In the Hot Seat of Dental Journalism

Dental Resource Asia recently sat down with Prof Lakshman `Sam` Samaranayake for a chat about his appointment to arguably the world’s most prominent editorial position on the dental field.

By Danny Chan

Born and raised in Colombo, Prof Lakshman `Sam` Samaranayake has come a long way from his birthplace in Sri Lanka – in some sense, literally.

Traversing the globe, the dental professor has contributed enormously to whichever intellectual station life has placed him – more specifically, universities in Hong Kong, Australia, UAE, UK and Canada – to become the world-renowned clinical academic he has been for some time.

In the interim, the Founding Editor-in-Chief of the Journal of Investigative and Clinical Dentistry has authored over 450 articles and been cited over 32,000 times (current h-index: 97). Not least in his extensive body of work is the seminal Essential Microbiology for Dentistry, currently in its fifth edition.

The rest, as they say, is Wikipedia history.

That said, after checking out Prof Samaranayake’s Wiki page, we unearthed several “first” accomplishments he has garnered over the years:

• Asia’s first to be awarded the King James IV Professorship of the Royal College of Surgeons of Edinburgh for exceptionally outstanding research in dental surgical sciences;
• Sri Lanka’s first to have spearheaded as Dean, the creation of a university faculty ranked number 1 in the World, according to QS World University Rankings;
• Sri Lanka’s first to be a Dean of two major University Faculties – the University of Hong Kong, and University of Queensland, Australia;
• Sri Lanka’s first dental professional to receive the Fellowship of the Royal College of Pathologists, UK;
• Asia’s first dentist to receive the Distinguished Scientist Award from the International Association for Dental Research;
• Sri Lanka’s first to receive an honorary fellowship from the Royal College of Physicians and Surgeons of Glasgow, Royal Australasian College of Dentists, the Royal College of Dental Surgeons of Edinburgh, and the Hong Kong College of Dental Surgeons;
• The first person to be awarded the Tam Wah-Ching Professor of Dental Sciences at The University of Hong Kong.

New role, new vision

Prof Samaranayake’s transcontinental work and global contributions to dental sciences and research, focused on clinical microbiology, to date have been ground breaking.

Recently, the former FDI Councillor and past chair of FDI’s Science Committee added yet another “Asia’s first” feather to his cap. He became the first Asian to assume the position as Editor-in-Chief at the International Dental Journal, the official journal of the FDI World Dental Federation, representing over a million dentists worldwide.

In the middle of penning a series of papers on COVID-19, the busy professor took time off his hectic schedule to update DRA readers on his 9-month journey (so far) and future vision for the prestigious FDI journal, since taking over its editorial helm in January.

Dental Resource Asia (DRA): How did your position as the current Editor-in-Chief of International Dental Journal (IDJ) come about?

Prof Lakshman `Sam` Samaranayake (LSS): For 10 years, I was the founding editor-in-chief of the Journal of Investigative and Clinical Dentistry, a title published by Wiley, so you could say, I had an established reputation in the clinical dental journal space.

It was also important that the IDJ position was floated at a time when I had somewhat less professional commitments as a semi-retiree (whilst still serving as Emeritus Professor and Immediate Past-Dean at the Faculty of Dentistry in the University of Hong Kong).

Plus the fact I knew the people at FDI pretty well, having managed its Science Committee about eight years ago. In fact, it was a former FDI colleague who approached me and asked whether I was interested in the role. Next thing you know, I applied for it and got the job after a rigorous interview process.

I was told about eight to nine people had applied for the position and they shortlisted three from different parts of the world. I am proud to be the first Asian to serve as the Editor-In-Chief for one of the oldest and most revered dental journals in the world.

DRA: What can you tell us about Asian representation at the International Dental Journal?

LSS: I have spent about 10 to 13 years as Dean in the University of Hong Kong and University of Queensland. During this period, I have accumulated not only broad work experience but also gained much from people-to-people connectivity within Asia Pacific’s vast dental fraternity.

When I inherited the reins of IDJ – and this is not something negative about the previous editors or anything like it – the editorial board membership tended to be more American- or European-centric.

So I thought in my new role that I could introduce more people from the Asian region into the mix. After all, if we are representing the World Dental Federation, the publication should reflect the geographical scope of interest of the mother association as broadly as possible.

DRA: Specifically, how have you sought to broaden the geographical representation at IDJ?

LSS: Actually I’ve got some numbers here, because I just did an annual report of the Journal.

Previously, the journal Editorial Board comprised only 31 editors from nine countries. Since last month, I’ve expanded that to 51, representing 21 countries. I’ve basically invited people from all over the world to contribute.

As mentioned, this comes from having good connectivity in Asia. Having met numerous dental colleagues throughout places like Indonesia, Malaysia, China and Hong Kong, I’ve made many friends, some of whom I know have much to contribute to the journal, so invited them to do so – and they responded positively and enthusiastically.

DRA: What other changes have you introduced to the journal?

LSS: Traditionally, the IDJ was thought of as more of a community- and public health-based dental journal, which is true. However, it also needs to evolve with the current pace of dentistry.

As you’re aware, the exponential growth of science and technology has permeated every facet of our profession. Therefore, I thought we needed to broaden the scope of the journal in those regards as well.

So, I have introduced a section called Science and Technology in dentistry into IDJ which as the name suggests, highlights these features of dentistry that are developing at a breath-taking pace. Hence, on the whole, the IDJ remit now is much more inclusive – not only accepting articles related to the public health sector, but virtually from any dental sphere.

IDJ readers can therefore expect a journal that is much broader in terms of its reach and scope, while at the same time, drawing closer the various branches of dentistry into a common space.

It’s also important to note that until 2021, the IDJ was a subscriber-only journal. We have now made it an open-access publication, meaning each edition is freely available to anybody in any part of the world who has access to the Internet. However, the authors have to pay an article-processing charge (APC) for their accepted publications.  

Inclusivity is a very important aspect of what we do, so this is a very positive step in that direction.

DRA: What are the some of the major trends that you see unfolding in the global dental scene?

LSS: I’ve observed some important trends taking shape over the last 10 to 15 years.

One of them is personalized or precision dentistry. Whereas in the past, dentists tended to assume a more “one size fits all” approach to treat diseases that affect the oral cavity, today’s dentists need to take a more precise and personalised view of patient care, especially when it comes to risk assessment and prevention of systemic diseases once considered outside the domain of dentistry.

Another area that has come to the fore is artificial intelligence (AI), which has a synergistic relationship with Big Data and their analysis. The continuous digitisation of dental practices and related research should yield a mountain of new patient data on their dental/medical histories, images, impressions, photographs etc. With the analyses of such digitised patient data using AI it will be feasible to readily diagnose diseases, predict outcomes and even suggest pre-emptive treatment for each individual. Salivary and microbiome analyses through new diagnostic technology may give clues to the general health of patients and even predict the possibility of systemic tumours.

Hence, the so called, oral-systemic axis is another new dimension that needs to be explored in future, and will bring dentistry and medicine much closer. There is little recognition of this connectivity within the dental community in the Asian region although in the West medics are paying greater attention to this merged relationship.

For example, in many Western countries, diabetologists and dentists work together in the diabetes clinics because there is a very close link between oral health and diabetes and periodontal disease, and so on. The same is true of inter-professional education, which again, is sorely lacking in our part of the world.

Additionally, we as a profession need to be mindful of the changes in our population demographics and keep up with them. For example, many people are living up to 100 years or even more, which was very rare 20 years ago, but now it’s becoming relatively common in Asian countries like Japan and Hong Kong due to improved living conditions in general.

As a dental community, this presents a new challenge because we now have to treat much older people who retain their teeth.

DRA: What are the some of the challenges facing Asian dentistry?

LSS: Dentistry is often not included in the national health programs in Asian countries. Even in regions where the medicine is provided free or at a very low cost, dentistry is excluded from the subsidised programs.

There is a need to emphasize to the NGOs and the governmental authorities, that we should include dentistry in their remit in terms of the financial and other health support services they provide to the public, and that’s very, very critical.

If you take Hong Kong as an example, we get free medical health, but you only receive a skeletal form of dental service, which is not comprehensive at all.

Policy makers in our region also need to pay more than just lip service when it comes to provision of dental services in rural areas – which I might add many well-meaning public health programs simply do not reach.  I’m not saying that we should socialize dentistry, but at least make it more freely available to the larger swathes of the needy populations.

Of course, one of the biggest problems we face in Asia and around the world has to do with research funding. Dental researchers and their medical counterparts are competing for research grants from the same pot of money. As you can predict, the people working on high-profile research projects involving heart diseases or COVID-19 for example tend to get more money than dental researchers.

When researchers can’t get the funds, they get disheartened and the progress of dental health is retarded. The only way out now is to get private funding or other NGO sources. I think this is one of the key reasons why advances in dental research have been so little over the last 20 to 30 years.

DRA: Are there positive developments coming out of Asia?

LSS: Most definitely! In developed regions like China, Hong Kong, Singapore, Korea, Japan and even Thailand, you will find dental research is rapidly evolving. This is especially true in Mainland China where the growth is exponential.

I just spoke about the unfortunate situation when it comes to global dental research funding – we call it the “step-motherly treatment”. I’m happy to say that China is an exception.

China is doing a lot of good work in dentistry and dental research, which are both backed by good funding. They also have the support of key research laboratories in places like Wuhan and Sichuan.

Having said this, there’s also a lot of international collaborative research happening just now. Although there is room for improvement, at least collaboration is ongoing.

The dental journals are becoming the de facto platforms on which people can collaborate. I think as journal editors, we should try to ensure that this cross-pollination of ideas continues unabated.

And then we have other platforms such as the International Association for Dental Research (IADR) where like-minded dentists get together once a year to disseminate new research data and network with colleagues. The same can be said of regional meetings such as the Southeast Asian Association of IADR. I need to add here also the FDI International Dental Federation and our journal International Dental Journal, which support research dissemination by and large.  

The only issue here is that the activities in the media are essentially in the English medium so there may be hesitancy by workers in some Asian countries where English language is not the mother tongue to be a part of this important research community.   

Perhaps this is an area where a multi-language dental platform like Dental Resource Asia will have a bigger role to play in bringing people closer together, particularly in the Asian region.