They are precious to us, and we do our best to give them a good start in life. We lavish time and attention on them. We give them the benefit of our hard-earned experience. We call in experts to make them stronger and better. And when the time eventually comes for them to go out into the world on their own, we have mixed feelings. Will they make us proud? Embarrass us? Or worse? We can’t control their destiny, but we will always be associated with it.

I refer, of course, to the papers we publish. No matter how well prepared, they take on a life of their own as soon as they appear in print. For the most part they are read and assimilated by some (usually small) fraction of our professional colleagues, and enter the general store of knowledge without much fuss. But every now and again, you will find something you wrote being used in unpredictable, unintended and sometimes unsavory ways.

Last month I railed against "junk science," work that is fundamentally defective and therefore less than worthless. But good quality science also is vulnerable to misuse and misinterpretation—sometimes innocent, sometimes intentional. Let’s take a look at the ways in which dental and medical science can become distorted by the time it reaches the general public.

OVERSIMPLIFICATION
If you have ever given an interview—whether a network news program, a local radio station or the high school paper—you know how it feels to have your detailed explanations reduced to a brief and rather misleading summary. Such oversimplification is the most common, inevitable and essentially benign form of distortion that authors must learn to deal with. Don’t blame the science writers or their editors, and don’t be in a hurry to fire off an indignant letter unless the error is a really intolerable one. It’s just a cruel fact that nobody is as interested in your topic as you are, and the general reader will not take the time to look much beyond the headline to the detailed reasoning and caveats you know to be important.

Your best defense as an author against oversimplification is clear writing and a clear statement of results, which you are prepared to restate, just as clearly, when interviewed. As a reader, you should always assume that scientific breakthroughs reported in the press have been oversimplified and reserve judgment until you have checked the source.

OVERGENERALIZATION
Scientific findings commonly are overgeneralized to apply to situations for which they haven’t been tested. While authors themselves fall victim to this behavior, it’s an epidemic among journalists. Our natural enthusiasm leads us to extrapolate promising results to major breakthroughs; moreover, headlines with the words "possibly" or "preliminary" don’t get the story read.

The classic case of overgeneralization is when association is confused with causation. The two are most emphatically NOT the same thing. I would not be surprised to find a correlation between baldness and bifocals, but does one cause the other? Almost certainly not. There are three types of links that can be established between a disease and other factors: association, causation and mechanism. Each level is substantially more difficult to prove, and substantially more valuable, than the previous; the difference may be measured in decades and millions of dollars. Much credibility is lost if we imply a higher level of connection than the evidence justifies.

The issue is becoming increasingly important in dentistry, as clinical research reveals links between oral and systemic disease. While such connections are potentially very important, we must resist the temptation to claim a cause-and-effect relationship without strong evidence to that effect. Be prepared for news stories that blur this all-important distinction.

TRIVIALIZATION
Research also can be distorted by trivialization. Unlike oversimplification and overgeneralization, which usually are unintentional, this is always a deliberate attack technique. It involves a contemptuous dismissal of an idea as being "obviously" (that is, without the need to provide reasons) unworthy of attention.

Sen. William Proxmire’s Golden Fleece Awards were a famous case in point. To dramatize government waste, the senator’s staff periodically singled out for ridicule a research project with a foolish-sounding name. The quality or importance or cost-effectiveness of the research didn’t count; all that mattered was a title that supported the general theme of wasteful spending.

Now make no mistake, some fraction of published papers are, arguably, trivial. But virtually all science is incremental, proceeding in small steps, and it is impossible to predict whether a particular piece of work ultimately will prove crucial or a dead end. In general, I treat any trivializing campaign with suspicion, and look closely for ulterior motives. Why are the critics unwilling to provide reasons for their criticism?

MISREPRESENTATION
Rounding out the list of distortions is misrepresentation, ranging from bald-faced lies about the content or authorship of a publication to more subtle forms of implied endorsement. The former is usually an issue only for "lightning-rod" works of long-dead authors (Darwin, Shakespeare) who can’t respond.

Publications like JADA, though, have to be vigilant about misuse of our name. Every so often, the ADA must explain to an inexperienced or overenthusiastic advertiser that while it is OK to say that a result was "published in" JADA, it is certainly not acceptable to imply that a product was "endorsed by" or "approved by" JADA. We publish papers that we and our reviewers think worthy of your attention, but we plainly aren’t in a position to audit the methods and data at the source, or to check for conflicts of interest.

Misleading the profession, and by extension the public, is a serious matter that can have very unpleasant consequences for those who try it. We can’t always prevent JADA articles from being misused in this way, but we do our best to undo the damage when it’s brought to our attention.

There’s a hoary but instructive party game in which some simple sentence is whispered in turn from person to person. When the whisper comes full circle, it is altered out of all recognition, usually in absurd ways. The same thing happens to scientific work, and, in a free society, we can do little to control the distortions that appear along the way. On the other hand, we don’t have to rely on what we’re told; the original author’s own words are there in print, available for the reading.

When in doubt, check the source.