberto Justus (Mexico City), who will succeed Athanasios Athanasiou as president of the World Federation of Orthodontists, and William DeKock (Cedar Rapids, Iowa), who will continue as secretary-general. I also have 3 grandchildren who live on the East Coast, so I expect that a few more trips in that direction will be in order. Of course, when called upon, I will always be available to help the next editor of the AJO-DO in any way possible.

RPS: Dave, this has been a most informative interview on the history of all 3 journals. I am sure that all our readers join me in saying thanks for a job well done and we wish you the very best in your continued support of our great specialty.